By Liz Neporent
Breast cancer survivors get ready for a game changer. Instead of sitting on the sidelines and avoiding physical activity for fear of aggravating the arm swelling experienced by up to 70 percent of surgery patients, experts are now recommending you pump iron.
For decades, breast cancer patients undergoing treatment have been warned away from lifting anything heavier than a small bag of groceries. The thought was overexertion might cause lymphedema, a painful, arm-swelling condition that’s a common side effect of surgery. Recent work by University of Pennsylvania scientists challenges this notion with findings that a carefully structured weight training program doesn’t make lymphedema worse. In fact, it can reduce the chances of arm swelling or even prevent it altogether.
The research involved 154 women who were diagnosed with breast cancer within the last few years and who had had at least two lymph nodes removed but hadn’t yet developed lymphedema. Half were told not to change their exercise habits. The rest attended twice weekly weight training sessions supervised by certified personal trainers. Routines got progressively more challenging over 13 weeks and then the women continued lifting on their own for up to nine months afterwards.
By the end of the one-year study, the weight lifters slashed their risk of developing lymphedema by 35 percent. Only 11 percent of the lifters developed lymphedema, compared to 17 percent in the do-nothing group. Among women who had the most aggressive surgery (five or more lymph nodes removed), weight training had a truly miraculous effect – they saw a nearly 70 percent risk reduction, with just 7 percent reporting problems with swelling.
“For decades women have been told they shouldn’t place any stress on the affected arm,” says the study’s lead author Kathryn Schmitz, PhD, MPH, an associate professor of Epidemiology and Biostatistics and a member of Penn’s Abramson Cancer Center. “Our work is showing that weight training can slowly and progressively increase the capacity to withstand the stresses of real life like lifting their purse, moving heavy boxes or carrying a child.”
Schmitz hopes her team’s research will do more than convince patients to pick up weights. She also wants doctors to start recommending supervised strength training to their patients. “It should be a wake-up call for women to be given a prescription for rehabilitation as a standard of care. If their doctor doesn’t automatically make a referral, women need to become squeaky wheels and demand it,” she said.
This advice is especially important for African American women who, studies show, are typically diagnosed with later stage cancer, have more nodes removed in surgery and more apt to return to manual labor jobs after medical care. Without proper rehab, they’re the most likely to develop swelling, and in turn, the most likely to feel a financial pinch because of it.
The take home message to breast cancer survivors? Lift weights! However, that doesn’t mean rushing into the gym right after surgery. Schmitz says she isn’t releasing her programs directly to the public because she fears doing the exercises wrong will do more harm than good. Instead, she recommends hiring a certified trainer or physical therapist that has experience working with breast cancer survivors; insurance should cover all or part of the cost. Any program should start off with very light weights and progress slowly. For further protection, get custom-fitted with a compression garment to wear on the affected limb during workouts.
Click here for the University of Pennsylvania’s resource guide on breast cancer and exercise.
Click here to see a video interview with Dr. Schmitz about this research.