Update on Lymphedema: Exercise After Breast Cancer Treatment Is OK

December 20, 2011

Lymphedema, swelling caused by a blockage in the lymphatic system, can occur as a result of surgical or radiation therapy associated with breast cancer treatment. Since some research has shown that exercise after breast cancer treatment has been associated with developing lymphedema, clinicians often advise patients to avoid exercising. But is this truly necessary?

Lymphedema, swelling caused by a blockage in the lymphatic system, can occur as a result of surgical or radiation therapy associated with breast cancer treatment. Since some research has shown that exercise after breast cancer treatment has been associated with developing lymphedema, clinicians often advise patients to avoid exercising. But is this truly necessary?

To better understand the actual risk, Dr Marilyn L. Kwan, research scientist at the Kaiser Permanente Northern California Division of Research, and colleagues conducted a systematic literature review of contemporary studies. After applying exclusion criteria, Kwan et al. identified 19 articles for review and synthesis. The researchers rated the evidence in the studies utilizing the Oncology Nursing Society Putting Evidence into Practice Weight-of-Evidence Classification.

Of the included studies, seven examined the effects of resistance exercises, seven examined regimens including aerobic and resistance exercises, and the remaining five studies looked at other exercise modalities. Kwan et al. found that slowly progressive exercise of varying modalities was not associated either developing or exacerbating lymphedema associated with breast cancer. Further, the studies indicated that, with careful supervision, patients should be allowed to participate in such exercise regimens. However, data from the studies examining combined aerobic and resistance exercise did not yield as conclusive results or recommendations. While the studies showed that these exercise regimens appeared to be safe, confirmation of their safety requires larger and more rigorous studies.

“Strong evidence is now available on the safety of resistance exercise without an increase in risk of lymphedema for breast cancer patients,” Kwan and colleagues concluded. “With reasonable precautions, it is safe for breast cancer survivors to exercise throughout the trajectory of their cancer experience, including during treatment.”

“Exercise can be beneficial and not harmful for breast cancer survivors,” Dr Jane Armer, one of the study’s co-authors and director of nursing research at the Ellis Fischel Cancer Center at Sinclair School of Nursing, explained in a statement to the press. “Each individual should balance the pros and cons of the activity she chooses, but keep in mind that being sedentary has risks and being active is beneficial in many ways, including possibly reducing the risk of cancer recurrence.”

References:

References:
Kwan ML, Cohn JC, Armer JM, et al. Exercise in patients with lymphedema: a systematic review of the contemporary literature. J Cancer Surviv. 2011;5(4):320-3.
Craven S. MU researchers recommend exercise for breast cancer survivors, lymphedema patients. University of Missouri Press Release. Nov. 30, 2011.