One of the side effects of breast cancer treatment when lymph nodes are removed or scarred is lymphedema. It causes painful swelling in the arm near the affected breast. A new study is aimed at helping patients cope with the problem.
Breast cancer survivor Valjean Waddy hopes strength training will stop the swelling in her arm.
She says, "When I’ve tried to buy clothes, one arm fits tighter. Some, some shirts that I have I can’t wear.”
The 43-year-old has lymphedema. Fluid builds up in her left arm as a result of her cancer treatment.
For years, women with the condition have been told to take it easy.
Dr. Kathryn Schmitz, Ph.D., says, "These women who have had breast cancer treatment are told not to lift anything heavier than five to 15 pounds ever again in their lives.”
But Dr. Schmitz doesn't but that and she says, "If someone has had a damaged heart, do you tell them to sit down and not to do any exercise again? No.”
So, women like Valjean are working out as part of a unique study at the University of Pennsylvania.
Dr. Schmitz says, "What we’re proposing is that twice-a-week strength training is actually safe for these women, healthful for them, health promoting.”
Participants start out with the lightest weights and add on gradually. A pilot study shows the exercise is safe and participants reported an improvement in their symptoms.
“They got a lot stronger," Dr. Schmitz says. "Their body fat percentage went down, their fitness improved and we found that their quality of life improved as well.”
Lymphedema can be very painful and disfiguring. It can also interfere with wound healing and increase the risk of infection.
Dr. Schmitz says, "It’s a chronic condition. It’s not something that will ever go away once you are diagnosed. And the issue is keeping it at bay.”
Valjean Waddy says, "You have to take care of yourself. You’re not the same person anymore, so you have to do what needs to be done to your new body.”
Depending on her findings, Dr. Schmitz hopes to organize an exercise program for lymphedema patients in the future. For more information on lymphedema log on to the National Lymphedema Network Web site. Women interested in taking part in the study in Philadelphia can call 215-898-5112.
Fast Facts:
Breast cancer is the most commonly diagnosed cancer in American women. Last year, about 211,240 cases were expected to be diagnosed in the U.S.
Breast cancer patients who have had lymph node surgery are at risk for development of lymphedema, a condition that causes accumulation of lymph fluid in the affected arm.
Women with breast cancer are usually advised not to overuse the arm on the affected side of the body to reduce the risk of lymphedema.
A researcher at the University of Pennsylvania is conducting a trial to find out if gradual building of exercise and strength training can be done to improve strength, without risk for development of lymphedema.
Breast Cancer Statistics
Breast cancer is the most commonly diagnosed cancer in American women. In 2005, the American Cancer Society estimated 211,240 cases of female breast cancer would be diagnosed in the U.S. It is the second leading cause of cancer death in women – killing more than 40,000 of them last year.
Lymphedema After Breast Cancer
Lymphedema is an abnormal accumulation of lymph fluid in the soft tissues. The lymphatic system is a network of vessels similar to the circulatory system. Instead of blood, however, the lymphatic system carries lymph, a clear, colorless fluid containing white blood cells that fight infection.
Normally, lymph fluid flows from the capillaries, through the lymphatic vessels and into the lymph nodes. The lymph nodes filter bacteria, waste products and toxic substances from the lymph fluid. The fluid then gets absorbed back into the veins to be refreshed by the body.
In patients who have had breast cancer surgery, some of the lymph nodes and channels may be removed or damaged. The remaining lymph nodes and vessels may not be able to adequately handle the volume of lymph fluid passing through the area. The excess fluid builds up, causing swelling in the tissues, or lymphedema. The swelling can occur in the whole arm or just a portion of the arm.
Risk for LYMPHEDEMA is increased when there is extra blood flow through the affected arm (like when the body is fighting a localized infection or trying to heal an injury). Being very overweight or a heavy smoker, having diabetes and exposure to heat or hot weather may also increase the risk of lymphedema.
As lymph fluid accumulates, patients may notice a fullness or heaviness in the affected limb. The skin becomes taut from the extra fluid and rings, watches and wrist jewelry may feel tight. As fluid continues to back up, a patient may have difficulty getting the affected arm to fit through shirt or jacket sleeves. The hand and wrist may lose some flexibility. The arm may ache or feel “tired.”
Lymphedema and Exercise
Typically, doctors encourage women who have had breast cancer to use the affected arm for routine activities (like brushing hair or teeth). However, experts generally caution against overuse of the limb (especially vigorous, heavy exercises) to prevent development of lymphedema. Kathryn Schmitz, Ph.D., MPH, Exercise Physiologist with the University of Pennsylvania, says breast cancer survivors who are at risk for LYMPHEDEMA are often advised not to lift anything heavier than 15 pounds with the affected arm. That restriction can greatly limit the ability to perform many chores (like carrying a bag of groceries or lifting a grandchild).
Schmitz says the exercise precautions may be too conservative. Instead, slow, gradual increases in exercise capacity may allow women to eventually use an arm more fully without the risk of developing lymphedema. She equates her arm muscle training with cardiac rehabilitation therapy for heart attack patients.
Schmitz is now testing the safety and benefits of her theory in a study called, “Physical Activity and LYMPHEDEMA Trial” (PAL). First, women will work to improve their range of motion. Then, they begin an exercise program on weight machines, starting with the smallest weight possible. Gradually, more weight is added in small increments. The women are monitored regularly to make sure they don’t develop any signs of lymphedema. Eventually, the women will have a full-body strength training program that includes bench pressing, shoulder and arm exercises, back strengthening exercises and lower body exercises.
An earlier study found the exercise program to be safe. In that trial, women who had signs of LYMPHEDEMA prior to the start of the trial reported an improvement in their symptoms. Participants also became stronger and improved their fitness and quality of life.
The current study is taking place in the Philadelphia, PA area. People outside the area should seek advice from a certified LYMPHEDEMA specialist and a qualified personal trainer before starting any kind of strength training or exercise program.
Web Resources
For information on lymphedema:
Visit the National Lymphedema Network Web site.
For information on breast cancer:
American Cancer Society Web site.
Breastcancer.org.
National Cancer Institute Web site.
Save
Email
Print
Terms of Use -
Privacy Policy -
EEO Statement
-
FCC Form 388