(Part 2)
Last month, we looked at one common fear among women who have had breast cancer – developing lymphedema. I told the story of a woman who came into the outpatient department where I worked at the time with a new onset of arm swelling after lifting heavy pots and pans while cooking for family during the holidays. This was an activity she didn’t regularly do. And that was the problem.
Another True Story
I opened a temporary Facebook group this past year to answer questions people had about lymphedema. The very first virtual meetup, a woman said she had been told not to fly. So, she hadn’t been to see her family a few states away in years! How sad! I couldn’t believe the misinformation and the radical impact on this woman’s life.
Flying
First of all, if you’ve had breast cancer, should you avoid flying to prevent or control lymphedema? No. My goodness, no!1 You might consider getting baseline measurements with a certified lymphedema therapist and a compression sleeve (and glove, if warranted) as a preventative for the potential risk flying can impose.
But there’s no reason to avoid flying. What else can be done in everyday life to reduce your risk of lymphedema – according to research?
How to Safely Use Your Arm
Several years ago, I attended a continuing education course on breast cancer-related lymphedema presented by Jodi Winicour of Klose Training.2 She mentioned a recent study reviewing strength training. I believe that was the PAL study from 2009.3 In that study, the safety of progressive strength training in breast cancer survivors was investigated. The study found slow, progressive weightlifting did not result in an increased incidence of lymphedema. But there are more recent studies that reinforce this principle.
Research
In 2016, the Integrative Cancer Therapies journal looked at the acute inflammation response in women with breast cancer-related lymphedema undertaking upper-body resistance exercise. Groups were divided into those participating in low, moderate and high-resistance loads. The findings were that lymphedema status and severity were not affected by the load lifted.4
In 2018, the International Journal of Nursing Sciences published an article summarizing the current literature on the effects of strength-training in breast cancer-related lymphedema.5 The article found that “supervised resistance exercise may be safe, feasible, and beneficial in patients with breast cancer-related lymphedema or [those] at risk for breast cancer-related lymphedema.”
And in 2019, the Danish Cancer Society Research Center noted in their study that “patients [previously] were encouraged to avoid strenuous activity of the affected arm because it was believed to stress the already compromised lymphatic transport system.” However, evidence suggests “that progressive resistance training is safe in terms of lymphedema onset and exacerbation.”
Final question
We’ve determined it is okay to use an arm affected by breast cancer as it relates to lymphedema (whether lymphedema is present or not). That leaves us with one question: How do you safely, progressively strengthen an arm to avoid causing or exacerbating lymphedema? You’ll have to wait for the next post … while I safely and progressively strengthen my fingers to type out the potential protocols.
References
1 https://lymphnet.org/position-papers (Air Travel)
2 https://klosetraining.com/about-us/faculty/
3 Schmitz KH, Troxel AB, Cheville A, et al. Physical Activity and Lymphedema (the PAL trial): assessing the safety of progressive strength training in breast cancer survivors. Contemp Clin Trials. 2009;30(3):233-245. doi:10.1016/j.cct.2009.01.001
4 Cormie P, Singh B, Hayes S, et al. Acute Inflammatory Response to Low-, Moderate-, and High-Load Resistance Exercise in Women With Breast Cancer-Related Lymphedema. Integr Cancer Ther. 2016;15(3):308-317. doi:10.1177/1534735415617283
5 Wanchai A, Armer JM. Effects of weight-lifting or resistance exercise on breast cancer-related lymphedema: A systematic review. Int J Nurs Sci. 2018;6(1):92-98. Published 2018 Dec 24. doi:10.1016/j.ijnss.2018.12.006
6 Ammitzbøll G, Johansen C, Lanng C, et al. Progressive resistance training to prevent arm lymphedema in the first year after breast cancer surgery: Results of a randomized controlled trial. Cancer. 2019;125(10):1683-1692. doi:10.1002/cncr.31962
