Breast cancer–related lymphedema (BCRL) is a chronic and progressive issue characterized by the accumulation of fluid in the interstitial tissues in the arm, shoulder, neck, or torso. This accumulation is attributed to the disruption of the lymphatic pathways from surgical resection and, or radiation of lymphatic vessels or nodes during breast cancer treatment.
In other cancers, lymphedema can occur elsewhere in the body. This post pays particular attention to breast cancer-related lymphedema and the relative recent research. You may transfer the information to your particular site of lymphedema.
The associated swelling may range from mild to disabling and is associated with feelings of discomfort, heaviness, and weakness in the arm (or limb), pain, and an increased risk for infection.
Survivors may experience this up to 20 years after.
Avoidance of Physical Activity (PA) is an issue if the use of the affected limb is restricted. That is, we know PA is crucial for mental, physical, and emotional wellness, and if you’re told not to use the arm, you may have a tendency to limit physical activity that will boost health and overall wellness.
Yes, exercise caution but do exercise. Resistance training, can be especially effective in helping increase strength and wellbeing as well as offset bone density losses that are associated with treatment.
Although there is no cure for BCRL, decongestive therapy is considered the gold standard for the management of BCRL and is performed by trained lymphedema therapists. Decongestive therapy often involves manual lymphatic drainage followed by compression bandaging to control arm (or affect limb) volume.
Can women who are at risk for, or currently have, BCRL increase muscular strength without increasing BCRL incidence or symptoms? That’s the question that a recent study sought to answer.
The results of the study were positive. Moderate-to-high intensity strength training showed greater gains in strength without negatively affecting lymphedema symptoms. Your question should then be, what is consider moderate-to-high intensity strength training? Repetitions done in the 10-15 repetition to fatigue range fit this category.
This is good news for women flipping 50 who also seek to increase or maintain both lean muscle tissue and bone density. The protocol fits that for weight loss and bone density (as I share in You Still Got It, Girl!)
Despite widespread misconceptions that breast cancer survivors should avoid upper-body Resistance Exercise Training (RET), there is no evidence to suggest that RET increases the incidence or is associated with BCRL exacerbations. Moreover, there is strong evidence that resistance training has favorable effects in women who are at risk for, or currently have, BCRL.
Initiate RET at a low level of intensity (15-20 reps decreasing to 10-15 after several weeks) and use a conservative model of progression. 5-10% increase of weight lifted after successfully reach goal number of repetitions several times. A frequency of 2-3 times a week (with 48 hours minimum between sessions) was proven optimal.
- Be cognizant of early signs of potential injury or symptom flare-up (e.g., increased muscle soreness, excessive fatigue, redness, or heaviness in the involved arm, bone, and joint pain
Note: All individuals with BCRL or those who are at risk for BCRL should have medical approval before beginning any exercise, particularly in the presence of cardiovascular, pulmonary, or metabolic disease.