Dec. 1, 2011 Lymphedema, a chronic swelling condition common in breast cancer survivors, affects three million people in the U.S. In the past, most people believed that exercise might induce or worsen lymphedema. After reviewing the literature, University of Missouri researchers say the benefits of exercise outweigh the risks for breast cancer survivors and patients with lymphedema. Jane Armer, professor in the Sinclair School of Nursing, says patients at risk for lymphedema can exercise if they closely monitor their activities.
"Exercise can be beneficial and not harmful for breast cancer survivors," Armer said. "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."
Lymphedema can occur any time after cancer treatment and is usually caused by the removal or radiation of lymph nodes as part of the treatment process. Armer found that patients who exercise had no greater risk for developing lymphedema than those who do not exercise. In addition, patients with lymphedema did not worsen their condition by exercising. She says future research is needed to determine whether exercise prevents the condition.
"Breast cancer survivors do not need to restrict their activity as we once thought," Armer said. "If patients want to be active, they should carefully condition their bodies by increasing repetitions of resistance exercises under proper supervision."
In another new literature review, Armer and her colleagues examined published literature pertaining to the surgical treatment of lymphedema. They found that in most studies surgery did not eliminate the need for traditional compression garments in patients with lymphedema.
"Many people think surgery will correct the underlying lymphatic problem, but that is not correct," Armer said. "There are several surgical techniques that may reduce the swelling associated with lymphedema. In most cases, it is recommended that patients undergo traditional therapy using specialized massage and compression garments and bandages to reduce fluid and swelling before considering surgery."
The literature reviews were the first two in a series of thirteen reviews to be published in conjunction with the American Lymphedema Framework Project (ALFP). Established in 2008, the ALFP aims to increase awareness of lymphedema, improve patient care and enhance training for professionals caring for persons at risk or with cancer-related lymphedema. The ALFP has two main goals: maintain up-to-date best practices supported with evidence-based lymphedema treatment guidelines for health practitioners, and create a minimum data set of all available lymphedema research and clinical data.
The first article, "Exercise in patients with lymphedema: A systematic review of the contemporary literature," was published in the Journal of Cancer Survivorship. The second, "The surgical treatment of lymphedema: A systematic review of the contemporary literature," was published in Annals of Surgical Oncology.
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