Setting the record straight: exercise and lymphoedema
March 7, 2013
One of the most feared and misunderstood side effects of breast cancer treatment is lymphoedema. Experienced by nearly one in three women who undergo treatment, this build-up of fluid causes swelling usually in the arm or upper chest. While many clinical guidelines recommend that women avoid use of the affected side of the body to prevent lymphoedema, this can create confusion about the safety of exercise.
With Lymphoedema Awareness Month [www.lymphoedema.org.au] taking place from March 1-31, there’s no better time to set the record straight, according to Exercise is Medicine Australia spokesperson Prof. Robert Newton, of Edith Cowan University, Perth.
“The last thing women undergoing breast cancer treatments need to worry about is misinformation about side effects. So, let’s be clear: exercise does not cause or worsen lymphoedema – and in fact, recent evidence suggests that exercise may help prevent the condition,” Professor Newton said.
“Well-controlled research studies** demonstrate that supervised, gradual aerobic and resistance exercise can be both safe and beneficial. Women who exercise regularly are less likely to experience treatment-related lymphoedema symptoms – and, if they occur, the symptoms are typically less severe.”
“We recommend supervised exercise for women undergoing active treatment of breast cancer, when the frequency and type of side effects are likely to fluctuate. The supervision required depends on the patient’s exercise history, the timing with respect to diagnosis, and the presence and intensity of treatment-related side effects.”
He also debunked the need for compression garments which are also a regular subject of debate.
“Current evidence does not support the need for women undergoing breast cancer treatment to wear compression garments during exercise. Such garments may interfere with heat transfer and physical function. Preliminary studies have shown that exercise was safe, whether or not garments were worn*,” he said.
Exercise is Medicine recommends the following exercise guidelines for breast-cancer survivors:
• Aerobic and supervised resistance (weights) training is safe and beneficial. Most sports and specific activities, other than walking and gym-based exercise, have not been well evaluated for safety or efficacy. However, participation is encouraged unless clearly contraindicated (e.g. if a risk of fractures or infection exists).
• Low to moderate-intensity exercise is recommended. Until the upper and lower limits of beneficial exercise intensity are known, it is best to start a program at low to moderate intensity and progress gradually. If a routine lapses, the exercise intensity should be lowered again when restarting. Under the supervision of an Accredited Exercise Physiologist, higher intensity aerobic and resistance training can be performed safely and will likely have greater benefit in the long term.
• Accumulating at least 30 minutes of daily exercise on at least three days each week can lead to benefits. Depending on one’s fitness level, many short sessions may be needed to accumulate at least 30 minutes of daily exercise. Build up to, and then maintain, at least 30 minutes of exercise on five days each week. Equally important, at least two sessions of resistance training should be completed each week.
Exercise is Medicine strongly recommends seeking out an Accredited Exercise Physiologist for an appropriate and safe exercise prescription. An exercise physiologist can help those undergoing treatment by explaining safe techniques for resistance exercises, and recognising and overcoming any barriers to exercise. For more information, please visit www.exerciseismedicine.org.au.
Download a fact sheet on the role of exercise in managing or preventing side effects of breast cancer at http://exerciseismedicine.org.au/wp-content/uploads/2011/10/Breast-Cancer.pdf.
Ends.
**Cormie, P., K. Pumpa, D.A. Galvão, E. Turner, N. Spry, C. Saunders, Y. Zissiadis and R.U. Newton. Neither heavy or light load resistance exercise acutely exacerbates lymphoedema in breast cancer survivors. Integrative Cancer Therapies. Published online 25 February 2013. DOI: 10.1177/1534735413477194.
*2 Schmitz KH. Balancing lymphedema risk: Exercise versus deconditioning for breast cancer survivors. Exerc Sport Sci Rev 2010; 38(1): 17-24.
ABOUT ESSA
Exercise & Sports Science Australia (ESSA) is the peak professional body for exercise and sports science in Australia and provides national leadership and advocacy on key issues. It supports its over 3,500 members and the community through fostering excellence in professional practice, education, training and research.
Website: www.essa.org.au
Official Media Spokesperson for this release:
Professor David Bishop BHMS Ed Hons PhD (QLD)
Board Member
Exercise & Sports Science Australia (ESSA)
and
Research Leader, Sport, Institute of Sport, Exercise and Active Living
Victoria University, Melbourne
david.bishop@essa.org.au
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M: 0435 962 364
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