How exercise can benefit breast cancer survivors: weight training may help avoid lymphedema after surgery.

Exercise is now seen as an important component in recovery from breast cancer. Recent studies show activity can improve quality of life, help lift fatigue during chemotherapy and radiation, and may even increase the odds of long-term cancer-free survival.

"Exercise definitely improves functioning, decreases fatigue, and speeds recovery. It enhances quality of life and allows cancer patients to take some of the control back. My goal is not only to get patients moving, but to educate and empower them," comments Amy Shapses, PT, director of physical therapy at the Iris Cantor Center for Women's Health at the Weill Cornell Medical Center. "There are still a lot of myths out there that exercise causes problems during breast cancer treatment. I try to address patients' fears and let them know that movement is helpful," says Shapses, who runs a physical therapy and exercise program for breast cancer patients.

Limiting lymphedema

One of the myths is that exercise brings on lymphedema, painful fluid retention and arm swelling caused by slowed lymphatic drainage after breast surgery and lymph node removal. Almost half of breast cancer survivors are either diagnosed with the condition or report symptoms of lymphedema, which can be chronic and debilitating. A new study finds that upper body exercise is safe and does not trigger lymphedema.

The Weight Training for Breast Cancer Survivors Study (WTBS) randomly assigned half of a group of 95 breast cancer survivors (4-36 months after surgery and chemotherapy) to a six month regimen of twice-weekly weight training at the University of Minnesota in Minneapolis. Exercises included use of resistance machines and free-weights, targeting both the upper body, back, and legs. Almost half of the women had lymphedema at the start of the study. After six months, there was no difference between the exercisers and nonexercisers in either the incidence of lymphedema or new lymphedema symptoms. No increase was seen in arm swelling or symptoms among the exercise group, according to the study, published online May 15 in the Journal of Clinical Oncology (JCO). The WTBS researchers theorize that lymphatic flow and drainage is improved by tissue compression from muscle contractions. Another report from the WTBS, published in the May 1 issue of Cancer, concluded that weight training improved strength as well as patients' quality of life.

How much, how soon?

There are some contraindications to exercise during breast cancer treatment, such as anemia or fever. Patients need to consult their oncologist for guidance about exercise.