In this final blog on breast cancer and exercise, these were two important points I wanted to discuss.
Lymphedema is swelling on the arm following breast surgery. The lymphatic system helps drain fluid and other things out of your arm. The lymphatics run up into the armpit where they go through lymph nodes and then the lymph is dumped into the venous system.
Rates of lymphedema have decreased since we evolved in our breast cancer surgery techniques. (The modified radical mastectomy- where the pectoralis muscle is preserved- lowered rates. Doing sentinel nodes and removing less lymph nodes- we used to have to remove at least 13 lymph nodes in all patients to stage the cancer- lowered rates. Radiation does increase the risk.) The reason you don’t have blood pressures taken or have IVs on your breast cancer side is to avoid infections and trauma to the lymphatics on that arm.
Does exercise and movement make your risk of lymphedema worse? Does it stir up fluid and overwhelm the system?
- Recent studies seem to indicate it may actually prevent development of lymphedema (Schmitz, New England Journal of MEdicine 2009, and Schmitz JAMA 2010, Kwan, Journal of Cancer Survivorship, 2011)
- Do exercises under a professional guidance
- do manual lymphatic drainage and wear a sleeve
- follow with measurements
- aerobic activity: swimming
- weights: light weights, many repetitions; focus on compound muscle groups, not small isolated muscles
- range of motion and stretching
BONE LOSS. Most breast cancer treatments have bad effects on your bones. The science here is not as good, but the College of Sports Medicine recommends:
- weight bearing endurance activities: jog, stair climb, tennis
- jumping activities: volleyball, basketball
- resistance exercises that target all major muscle groups (chest, back, arms, shoulders, abs, quads, hamstring, calf, gluteal)
So get out there and get moving!