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Changing with the Times: What we know about exercise and breast cancer

breast cancer, exercise, lymphedema, kingston, gym, work out

What is breast cancer?

Breast cancer is a malignant (which means it continues to grow) tumour developing in the tissue of the breast. Breast cancer accounts for 26% of all cancers diagnosed in women (1). According to the Canadian Cancer Society, based on estimates from 2006-2008, 87.8% of women with breast cancer survived over 5 years (1). This creates a group of women that require guidance on how to stay healthy. Living cancer free means they need to keep their bodies healthy.

Common treatments

Many women diagnosed with breast cancer will undergo chemotherapy or radiation. A surgical option is a removal of part of or the entire breast – a procedure known as a mastectomy. Because the breast is so close to the lymph nodes underneath the armpit, there is an increased risk of the cancer travelling there and affecting other tissues. Because of this, many times women have a lymph node resection. This is when they remove a select number of lymph nodes underneath the arm pit and do a biopsy to check if there are any cancerous cells.

What are women told

Many women after mastectomy and lymph node resection are told that they can never lift more than 5-10 lbs in the affected arm (2). This is due to the thought that a women may develop lymphedema. Lymphedema is a swelling of the arm due to the inability of the body to clear the lymph fluid in the arm because lymph nodes have been removed. The prevalence of lymphedema in women has been estimated to be 13-65% depending on the study (2).

Is this true?
Not at all.

Over the last five years, randomized control trials (RCTs – the best form of research evidence) have shown that strength training for women with or without lymphedema is safe and beneficial! In 2013, Cormie and colleagues published an RCT that looked to see if women that performed heavier weight training (low group was 55-65% of 1 rep max and high group was 75-85% of 1 rep max) would be at increased risk of developing lymphedema or making their lymphedema worse. What this study showed was that none of the women involved reported worsening symptoms of lymphedema (3). No negative events were reported at all! The outcome? Women got stronger!

This and other studies have prompted the American College of Sports Medicine to publish a position statement that advocates for women to perform the same amount of exercise as prescribed in the American Physical Activity Guidelines (4). This includes strength train during and after cancer treatment as long as they have been cleared by their treating physician.
Lifting is an key part of recovery and it is important for women to know this. Being strong helps with your independence and can improve your quality of life.
Women recovering from breast cancer need to know that lifting weights is going to improve their health. It is okay to lift a barbell! In fact, we encourage it!

References:

1. Canadian Cancer Society. Canadian Cancer Statistics publication. 2014. http://www.cancer.ca/en/cancer-information/cancer-101/canadian-cancer-statistics-publication/?region=on. Accessed 5 October 2014.
2. Schmitz KH, Ahmed RL, Troxel AB, Cheville A, Lewis-Grant L, Smith R et al. Weight lifting for women at risk for breast cancer-related lymphedema. JAMA. 2010. 304(24): 2699-705.
3. Cormie P, Pumpa K, Galvao DA, Turner E, Spry N, Saunders C, et al. Is it safe and efficacious for women with lymphedema secondary to breast cancer to lift heavy weights during exercise: a randomised controlled trial. J Cancer Surviv. 2013. 7: 413-24.
4. Schmitz KH, Coruneya KS, Matthews C, Demark- Wahnfriend W, Galvao DA, Pinto BM et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exer. 2010. 1409- 26.

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