Lymphedema and Exercise
Up to 40% of cancer patients will be diagnosed with lymphedema – a side effect from cancer treatment. Although most people associate lymphedema with breast cancer, patients with head and neck, gynecological, and other forms of cancer are also susceptible. And lymphedema isn’t limited to the arms and legs, it can affect other parts of the body as well.
What is Lymphedema?
Fluid (lymph) that would normally flow freely throughout the body builds up in certain areas causing swelling. This occurs because the system that moves this fluid around your body – the lymphatic system – has been altered in some way during the course of cancer treatment. This can be due to surgery and removal of lymph nodes or it can be from other forms of treatment, like radiation, that damages the lymph nodes and vessels. Certain types of chemotherapy have also been found to increase the risk of lymphedema.
Lymphedema may occur right after surgery or it can take months or even years for symptoms to develop. Patients can feel swelling, heaviness, numbness, and skin tightness – and if lymphedema progresses, there will be visible changes to the skin.
Side Effects of Lymphedema
Besides being painful, lymphedema can affect your function. When there’s extra fluid around the joints it makes it more difficult to move. In addition, when there’s swelling, it makes it harder for nutrients to get to certain parts of the body. This affects wound healing and can lead to infections. When patients have pain and cannot function as they would like, there are negative psychological affects like depression that can occur as well.
The easiest, quickest, and most cost effective way to evaluate lymphedema is by taking measurements. If possible, have baseline measurements taken prior to treatment. Then you’ll know what your ‘normal’ is.
After treatment, if you feel any symptoms, you’ll be able to have measurements re-taken and compared to your values. For example, a breast cancer patient scheduled for surgery on the right side can have measurements taken beforehand – of both the right and the left arm. This is her baseline. Then if she suspects lymphedema later on, measurements can be taken and compared to her baseline to see if there are any changes to the circumference of her arm and also between the right and left sides.
From my perspective, here’s the great news. Of course I’m biased as a Cancer Exercise Professional. But, research studying patients with and without lymphedema have shown two important things.
Patients without lymphedema do NOT increase their risk of lymphedema by exercising.
And second, for patients with lymphedema, exercise has been shown to improve lymphedema and has been indicated as a positive therapy choice to reduce symptoms.
As I said – this is amazing news. It wasn’t too long ago patients who were at risk of lymphedema were warned not to exercise. And if you had lymphedema – the fear of doing anything physical that could make things worse had patients sitting and doing nothing.
This negatively impacts cancer patients in many ways including their quality of life, mental well being, and overall health. One of the biggest risk factors for lymphedema is obesity so the lack of exercise has a secondary impact.
But today, things are changing. Look up lymphedema on www.cancer.org and you’ll find the following.
It’s important to use the part of your body that’s been affected by cancer for normal, everyday activities to help you heal properly and regain strength. Using your muscles also helps the lymph fluid drain like it should. It also helps keep your muscles flexible and helps reduce scarring.
Certain types of exercise can help reduce your lymphedema risk, too, and some exercises can make lymphedema better after it starts. Avoiding exercise and allowing your body to get out of shape may lead to lymphedema and bouts of swelling that are sometimes called flare-ups.
But keep in mind that some kinds of exercise can increase your risk of lymphedema or make lymphedema worse if you already have it. Overuse, which can result in injury, has also been linked with the start of lymphedema in some people. Work with a trained fitness or health professional to design an exercise plan that’s right for you and starts at a low level of intensity and progresses slowly to avoid overuse.
As outlined by cancer.org safety is always the most important factor with any exercise program so you need to start slowly, know your risk factors, and work within your own personal boundaries. See your Cancer Exercise Professional if you have questions.