Exercise Benefits Breast Cancer Survivors
by Barbara Lock, MDAugust 18, 2009
I wasn't that surprised, really, to read that women who had swelling of the arm after having had breast cancer or surgery on the same side benefit from weight lifting. Generally, when you use your body the way it was designed to be used, you get health benefits.
Weight lifting has traditionally been strongly discouraged in patients with so-called breast cancer lymphedema (arm swelling), due to fears that exercise could worsen the swelling. Schmitz et al performed a randomized controlled trial to see if that assumption was true. They randomly assigned women with stable breast cancer lymphedema to twice-weekly weight lifting or to no weight lifting, and found no difference in lymphedema in women in the two groups after the trial. They also found that women who were in the weight-lifting group had more upper AND lower body strength than those who did not lift weights.
This finding is important because we know that women who exercise are less likely to die from breast cancer than those who do not.
What is not known is whether prescribing exercise in women with or without breast cancer will reduce their likelihood of death from breast cancer. This is an important difference. It may be that women who happen to exercise are different in some important way than women who prefer not to exercise, and that it is not the exercise that makes the difference in breast cancer survivorship, but something else altogether. Maybe it has to do with body mass index or diet.
Researchers for the Yale exercise and survivorship study aim to answer that question. They randomized 75 breast cancer survivors to either exercise, with a goal of 30 minutes of aerobic exercise 5 days a week for 6 months, or usual care. By allocating patients to each of the trial arms in a randomized way, the researchers reduce the chance that factors other than the trial intervention (exercise) could influence the result of the trial. While the clinical outcome measure of the trial has not been published yet, some preliminary data is available: patients who adhered to the trial intervention (exercise) were more likely to be thin than those who did not adhere to the trial intervention.
So the jury is still out as to whether exercise (as an intervention) prevents breast cancer death, but women with breast cancer who want the health benefits that come with increased strength should openly discuss their own risk and benefit profile with their physician.
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