Recent Edition of the MASCC Journal Supportive Care in Cancer Features “Resistance exercise and breast cancer–related lymphedema—a systematic review update and meta-analysis”

2020    The MASCC journal Supportive Care in Cancer recently featured a systematic review update and meta-analysis to analyze resistance exercise (RE) intervention trials in breast cancer survivors (BCS) regarding their effect on breast cancer-related lymphedema (BCRL) status and upper and lower extremity strength.

Summary information from the articles includes:  Breast cancer is the most common cancer in women with incidence rates of over a quarter million new cases in the USA and just short of half a million in Europe representing about one third of all new cancer diagnoses in women. Of those patients, about 20 percent develop breast cancer–related lymphedema (BCRL) over the course of their treatment. Lymphedema is an excess accumulation of a protein-rich fluid which would otherwise drain through the lymphatic system and leads to a regional swelling—in the particular case of BCRL—the swelling of the arm of the affected side. It is associated with symptoms like pain, heaviness, tightness, decreased range of motion, adversely affected gross and fine motor skills, impaired daily function, and decreased quality of life.  BCRL is currently considered being an incurable and chronic disease and its treatment aims on the management of the lymphedema status and the preservation of the function of the affected arm.  Up-to-date standard of care is the complete decongestive therapy consisting of manual drainage, bandaging, compression, skin care, and exercise.

Exercise as a part of the current treatment standard of care is a more recent development. Up to the early 2000s, breast cancer survivors (BCS) were advised to refrain from “vigorous, repetitive, or excessive upper body exercise” because of the fear that these physical activities could lead to the development of new or an increase of existing lymphedema. Only some decades ago, Harris and Niesen-Vertommen started to challenge the myth that intensive physical loading of the affected arm side of BCS would lead to either the development of a fresh or the increase of an already existing BCRL. This field of research they initiated then has led to publication of over twenty resistance exercise (RE) intervention studies and a number of systematic reviews, and it is safe to say that the initial fears that physical loading could harm the BCS via negatively affecting the BCRL were unjustified.  

Contributors include MASCC member Richard Crevenna as well as Timothy Hasenoehrl, Stefano Palma, Dariga Ramazanova, Heinz Kölbl, Thomas E. Dorner, and Mohammad Keilani.  To read the complete article, click here.  

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