Q: During recovery from breast cancer treatment several years ago, I was advised that I should not carry weights heavier than 10 pounds with my left arm, nor press weights, because of the risk of lymphedema... What is the latest advice for survivors to both protect their compromised arms but still enjoy an active life?
Answer from the expert staff of breast cancer research at the Robert W. Franz Cancer Research Center at Providence Portland Medical Center: Despite the prevalence of lymphedema, only recently are we starting to see research on this condition. What we have right now are guidelines that we believe reduce your risk of developing the condition. The following are lymphedema prevention guidelines provided by the American Cancer Society:
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Try to avoid blood pressure checks or injections in the at-risk arm. |
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Avoid heavy lifting with the affected arm – never carry heavy handbags or bags with over-the-shoulder straps. |
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Wear gloves while working in the garden or in the kitchen to protect hands and prevent infection. |
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Avoid cuts, scratches, pinpricks, hangnails, insect bites, burns, and strong detergents. |
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Keep the affected arm clean – wash twice daily if you get dirty or perspire. Avoid vigorous scrubbing and dry your arm thoroughly. |
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Moisturize your skin if it tends to dry and/or crack. |
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Use an electric shaver because razors are more likely to cut the skin. |
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Maintain your ideal weight through a well-balanced, nutritious diet. |
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Exercise regularly, but discuss your exercise program with your health care team; do not fatigue the affected arm.
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Wear loose-fitting clothing, avoiding anything (tight sleeves, watchbands) that will constrict your hand or arm. |
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Report any swelling, redness, tightness or sign of infection immediately to your doctor. |
The key is to avoid any trauma to the at-risk arm, explains Saskia Thiadens, RN, founder and executive director of the National Lymphedema Network. Trauma includes extreme temperature changes, repetitive movements against resistance (pushing or pulling), heavy lifting, and excessive exercise.
Dr. Jeanne Petrek at Memorial-Sloan Kettering Cancer Center conducted a study of 923 women who were followed over the course of twenty years after having a mastectomy and complete axillary dissection. Of fifteen potential predictive factors analyzed, only two were statistically significantly associated with lymphedema: arm infection/injury and weight gain since operation.
To answer your question, yes, it is a good idea to maintain your active lifestyle and to use your affected arm as normally as possible so you can maintain your strength and range of motion. Just remember to avoid overdoing activities that could overstress or injure your arm. If you are not sure what your strength, movement and limitations are, a physical therapist could be helpful.
Use common sense precautions such as a sunscreen (32 SPF) and insect repellant when you are outdoors, and take care of cuts, scratches and burns to prevent infection. Contact your physician if you are concerned you may be developing lymphedema. Your physician can refer you to Providence Regional Rehabilitation Oncology Services, which has therapists who are specifically trained in the treatment and management of lymphedema.
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July 2002
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