Not surprisingly, a question that I get asked frequently is whether it is safe to exercise after breast cancer, usually with regard to swelling. As always, there is no stock answer as no two cancer patients are identical and people's perception of strenuous or gentle exercise varies hugely. All I can say is that light exercise has so many benefits.
The most common fear is that exercise, especially arm exercises may cause lymphoedema.
So, what is lymphoedema?
Well, it's a buildup of lymph fluid in the fatty tissues just under you skin. Our bodies have a network of lymph nodes and lymph vessels that collect and transport lymph fluid around the body. This watery fluid contains proteins, salts and water, as well as white blood cells, which help fight infections. Lymph nodes are small collections of tissue that work as filters for harmful substances.
During surgery for breast cancer, the doctor might take out lymph nodes from under the arm (axillary nodes) to see if the cancer has spread. When lymph nodes are removed, lymph vessels that carry fluid from the arm to the rest of the body are also removed because they go through and are wrapped around the nodes. It is therefore harder for fluid in the chest, breast and arm to flow out of these areas, causing a fluid build-up, or lymphoedema.
So the women that contact me are usually post treatment, feeling out of shape, maybe carrying extra unwanted weight and often say "I can't do much arm or shoulder stuff as I have lymphoedema".
The truth is that exercise is pretty crucial after cancer treatment. I don't mean marathon running or kick-boxing! (well, not initially...) We know that overweight women are at higher risk for lymphoedema so exercising, in general, to retain a healthy weight is very advisable.
It's important to use your affected arm for normal, everyday activities to help you heal properly and regain strength. Hair brushing and bathing are good as they involve lifting the arm above the heart. Using your muscles helps to drain lymph fluid! It also keeps your muscles flexible and helps reduce scarring. Avoiding exercise and allowing your arm to get out of shape can actually lead to lymphoedema.
What should you avoid?
There are two things I'm usually a great advocate of...Body resistance exercise and swimming.
Neither of these would be great for reducing risk of oedema. So no push-ups, or 'mountain climbers' ..or 'down dog' in yoga for a while please after surgery. Swimming is fine if you want to hold a float instead of doing the arm stroke and concentrate on legs and breathing!
At home a simple , frequently repeated (3-4 times a day) exercise can help...
1. Support your arm above heart level (maybe rest it on the back of the sofa)
2. Open and close your hand 15-25 times.
This encourages the lymph fluid to pump through the undamaged vessels and so aid drainage.
If you do want to go to a gym or do home workouts, lifting very light weights is excellent. I'd start with bicep curls, then as you get stronger, shoulder presses and chest presses can be introduced. Still with light weights and progressing steadily and slowly.
Next week I'll discuss how certain foods can help with lymphoedema.