STRONG SATURDAY - Weight Lifting Benefits Breast Cancer Survivors

The following article appeared on CNNhealth.com, and I thought I'd share it...

Occupational therapist Cathy Kleinman-Barnett works with breast cancer patients, but she has never encouraged women with lymphedema, a breast cancer-related swelling of the arm, to lift weights. A new study contradicts recommendations that breast cancer survivors avoid weight lifting, because of swelling.

However, she may be changing her tune, thanks to a new study in the August 13 (2009) issue of the New England Journal of Medicine. It turns out that breast cancer survivors with lymphedema who engage in a progressive, supervised weight-lifting program fare better than their counterparts who do not lift weights.

Lymphedema occurs in as many as 70 percent of women who have breast cancer surgery. Sometimes lymph nodes in the armpit are removed for cancer testing, which can cause the clear fluid (lymph) that circulates in the body to build up in the affected limb. As a result, women must wear a compression sleeve and glove during waking hours.

"For so long, we were taught no heavy lifting and no resistance for our patients, but this article is shouting out yes to resistance and weight," says Kleinman-Barnett, who is a lymphedema specialist at Northwest Medical Center in Margate, Florida. "The benefits seem to outweigh the risks, and a weight-lifting program may help these women prevent injuries from everyday tasks by boosting strength in the affected limbs."

Oftentimes breast cancer survivors were told to steer clear of weight lifting -- or even carrying their children or heavy grocery bags, because doctors thought it could worsen the swelling. The new study, the largest to date, seems to contradict that recommendation.

In fact, the research team led by Kathryn Schmitz, an associate professor of epidemiology and biostatistics at the University of Pennsylvania, in Philadelphia, and a member of the university's Abramson Cancer Center, found that weight lifting increased muscle strength, decreased the number and severity of arm and hand symptoms, and reduced lymphedema exacerbations.

"Our study shows that participating in a safe, structured weight-lifting routine can help women with lymphedema take control of their symptoms and reap the many rewards that resistance training has on their overall health," says Schmitz. Resistance training helps build bone density and can improve health in general.

In the new study, 141 women with lymphedema after breast cancer treatment were divided into two groups. Women in the weight-lifting group received a one-year membership to a local gym. For the first 13 weeks, they participated in twice weekly, 90-minute supervised exercise sessions that included stretching, a cardiovascular warm-up, and abdominal and back exercises. The weight-lifting exercises involved low weights, and one to three new exercises were added at each session.

The number of sets increased from two to three, with 10 reps in each set, during the first five weeks. If the women felt OK, more weight was added.

After 13 weeks, women in the weight-lifting group continued twice-weekly exercise sessions on their own for an additional 39 weeks. By contrast, the women in the other group continued their normal exercise routine throughout the study period. All women wore a custom-fitted compression garment on their affected arm during their workouts.

Overall, the women who lifted weights experienced fewer exacerbations of their lymphedema, and they showed a reduction in symptoms compared to the women in the control group. Nineteen women in the control group had lymphedema exacerbations, compared to nine in the treatment group, the researchers report. A similar proportion of women in both groups showed an increase of 5 percent or more in their limb swelling.

Kleinman-Barnett currently prescribes range-of-motion exercises, stretching, and massage to stimulate lymphatic flow in her patients. "I will now incorporate weight lifting using 2 to 3 pound weights, and slowly increase it, and teach them how to monitor themselves to be sure they are not increasing swelling," she said. Red flags that weight lifting may be making things worse include more swelling, heaviness, and pain in the arm, she said.

Dr. Marisa Weiss, the president and founder of the advocacy group Breastcancer.org, and the author of the forthcoming new edition of "Living Well Beyond Breast Cancer," said the new study is good news for two groups of women -- those who have lymphedema and those at risk of developing it.

"For women who already have lymphedema, this is good news because we have not known how to get them back to moving and grooving again," said Weiss, who is the director of breast radiation oncology and breast health outreach at Lankenau Hospital in Wynnewood, Pennsylvania. "Our arms are essential to our ability to be physically active, and we haven't known how to advise these women in the past."

Lymphedema is more common after surgeries that remove most or all of the lymph nodes in the under arm area because there are few if any lymphatic drains left intact after such surgeries, she says. "If regular weight lifting with a sleeve in a supervised setting is OK for women with lymphedema, then it is reasonable for women with breast cancer treatment who are at risk of developing lymphedema to go back to some of the things they enjoyed in the past," she said.

Karen Strauss, a 50-year-old breast cancer survivor who developed lymphedema four months ago, is excited about the findings because she may be able to return to some of the exercises she did before developing breast cancer.

"I used to do a whole workout when I went to the gym, but I have gotten away from it because I am afraid I would make things worse," said Strauss, a clinical social worker in Fort Lauderdale, Florida. "I have been afraid to do anything, but not anymore."

Strauss currently wears a compression sleeve and glove, gives herself light-touch massages, and does non-weight-bearing exercises to treat her lymphedema. But the new study results have convinced her to talk to her lymphedema specialist about adding light weights to the mix.

Copyright Health Magazine 2009

STRONG SATURDAY - Sister Survivor's 5K Walk/Run...

Sister Survivors, with the help and support of Pinnacle Security, will be hosting a 5k walk/run on October 16th, 2010. The run will take place in American Fork, with registration starting at 8:00 am. There will be a motivational speaker, and great music, to kick the race off. More information is coming.

I'm telling you this now, so that you can train! If you've never participated in a 5k, it's just over 3 miles. Walking at least a 1/2 hour each day will get you ready to have fun in this race. Other exercises that will help - biking, swimming, jogging. If you are a recent survivor, take it easy - don't over do it. Again, just walking 1/2 each day will help.

We look forward to walking with all of you! Tell everyone you know - this is for the public, not just survivors.

**In the near future, we will have a registration page where you can sign up and buy a ticket for the race. Look for an announcement on that soon.

Have a great weekend!

STRONG SATURDAY - Swimming

Is there an exercise that works all of your major muscle groups, is great for your heart and lungs, builds endurance, lung capacity, and strength, is low-impact and better for sore joints??!! Yes - it's called.... SWIMMING! If you've never tried this exercise, it's not too late to take a swimming class. Local gyms and rec centers offer adult swimming classes all the time. Take one to learn the correct techniques and you'll get much more benefit out of your time swimming.

Check out this article by Kristoph Thompson, on NetDoctor. It has a great 6-week swimming plan you can try...

How to Get Fit: Swimming

STRONG SATURDAY - Benefits of Exercise

Regular exercise is important in many ways to your overall health. Benefits include...

1. helps keep you limber and strong
2. relieves stress and tension
3. helps elevate mood
4. stimulates the process of digestion, absorption, metabolism, and elimination
5. helps prevent osteoporosis
6. helps you sleep better
7. stimulates the brain, helping to improve memory and attention span
8. helps regulate weight
9. increases your sense of control and improves your self-esteem.

Studies show that regular exercise might even help to prevent certain forms of cancer. Many oncologists advise their patients to stay as active as possible during treatment. If you had a regular exercise program before diagnosis and treatment, try to maintain as much of your regimen as you can. If you were relatively inactive before, there are still some things you can do that will be beneficial to you...

Ordinary Activities to increase your level of activity:
1. walking
2. cleaning
3. making the bed
4. climbing the stairs
5. gardening

Even if you are confined to bed or a wheelchair, you can do some simple things to keep from getting weak and more fatigued. If you have your doctor's permission, try some of these exercises...

1. move your feet and wiggle your toes
2. raise your arms above your head
3. lift your legs
4. shrug your shoulders
5. do deep breathing exercises

Remember to: start slowly and build up gradually, begin with a light warm-up and end with a cool-down, and slow down or stop if it hurts or you get too tired.

**You need to check with your doctor before you begin ANY exercise program and ask if it is appropriate in your particular situation.

(information taken from chapter 8 of "Finding the "CAN" in Cancer" by Nancy Emerson, Pam Leight, Susan Moonan, and Terri Schinazi)

STRONG SATURDAY - Backyard games

Prevention's July issue listed several backyard games you can play with your family. Exercise doesn't have to be routine all the time - try one or two of these games and have fun with your family...

Badminton: You can play this even without a net - just volley to see how long you can keep the shuttlecock in the air. Count the hits and aim for more each time. *A great arm workout. (you can buy the rackets and birdies starting at $15)

Frisbee: Run to catch the frisbee (works your legs), or just pick a target and play Bull's Eye. Take turns throwing the Frisbee to see whose shot lands the closest. Play with two different frisbees to mark the spots. You can get the same kind of exercise by throwing a football, too! And, there are lots of fun different kinds of frisbees and footballs. (buy a frisbee for $8 to $20)

Shooting Hoops: Challenge everyone to a game of Around the World. Shoot from five or seven spots in an arc around the basket. Every time you make a shot, move to the next spot. The first person to finish wins! Play it faster and faster, and you'll have a great cardio workout. ($10 and up for a ball)

Bocce Ball: This Italian game, easier than bowling, is becoming more and more popular. Just toss the pallino, a small ball, onto the grass. Then try to get your balls as close as possible. (Bocce sets start at $20 and go up to over $100: don't get the cheap sets, they are just plastic balls filled with water. Splurge for a little bit better set with resin balls)

Hopscotch: This is one of the best cardio exercises of all. Speed and balance challenge both kids and adults. Race to see who can hop through the pattern the fastest. To really test your stability, throw two stones, one at the start and one at the end, to hop over two squares each time. Or use a coin, because it's harder to pick up than a stone. (Buy a box of chalk - $2 to $5 - to draw the diagram.

Have FUN this summer!

SATURDAY STRENGTH - Does Walking Help Breast Cancer Survivors?

Information was taken from an article entitled... "Role of Obesity and Exercise in Breast Cancer Survivors" April 9, 2010:
Holmes and colleagues examined data from 2,987 nurses in the Nurses Health Study diagnosed with stage I, II, or III breast cancers and looked at breast cancer mortality in relation to physical activity level. The study showed that woman engaged in at least 3 metabolic equivalents (MET) of exercise per week had a relative risk of death from breast cancer of 0.80 (95% CI = 0.60–1.06), while those with 9 to 14.0 MET/wk had a relative risk of 0.50 (95% CI = 0.31–0.82). Adjusted for other risk factors, the relative risk of death from breast cancer and the risk of breast cancer recurrence was 25% to 40% lower in women with the highest level of activity, compared to women with the lowest levels of activity. Of note, most of the benefit was seen in women with moderate activity, equivalent to walking 3 to 5 hours a week at an average pace of 2 to 2.9 mph. Patients who were ER- and PR-positive appeared to benefit the most from exercise.


To read the full article, see http://www.cancernetwork.com/display/article/10165/1552213

Challenge for this week: try to get at least 30 minutes of walking on each day this next week. The study above shows that walking at a moderate rate really does help!