Lifting Weights after a Masectomy

Dawne.Hope
Dawne.Hope Member Posts: 823
edited March 2014 in Breast Cancer #1
I was just diagnosed with DCIS a couple of weeks ago and had my first onocologist visit last week. There's still a lot to be figured out, tests to be run. My mother and my grandmother have had breast cancer.

There is a part of me that wants to go ahead and get a bi-lateral masct. just to be done with it. Yet there's another part of me that says why do it if it's not necessary. A variable that I'd like your advice on is being able to lift weights (bench press, biceps, triceps, rows, etc). I'm a gym rat and love lifting weights. I've heard conflicting things about being able to do that after mast. I know lymphedema is an issue, but is it only an issue if you've had nodes removed? I just don't know and would welcome any advice. I would really, really miss not being able to lift weights again.

Thank you!!!

Comments

  • VickiSam
    VickiSam Member Posts: 9,079 Member
    Dawne. Hope .. Hold on to your weight belt .. more experienced
    and wiser women will be posting ..
  • phoenixrising
    phoenixrising Member Posts: 1,508
    Hi Dawn, I don't have
    Hi Dawn, I don't have lymphedema but know there are some here who do. I was going to start a thread with this article but now seems like a good time to post it. Hope you find it useful. Sorry it's so long.

    jan

    Slowly Progressive Weight Lifting May Be Helpful in Breast Cancer Survivors With Lymphedema CME
    News Author: Laurie Barclay, MD
    CME Author: Désirée Lie, MD, MSEd


    August 14, 2009 — Slowly progressive weight lifting may be helpful in breast cancer survivors with lymphedema, according to the results of a randomized controlled trial reported in the August 13 issue of the New England Journal of Medicine.

    "Weight lifting has generally been proscribed for women with breast-cancer–related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density," write Kathryn H. Schmitz, PhD, MPH, from the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine and Abramson Cancer Center in Philadelphia, and colleagues.

    "A program of controlled exercise through weight lifting may increase the physical-work capacity of the affected arm, thereby protecting it from injury sustained during common daily activities. Weight lifting offers additional benefits particularly relevant to breast-cancer survivors, including control of body fat and improved functional outcomes and bone health."

    Weight-Lifting Improved Secondary Endpoints

    In this study, 141 breast cancer survivors with stable lymphedema of the arm were randomly assigned to a group that received twice-weekly progressive weight lifting or to a control group. While weight lifting, participants were required to wear a well-fitted compression garment. The main study endpoint was the change in arm and hand swelling, measured by displaced water volume of the involved and uninvolved upper extremity, at 1 year. Secondary endpoints were the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength.

    Limb swelling increase of at least 5% occurred in 11% of the weight-lifting group and in 12% of the control group (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 – 1.13).

    The weight-lifting group had greater improvements than the control group in self-reported severity of lymphedema symptoms (P = .03) and upper- and lower-body strength (P < .001 for both comparisons). In addition, the weight-lifting group had a lower incidence of lymphedema exacerbations, as determined by a certified lymphedema specialist (14% vs 29%; P = .04). Weight lifting was not associated with any serious adverse events.

    "In breast-cancer survivors with lymphedema, slowly progressive weight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength," the study authors write. "The results of this study reduce concerns that weight lifting will worsen arm and hand swelling associated with lymphedema in breast-cancer survivors."

    Limitations of this study include incomplete blinding, that multiple therapists were used to evaluate for exacerbations, and possible reporting bias.

    "The substantive treatment-related increases in strength, coupled with the lack of change in lean mass, indicate that the program was more focused on building muscle strength than on hypertrophy, as intended," the study authors conclude. "Further research is needed to determine the critical components of this intervention in order to facilitate its optimal use by breast-cancer survivors with lymphedema.... These findings support the potential benefits of a slowly progressive weight-lifting program in women with breast-cancer–related lymphedema, in conjunction with appropriate use of compression garments and close monitoring for arm and hand swelling."

    Promising Results, More Research Needed

    In an accompanying editorial, Wendy Demark-Wahnefried, PhD, RD, from M.D. Anderson Cancer Center in Houston, Texas, calls this intervention "promising" but recommends critical follow-up research, including detailed cost analysis and dissemination analyses.

    "The report by Schmitz et al. provides strong reassurance regarding the safety of appropriately supervised weight training in women with a history of breast cancer and lymphedema," Dr. Demark-Wahnefried writes.

    "A comprehensive strategy to improve the outcomes in these women should include dietary and exercise interventions aimed at weight management, since overweight, obesity, and weight gain after diagnosis are recognized as significant risk factors for lymphedema as well as for breast-cancer–associated death. Multifactor interventions that promote healthy eating, regular exercise (e.g., aerobic and progressive resistance training), and other lifestyle improvements (e.g., reducing smoking and alcohol use) have the potential to substantially improve overall health and survival among women with this common cancer."

    The National Cancer Institute and the National Center for Research Resources supported this study. BSN Medical provided custom-fitted compression garments, and the fitness centers where the weight-lifting sessions took place (YMCA of Philadelphia and Vicinity, Sisters in Shape, and the Family YMCA of Burlington County, NJ) provided discounted membership fees for study participants. The study authors have disclosed no relevant financial relationships. Dr. Demark-Wahnefried has disclosed that she receives honoraria for consulting at the Livestrong Centers for Excellence at Ohio State University and at the University of Pennsylvania.

    N Engl J Med. 2009;361:664–673; 710–711. Abstract
  • This comment has been removed by the Moderator
  • dyaneb123
    dyaneb123 Member Posts: 950
    unknown said:

    This comment has been removed by the Moderator

    So what's with the Ababic
    So what's with the Ababic posts Haytham? Most peculiar......

    Yeah, I read that lifting weights may be good for lymphodema after all. I'm glad you posted that article.
  • m_azingrace
    m_azingrace Member Posts: 399

    Hi Dawn, I don't have
    Hi Dawn, I don't have lymphedema but know there are some here who do. I was going to start a thread with this article but now seems like a good time to post it. Hope you find it useful. Sorry it's so long.

    jan

    Slowly Progressive Weight Lifting May Be Helpful in Breast Cancer Survivors With Lymphedema CME
    News Author: Laurie Barclay, MD
    CME Author: Désirée Lie, MD, MSEd


    August 14, 2009 — Slowly progressive weight lifting may be helpful in breast cancer survivors with lymphedema, according to the results of a randomized controlled trial reported in the August 13 issue of the New England Journal of Medicine.

    "Weight lifting has generally been proscribed for women with breast-cancer–related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density," write Kathryn H. Schmitz, PhD, MPH, from the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine and Abramson Cancer Center in Philadelphia, and colleagues.

    "A program of controlled exercise through weight lifting may increase the physical-work capacity of the affected arm, thereby protecting it from injury sustained during common daily activities. Weight lifting offers additional benefits particularly relevant to breast-cancer survivors, including control of body fat and improved functional outcomes and bone health."

    Weight-Lifting Improved Secondary Endpoints

    In this study, 141 breast cancer survivors with stable lymphedema of the arm were randomly assigned to a group that received twice-weekly progressive weight lifting or to a control group. While weight lifting, participants were required to wear a well-fitted compression garment. The main study endpoint was the change in arm and hand swelling, measured by displaced water volume of the involved and uninvolved upper extremity, at 1 year. Secondary endpoints were the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength.

    Limb swelling increase of at least 5% occurred in 11% of the weight-lifting group and in 12% of the control group (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 – 1.13).

    The weight-lifting group had greater improvements than the control group in self-reported severity of lymphedema symptoms (P = .03) and upper- and lower-body strength (P < .001 for both comparisons). In addition, the weight-lifting group had a lower incidence of lymphedema exacerbations, as determined by a certified lymphedema specialist (14% vs 29%; P = .04). Weight lifting was not associated with any serious adverse events.

    "In breast-cancer survivors with lymphedema, slowly progressive weight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength," the study authors write. "The results of this study reduce concerns that weight lifting will worsen arm and hand swelling associated with lymphedema in breast-cancer survivors."

    Limitations of this study include incomplete blinding, that multiple therapists were used to evaluate for exacerbations, and possible reporting bias.

    "The substantive treatment-related increases in strength, coupled with the lack of change in lean mass, indicate that the program was more focused on building muscle strength than on hypertrophy, as intended," the study authors conclude. "Further research is needed to determine the critical components of this intervention in order to facilitate its optimal use by breast-cancer survivors with lymphedema.... These findings support the potential benefits of a slowly progressive weight-lifting program in women with breast-cancer–related lymphedema, in conjunction with appropriate use of compression garments and close monitoring for arm and hand swelling."

    Promising Results, More Research Needed

    In an accompanying editorial, Wendy Demark-Wahnefried, PhD, RD, from M.D. Anderson Cancer Center in Houston, Texas, calls this intervention "promising" but recommends critical follow-up research, including detailed cost analysis and dissemination analyses.

    "The report by Schmitz et al. provides strong reassurance regarding the safety of appropriately supervised weight training in women with a history of breast cancer and lymphedema," Dr. Demark-Wahnefried writes.

    "A comprehensive strategy to improve the outcomes in these women should include dietary and exercise interventions aimed at weight management, since overweight, obesity, and weight gain after diagnosis are recognized as significant risk factors for lymphedema as well as for breast-cancer–associated death. Multifactor interventions that promote healthy eating, regular exercise (e.g., aerobic and progressive resistance training), and other lifestyle improvements (e.g., reducing smoking and alcohol use) have the potential to substantially improve overall health and survival among women with this common cancer."

    The National Cancer Institute and the National Center for Research Resources supported this study. BSN Medical provided custom-fitted compression garments, and the fitness centers where the weight-lifting sessions took place (YMCA of Philadelphia and Vicinity, Sisters in Shape, and the Family YMCA of Burlington County, NJ) provided discounted membership fees for study participants. The study authors have disclosed no relevant financial relationships. Dr. Demark-Wahnefried has disclosed that she receives honoraria for consulting at the Livestrong Centers for Excellence at Ohio State University and at the University of Pennsylvania.

    N Engl J Med. 2009;361:664–673; 710–711. Abstract

    Thanks for posting this
    Thanks for posting this report. However it looks to be about using the hand-held weights, though, rather than bench pressing. I would advise asking your doctor, or a physical therapist who is trained in lymphedema exercise and therapies if you can do heavy weightlifting.
  • Ltalcott
    Ltalcott Member Posts: 119
    back to the gym
    I lift weights two-three times a week. I had a bilateral mastectomy on March 4th, and started back at the gym the first of May. I didn't lift weights for maybe a week, and then I mostly went through the paces, not much weight at all. (Not that I'm any kind of a power lifter.) I was back to normal by the end of July and then I took another three weeks off after nipple construction on August 4th. Not back up the full weights yet. When I returned to work, the doctor's note said no lifting over ten pounds. I don't think he meant no weight lifting over ten pounds!

    On thing that is starting to bother me is that I can't do a sit up. I actually have to roll on my side to get out of bed. I get on an exercise ball and try to do curls, but even though no muscles were cut or removed in the DIEP reconstruction, I can't do it.

    Lisa
  • mlmjt1
    mlmjt1 Member Posts: 537
    Hi Dawn
    I had bilateral mastectomies in May and am currently doing chemo. I had 21 lymphnodes removed from the right side. I did see an occupational therapist who was trained in lymphedema massage and was taught the technique for doing myself. The therapist told me that I could start lifting light, and I mean light weights and I am talking 1 to 3 pounds. I was also advised to purchase a compression sleeve for the right arm if I played tennis but she wasnt thrilled about me playing tennis. We bike alot and she also advised me to purchase a bike where I didnt lean on the handle bars. She says that contributes to lymphedema as well. I do yoga and she didnt want me to bear too much weight on my arms doing yoga. My lymphedema has not been in the arms but rather the remaining breast tissue and along the back next the arm. It has not been severe. I do think lymphedema is directly related to the number of nodes removed. Resistance exercises may be an issue especially if you lift heavy weights.

    Maybe she is just being cautious...
    Hugs
    Linda T
  • lanie940
    lanie940 Member Posts: 490
    Ltalcott said:

    back to the gym
    I lift weights two-three times a week. I had a bilateral mastectomy on March 4th, and started back at the gym the first of May. I didn't lift weights for maybe a week, and then I mostly went through the paces, not much weight at all. (Not that I'm any kind of a power lifter.) I was back to normal by the end of July and then I took another three weeks off after nipple construction on August 4th. Not back up the full weights yet. When I returned to work, the doctor's note said no lifting over ten pounds. I don't think he meant no weight lifting over ten pounds!

    On thing that is starting to bother me is that I can't do a sit up. I actually have to roll on my side to get out of bed. I get on an exercise ball and try to do curls, but even though no muscles were cut or removed in the DIEP reconstruction, I can't do it.

    Lisa

    I will have to ask one of my
    I will have to ask one of my friends who had a TRAM flap if she can do sit-ups.But knowing my dear friend, she probably hasn't done sit-ups since we were in Gym class in elementary school. LOL! She told me her stomach was flat after her TRAM-Flap 11 yrs ago, but now she has gained back all the fat. Some people just can't be thin or normal weight. that is the case with my friend. I am so happy for her that she has had no re-occurance of cancer though!
  • lanie940
    lanie940 Member Posts: 490
    My friend I spoke of in a
    My friend I spoke of in a previous post had DCIS and she had only the mastectomy on her side with the DCIS. She has had no re-occurance on the other breast, she thought she might have some necrosis in the breast that was reconstructed after her surgery, but she didn't.
  • lolad
    lolad Member Posts: 670
    lanie940 said:

    My friend I spoke of in a
    My friend I spoke of in a previous post had DCIS and she had only the mastectomy on her side with the DCIS. She has had no re-occurance on the other breast, she thought she might have some necrosis in the breast that was reconstructed after her surgery, but she didn't.

    You definately
    Have to give yourself at least 6 weeks to recuperate from the mastectomy. As far as lifting after that i would definately ask your doc. take care

    laura
  • bfbear
    bfbear Member Posts: 380
    lolad said:

    You definately
    Have to give yourself at least 6 weeks to recuperate from the mastectomy. As far as lifting after that i would definately ask your doc. take care

    laura

    Weights
    I had a dbl. mastectomy in May, with reconstruction at the same time. Also DCIS. Other than sentinel nodes, no other nodes were removed, so there was no issue of lymphadema.

    You definitely need 6 weeks of recovery time to let your body heal and you should talk to your doctor. You don't want ot rip stitches or more muscle.

    After 6 weeks, I started "testing the waters," with various exercises and weights to see what I could do. The muscles healing over the implants have definitley been an inhibiting factor, but at this point I can do pushups, yoga arm balances, sea-kayaking, and I'm working back up to heavier stuff. I am 54 years old. I doubt I will ever be "ripped" again, but that's OK. I think you can probably push it as far as you're willing to go, if you don't have more than a couple of nodes removed...at least that's what I've been told. I believe if I had the time and inclination to go back to being a "gym rat," I could.

    So....talk to your doc(s), and don't worry too far ahead!!! Remember to keep your priorities in perspective, too. That's my 2 cents worth!

    Stay strong,
    Debi
  • Dawne.Hope
    Dawne.Hope Member Posts: 823
    bfbear said:

    Weights
    I had a dbl. mastectomy in May, with reconstruction at the same time. Also DCIS. Other than sentinel nodes, no other nodes were removed, so there was no issue of lymphadema.

    You definitely need 6 weeks of recovery time to let your body heal and you should talk to your doctor. You don't want ot rip stitches or more muscle.

    After 6 weeks, I started "testing the waters," with various exercises and weights to see what I could do. The muscles healing over the implants have definitley been an inhibiting factor, but at this point I can do pushups, yoga arm balances, sea-kayaking, and I'm working back up to heavier stuff. I am 54 years old. I doubt I will ever be "ripped" again, but that's OK. I think you can probably push it as far as you're willing to go, if you don't have more than a couple of nodes removed...at least that's what I've been told. I believe if I had the time and inclination to go back to being a "gym rat," I could.

    So....talk to your doc(s), and don't worry too far ahead!!! Remember to keep your priorities in perspective, too. That's my 2 cents worth!

    Stay strong,
    Debi

    Thank you, ladies!
    I really

    Thank you, ladies!

    I really had no idea and what you've shared is helpful. I thought it was a definite no no to lift if you had lymphedema and that belief seems to be changing, although it's gotta be light.

    Debi, you're right about perspective. This by no means is the most important thing, it's just something I've been wondering about and no seemed to be able to give me any answers until I posted something here.

    Thanks again, ladies! Your attitudes are such an encouragement to me. Our lives are forever changed, but it's nice to know that maybe some things can still stay the same.

    Trying to stay strong,
    d.h
  • Angie2U
    Angie2U Member Posts: 2,991
    dyaneb123 said:

    So what's with the Ababic
    So what's with the Ababic posts Haytham? Most peculiar......

    Yeah, I read that lifting weights may be good for lymphodema after all. I'm glad you posted that article.

    I had a lumpectomy, but, I
    I had a lumpectomy, but, I was told to still be careful. I am exercising, I just don't go to a gym. You should probably check with your plastic surgeon and oncologist to see what they think.

    Angie
  • nbabq
    nbabq Member Posts: 3
    bi-lateral
    I exercise with weights. I personally know 5 people that got it in the other breast years later and had to go through that treatment all over again. So I decided to do a bi-lateral and plan to go to New Orleans to get DIEP reconstruction soon.
  • e_hope
    e_hope Member Posts: 370
    I had a double mastectomy
    I had a double mastectomy with 8 nodes removed. I am seeing a physical therapist for lymphedema. Mine is not serious I went early when I noticed just a slight swelling. I would consult a Physical Therapist and you doctor before starting with heavy weight training. It has always been taboo to lift heavy weight after lymphnodes are removed, they are only doing studies now if there is some benefit to lifting, but I'm not sure if those studies are with the type of lifting your talking about..

    I was told by my surgeon, If I would've done a tram flap. I would not be able to do sit ups anymore.. I had reconstruction done with expanders..