A Weighty Matter — Lifting after Breast Cancer  

Oleh:

Demark-Wahnefried, Wendy

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 361 no. 07 (Aug. 2009), page 710-711.
Topik: Breast cancer

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2009.04 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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In 1996, the Canadian Medical Association Journal featured a cover story entitled "Breast-cancer survivors begin to challenge exercise taboos."1 This story appeared during an era when lymphedema was reported in up to 62% of women treated for breast cancer, and patients were cautioned against making repetitive arm movements and lifting more than 10 to 15 lb (4.5 to 6.8 kg). The article also chronicled the fledgling research efforts of a group of Canadian investigators who were exploring progressive resistance training (exercise regimens that promote gradual increases in intensity, frequency, and load to improve muscle strength) as a means to improve physical function and the quality of life, testing the hypothesis that such exercise may actually reduce the risk of lymphedema or at least not exacerbate it.2,3 At that time, there was speculation about the potential benefits of progressive resistance training on the lymphatic system,4 yet the Canadian research was in direct opposition to clinical practice that advocated limitations on weight lifting. The concern about weight lifting has largely been based on epidemiologic studies of women who had undergone axillary-node dissection or radiation therapy, in which significant associations between infection or injury to the affected arm and lymphedema were reported.5 Although injury and infection are different, they unfortunately were grouped together in the analysis. Furthermore, in translating these data to simple "patient-friendly" steps for the prevention of lymphedema, a strategy of avoidance, rather than rehabilitation, was adopted. Three widely disseminated recommendations cautioned against vigorous, repetitive arm movements ("[do not engage in] scrubbing, pushing, pulling, and hammering"), heavy lifting ("never carry heavy handbags and grocery bags . . . [and] do not lift more than 15 pounds"), and resistance training exercises that "overtire an arm at risk." Though the recommendations advocated exercise, suggested activities were limited to walking, swimming, light aerobics, bike riding, and "specially designed ballet or yoga." But what should a woman do if, after her treatment, she returns home to a houseful of toddlers or has to push a mop for a living?

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