Exercise at home may relieve lymphedema in breast cancer

By Sarah Guy, medwireNews Reporter

Women who complete an at-home exercise program designed to treat breast-cancer-related lymphedema have significantly reduced excess limb volume (ELV) measurements after 6 months compared with their peers who undertake standard care alone, show study results.

While the study involved only a small number of participants, "the results support the findings of other exercise studies which have shown trends towards improvement," say the researchers.

The exercise intervention required no specialist equipment and was "simple and easy to teach," they add, in Supportive Care in Cancer, remarking that 10 study participants intended to continue the exercises after the study end.

In all, 23 women with breast cancer-related lymphedema - the accumulation of fluid in the tissues as a result of reduced lymph drainage routes - were randomly assigned to undertake either standard self-care (n=12), involving the use of compression hosiery, skin care, and general activity and exercise; or to the exercise intervention (n=11).

The intervention involved a series of gravity-resistive arm exercises, designed to stimulate manual lymphatic drainage. Participants were instructed to complete them daily (10-15 minutes) while wearing compression hosiery, explain Eunice Jeffs (Guy's and St Thomas' NHS Foundation Trust, London, UK) and co-workers.

Women attended follow ups at weeks 0, 4, 12, and 26 of the study for assessment of limb measurements and other clinical and demographic factors including quality of life (QoL). The researchers calculated ELV taking into account individual variations in size and changes to body mass.

At the 12-week follow up, Jeffs and colleagues report a significant reduction in ELV from baseline for both the standard-care and intervention groups, at 2.83% and 8.08%, respectively. ELV reduced further still by week 26, but not by a significant amount, notes the team.

But after exclusion of one participant who had extreme measurements at weeks 12 and 26 that were considered to contain unexplained anomalies, the reduction in ELV at week 26 was significant for the intervention group but not for the standard-care group, at 11.7% versus 9.2%.

While the researchers observed no measured improvement in QoL markers, participants in the intervention group spontaneously reported benefits they had seen in their arm, using words including "lighter," "softer," and "smoother" to describe it.

On this basis, the team recommends that outcome measures in future studies should include monitoring of participants' perceptions of benefit, in addition to clinical measurements.

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