Evidence Update: Water Exercise and Lymphedema
A recent study examined the effect of water versus land exercise in improving lymphedema. Eighty-eight eligible patients with secondary lymphedema after breast or gynecological cancer participated in this controlled clinical intervention study. Patients participated in either a water-based or land-based exercise program. Researchers measured subject’s arm volume, as well as BMI, function, well-being and body image. In patients who participated in water exercises, more women had reduced arm limb volume and there were also significant improvements for these women in lower BMI and decreased self-reported frequency of swelling. Women with arm lymphedema in the land exercise group showed more improvement in upper extremity function and range of motion. Researchers conclude that water exercise may be offered to patients when the goal is to reduced lymphedema while to improve daily shoulder function, land exercises are preferred. Your TurningPoint physical therapist can help you develop an exercise plan that is designed specifically to help meet your unique goals. Lindquist H et al. Water exercise compared to land exercise or standard care in female cancer survivors with secondary lymphedema. Lymphology. 2015 Jun;48(2):64-79.
Evidence Update: Resistance Training Reduces Fatigue and Increases Quality of Life in Breast Cancer Survivors
A recent study examined the benefits of resistance training (as an adjunct to usual care) on quality of life and fatigue in breast cancer survivors. Subjects in the study were 39 breast cancer survivors, with an average age of 52 years and average time since diagnosis of 12 months. Fatigue and quality of life were measured with standard self-report questionnaires. Subjects were divided into two groups, an exercise and control group (usual activity only). The exercise group received supervised resistance training 3 days per week for 16 weeks. Perceptions of fatigue and quality of life improved significantly in the resistance training group compared to controls. The authors concluded that resistance training significantly improves fatigue and quality of life in breast cancer survivors. Hagstrom AD et al. Resistance training improves fatigue and quality of life in previously sedentary breast cancer survivors: a randomised controlled trial. Eur J Cancer Care (Engl). 2015 Nov 23. doi: 10.1111/ecc.12422. [Epub ahead of print] Resistance training (often used interchangeably with “strength training”) is the process of stressing the body (usually with weights, resistance bands, or the bodyweight) to increase a muscle’s size, strength, and/or endurance.
Evidence Update: Body Image and Sexuality after Breast Cancer
A recent review of research examined the relationship between breast cancer and body image and sexuality. Breast cancer treatment commonly alters a woman’s reproductive and sexual functioning, body integrity, and the ways in which she self-identifies as a sexual being. Research has shown that women with breast cancer experience significantly greater rates of sexual dysfunction and poorer body image than do healthy women. Unfortunately, most breast cancer patients are dissatisfied with the amount and quality of care they receive from their healthcare providers around sexuality. Although a substantial proportion of survivors experience difficulties with sexual functioning, reproduction, and body image, each woman’s experience is individual and influenced by a range of factors including age, stage of breast cancer, types of treatment and relationship status. This review of research in the field suggests that a high proportion of women experience difficulties with sexual health and self-concept secondary to breast cancer, yet an overwhelming number report receiving inadequate or nonexistent care in these domains from their healthcare providers. The authors state that there is too wide a gap between the needs of this population and the healthcare system’s response to such needs. The authors conclude that oncology professionals across a range of disciplines must be better trained to identify, assess, and treat such difficulties, preferably using a multimodal approach that includes biological, as well as psychological and social strategies. Please join us for this month’s education event that will focus on body image and sexuality during and after breast cancer treatment. You will gain a better understanding of the relationship between breast cancer and these issues and leave knowing you are not alone and with some strategies to help you address these issues. Male DA. Sexual identity after breast cancer: sexuality, body image, and relationship repercussions. Curr Opin Support Palliat Care. 2015 Dec 29. [Epub ahead of print]
Evidence Update: Lymphedema and Shoulder Pain
TurningPoint clinicians have long been aware that there is a relationship between long-standing lymphedema and shoulder pain and problems. In a study published last month, researchers in Korea examined the relationship between lymphedema and shoulder joint changes in breast cancer patients. Forty-seven breast cancer patients with lymphedema were assessed. The duration of the arm swelling and shoulder pain were recorded. Ultrasound examination of the shoulder joint was performed in all patients to detect any changes in the soft tissue around the shoulder joint. Interestingly, abnormalities were found in 87% of the 47 participants. These changes included thickening of the bursa and small tears in the rotator cuff tendons. The changes tended to be more significant in patients who had lymphedema for a longer period of time. The authors concluded that there is a relationship between shoulder problems and lymphedema and that clinicians should adopt an early management approach for shoulder pain in patients with breast cancer-related lymphedema, http://affectivebrain.com/?attachment_id=5775. TurningPoint’s lymphedema screening program which facilitates early detection and management of lymphedema, along with providing rehabilitation for shoulder issues when they occur, should reduce the impact of lymphedema on long-term shoulder issues. Yang DH et al. The Influence of Arm Swelling Duration on Shoulder Pathology in Breast Cancer Patients with Lymphedema. PLoS One. 2015 Nov 16;10(11):e0142950. doi: 10.1371/journal.pone.0142950. eCollection 2015.
