How Exercise And Nutrition Can Help You Deal With Lymphedema
Lymphedema is a chronic swelling caused by an insufficiency or damage to the lymphatic system.
While not exclusive to cancer patients and survivors, many cancer survivors are becoming outspoken advocates for the condition, including award-winning actor and breast cancer survivor Kathy Bates.
Bates, like other breast cancer survivors, was looking forward to life after treatment when she could return to her usual activities. But, her treatment involved the removal of 19 lymph nodes from both underarms. Almost immediately after her surgery, she began to experience lymphedema in both arms. Today, she reports that even holding a book is difficult.
Not everyone who has breast cancer develops lymphedema. But if you have had lymph nodes removed or lymph nodes in the radiation field then you have a lifelong risk of developing lymphedema.
According to Stanley Rockson, MD, if you have had one lymph node removed your lifetime risk of developing lymphedema goes up by 6%. If you have had more than one removed that risk goes up to 15% and increases with each additional node removed.
Thankfully, there are several tools you have at your disposal to reduce that risk and manage the condition should it occur. Two of those tools are exercise and diet. It used to be thought that women should refrain from exercise after breast cancer for fear of promoting lymphedema.
This belief was challenged when 20 women sat abreast in a dragon boat in 1996 and demonstrated that, even with a sport as intensive to the upper body as dragon boat paddling, that lymphedema was not brought on by exercise. Since then, more research has supported the now established recommendation that exercise is beneficial for both prevention and management of lymphedema.
EXERCISE FOR LYMPHEDEMA
Exercise is one of the four components of Complete Decongestive Therapy (CDT) which is the treatment used to manage lymphedema. The other three components of CDT are bandaging, manual lymphatic drainage and compression.
Exercise is very important to lymphedema as it engages the joint and the muscle pumps, which help return lymphatic fluid to the blood supply. If you have lymphedema then exercise should be done while wearing either compression bandages, sleeve or chest garments to help create a positive working pressure and enhance the return of lymphatic fluid to the heart.
Strengthening exercises such as the specialized program Strength After Breast Cancer (SABC) have been proven to be a safe and effective way to increase muscle strength without worsening lymphedema swelling or risk. All exercise should be done in a slow, progressive way as to not overwhelm the lymphatic system and ideally under the supervision of a certified lymphedema therapist.
DIET FOR LYMPHEDEMA
Nutrition and diet are another tool for the prevention and treatment of lymphedema. Probably the biggest risks to lymphedema would be obesity and a high salt diet. Many cancer survivors can be concerned about being underweight, but evidence from the World Research Cancer Fund tells us that excess body fat is a risk factor, and so being lean can be protective.
It is important though, not to lose weight too quickly. Based on some research, it is best to stick within a 2 lb per week goal. There is some thought that if weight loss is too rapid, the overstretched skin doesn’t shrink quickly enough, and the extra space could be filled by lymphatic fluid.
Be careful with your salt, alcohol and fat intake – three key diet triggers for lymphedema. Other diet strategies include an anti-inflammatory diet and time-restricted eating.
LYMPHEDEMA AND CANCER RISK REDUCTION
Many of the strategies to reduce the risk of cancer recurrence are consistent with reducing lymphedema risk including; being physically active, gradually reducing excess body fat, reducing the total fat, saturated fat and alcohol intake.
It is best to work with a registered dietitian who understands both cancer and lymphedema and a certified lymphedema therapist to learn about all of the tools you can use to reduce your risk and manage lymphedema.
To find out more about lymphedema, how to protect yourself, how to manage the condition once you have it, read The Complete Lymphedema Management and Nutrition Guide by Jean LaMantia, RD and Ann DiMenna PT, CDT, available wherever books are sold.
About the Authors
Ann DiMenna is a physiotherapist and certified lymphedema therapist with a thriving lymphedema clinic in Markham, Ontario.
Jean LaMantia is a cancer survivor and registered dietitian that specializes in nutrition during and after cancer as well as the specialized care of people with lymphedema.
They recently released their first book together, The Complete Lymphedema Management and Nutrition Guide. Find out more about Jean and Ann from their websites; www.jeanlamantia.com and www.markhamlymphaticcentre.com