Last Modified: January 11, 2009
Dear OncoLink "Ask The Experts,"
I am about to start radiation therapy for breast cancer. Can I swim during this time? I have heard conflicting reports about exercise during therapy.
Linda McGrath Boyle PT, DPT CLT-LANA, Cancer Rehab Specialist and OncoLink Lymphedema Team Editor, responds:
Your doctors, including the surgeon, medical oncologist, and radiation oncologist, will need to give approval for you to swim based on your specific situation. If you have no open, erythemic (red), or rashy skin areas and are not immunosuppressed (this is especially a concern in public pools, which can have lots of germs), swimming may be allowed. Many patients undergoing radiation therapy do have some type of skin eruptions after the first 2 weeks of therapy, so you will need to frequently revisit the issue with your radiation oncologist while on therapy.
Underwater exercise is great for increasing the external pressure exerted on the skin and can help to avoid swelling in the affected areas. Swimming will not in itself prevent lymphedema. Most importantly, gradually increasing exercise time and effort are key to avoiding sudden increases in circulation, increased blood capillary pressure, and the influx of edema (swelling), thereby helping to avoid TRIGGERING the lymphedema. (We use the term "preventing" lymphedema, but this is probably not accurate, and trying not to “trigger” the lymphedema may be a better way to describe it.”.
Persons at risk for lymphedema (breast cancer survivors) should moisturize their skin and prevent injury or open areas to avoid introduction of bacteria and therefore infection in the affected lymphatic quadrant.
We know that diaphragmatic breathing is helpful in facilitating lymphatic return. We also know that muscle contractions assists in movement of lymph fluid from the extremities to the central lymphatics.
Kathryn Schmitz completed the PAL study for breast cancer survivors that speaks to the benefits of exercise in this population. The following article was published about this study:
Randomized controlled trial of weight training and lymphedema in breast cancer survivors.
Ahmed RL, Thomas W, Yee D, Schmitz KH.
J Clin Oncol. 2006 Jun 20;24(18):2765-72.