The Physical Activity and Lymphedema (PAL) Trial Study Summary

The Abramson Cancer Center of the University of Pennsylvania
Last Modified: December 18, 2005

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The purpose of this study is to test the effects of twice-weekly strength training on lymphedema symptoms and arm measurements, as well as quality of life for breast cancer survivors. The knowledge gained from this study may influence exercise recommendations for breast cancer survivors as well as help to promote a healthier lifestyle following treatment of breast cancer.

Lymphedema is one of the most common and often feared conditions associated with breast cancer treatment. There are an estimated 2-400,000 diagnosed cases in the United States. Those who experience lymphedema may have limited movement of their arms, a decrease in muscle strength, and restricted activity in daily life. Survivors may find lymphedema more distressing than a mastectomy as it is more difficult to hide the swelling and limited functioning of the arm.

Although there is no evidence to show that strength training exercise is harmful to breast cancer survivors, current clinical guidelines advise against participating in any vigorous upper body exercise, and in particular, lifting objects that weigh more than 5 to 15 pounds. Strength training can allow women to gradually increase their strength in a supervised setting, making it less likely that daily life activities like shoveling snow or carrying children would harm the lymphatic system and the arm.

Our research study is based on a smaller study involving progressive twice-weekly strength training in 81 recent breast cancer survivors. One group of women performed the strength training exercises for six months compared to a group of women who did not do strength training. In the group of women who did strength training, no one developed lymphedema, or experienced a worsening of symptoms if they had already been diagnosed with lymphedema. This information, along with other research on this topic, tells us that a larger study is needed to look at the effects of twice-weekly progressive strength training on lymphedema symptoms and the lymphatic system, as well as quality of life issues, compared to a non-exercising group of survivors. We will recruit 288 survivors (144 with lymphedema, 144 without lymphedema) 1-15 years post-breast cancer diagnosis to participate in this exercise intervention. The knowledge gained from this study may impact recommendations for therapy, participation in activities of daily living, and recommendations for exercise for health promotion in breast cancer survivors.

This research will take place in the Philadelphia, PA metropolitan area. All participants receive a free one year membership to a gym/fitness center in the metro region, access to a qualified fitness trainer, access to a physical therapist, and financial compensation. We are looking to recruit women who have been diagnosed 1 – 15 years ago and have had at least 2 lymph nodes removed during treatment. For more information about this study, or to see if you are eligible, please contact Amy Rogerino at 215-898-5112 or e mail her at


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