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Patients who have just undergone breast cancer surgery often develop pain, shoulder stiffness, and arm swelling after treatment. Doctors regularly prescribe preventative exercises, but sometimes the problems persist for years. In order to prevent the post-surgical pain and diminished range of motion, Cochrane Collaboration reviewers examined 24 research studies to find which type of exercise is best and how soon after surgery exercise should begin.
The Cochrane review found that beginning an exercise program one to three days after breast cancer surgery can help patients maintain shoulder movement and minimize loss of arm or shoulder function. Survivors who participated in a structured exercise program including physical therapy, as opposed to those who received only a pamphlet or no exercise instruction at all, had significant improvement in shoulder range of motion over the short and long term. The exercise programs included range of motion movements and stretching exercises.
However, lead review author Margaret McNeely, an assistant professor of physical therapy at the University of Alberta, cautions that there are concerns about aggressive movement so soon after surgery. “[It] may cause more wound drainage and require drains to remain in place longer than if exercise is delayed by about one week,” McNeely said. Earlier exercise lengthened wound-healing time by about one day.
The Cochrane team reviewed 24 studies comprising 2,132 women who had undergone surgeries such as radical mastectomy, modified radical mastectomy, or lumpectomy. All had surgery removing lymph nodes from the armpit to determine the extent of the cancer.
Dr. Douglas Blayney, medical director at the University of Michigan’s Comprehensive Cancer Center, said this review demonstrates how the early involvement of a health care team member who manages a patientâ€™s exercise or physical therapy would be useful for the best outcome in optimal breast cancer care.
The Cochrane Collaboration, which published the review, is an international organization that evaluates medical research.
For further information, please visit Medical News Today or The Cochrane Collaboration.
July 9, 2010