Breast cancer survivors have been getting bum advice. For decades, many doctors warned that lifting weights or even heavy groceries could cause painful arm swelling. New research shows that weight training actually helps prevent this problem.

    "How many generations of women have been told to avoid lifting heavy objects?" Dr. Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston, lamented after seeing the surprising results of the new study. "Women who were doing the lifting actually had fewer arm problems because they had better muscle tone."

    The study was led by Kathryn Schmitz, an exercise scientist at the University of Pennsylvania, and funded by the federal government. Results are in Thursday's New England Journal of Medicine.

    More than 2.4 million Americans are breast cancer survivors, and the study could mean a big difference in their quality of life. Cancer treatment-related arm swelling now appears to be one of many ailments made better by exercise - not worse, Schmitz said.

    "Fifty years ago we told people who had a heart attack not to exercise anymore," and people with sore backs to heal with bed rest, Schmitz said. "It was well-meaning advice but it was polar opposite of the truth."

    Women who have had radiation to the armpit, or lymph nodes removed to check for cancer, can suffer lymphedema - a buildup of fluids that causes painful and unsightly swelling of the arms or hands.

    To avoid it, doctors have advised women to avoid using the affected arm to lift toddlers, carry a heavy purse or scrub floors. Even activities like golf and tennis raised concern.

    Women think, "Oh, my God, I need to baby the arm," Schmitz said.

    Lifting weights - which boosts mood, muscle mass, bone strength and weight control - was thought to be a bad idea for women prone to lymphedema.

    Schmitz challenged that notion with a small study several years ago, finding that weight training did not make lymphedema worse. Her new study is the first one large and long enough to give clear proof that this is so, and even suggests that weightlifting can help.

    It involved 141 breast cancer survivors who had suffered lymphedema. Half were told not to change their exercise habits. The rest were given 90-minute weightlifting classes twice a week for 13 weeks at community gyms, mostly YMCAs.

    They wore a custom-fitted compression garment on the affected arm and gradually worked up to more challenging weights and repetitions. For the next 39 weeks, they continued these exercises on their own.

    The women's arms were measured monthly. After one year, fewer weightlifters had suffered lymphedema flare-ups - 14 percent versus 29 percent of the others. Weightlifters reported fewer symptoms and greater strength. Rates of change in arm size due to swelling were similar in both groups.

    "I found it was really very effective. It not only gave me strength and mobility but it improved my balance and coordination," said one participant, Clare Faber, 66, of suburban Philadelphia. "It really does offer women hope."

    Another participant, Gay McArthur, 56, of Smithfield, N.J., has continued weightlifting on her own since the study ended.

    "When I first got diagnosed with lymphedema, they said I couldn't lift more than five pounds," she said. But weight training caused no problems and has made her feel better, she said.

    It also should save money, though the study did not measure this, Wendy Demark-Wahnefried, of the University of Texas M.D. Anderson Cancer Center in Houston, wrote in an editorial in the medical journal. In the study, the group of weightlifters made only 77 visits to doctors or physical therapists for lymphedema flare-ups versus 195 visits for the others, she noted.

    Another part of the study is evaluating whether weight training can prevent a first case of lymphedema in breast cancer survivors; results are expected soon, Schmitz said.

    Breast cancer survivors should not rush into weight training - that could trigger problems. Schmitz suggests:

    -Have a certified fitness professional teach you how to do the exercises properly.

    -Start slow, with a program that gradually progresses.

    -Wear a well-fitting compression garment during workouts.

    乳腺癌的康復(fù)患者一直以來都在收到各種毫無價(jià)值的建議。過去的幾十年里，許多醫(yī)生警告說，舉重或者即使是搬動(dòng)重物，都可能引起臂部的腫脹酸痛。新的研究表明，練習(xí)舉重實(shí)際上可以幫助避免這一問題。

    "曾有多少代婦女被告知說不要搬弄重物��？"當(dāng)波士頓丹娜-法伯癌癥研究中心的埃里克。溫納博士，看到新的研究所作出的出人意料的結(jié)論后，這樣悲嘆道。"事實(shí)上，婦女做提舉運(yùn)動(dòng)對臂部損傷甚少，因?yàn)樗齻兡苡懈�好的肌肉緊張度。"

    這項(xiàng)研究由賓夕法尼亞大學(xué)的訓(xùn)練學(xué)家凱瑟琳。施米茨領(lǐng)銜，并受到聯(lián)邦政府的資助。研究結(jié)果發(fā)表在了周三出版的《新英格蘭醫(yī)學(xué)期刊》上。

    美國有超過240萬名乳腺癌康復(fù)患者，這項(xiàng)研究意味著他們的生活品質(zhì)將大為改觀。施米茨說，與癌癥治療相關(guān)的臂部腫脹，目前被看做是許多小癥狀之一，可以通過訓(xùn)練得以改善，而不是惡化。

    "五十年前，我們告誡患有心臟病的人們不要再做任何鍛煉，"而受疼痛困擾的人們也就此呆在床上等著康復(fù)，施米茨說。"這種建議的意向是好的，但卻徹底背離了事實(shí)。"

    那些腋下接受放射或移除淋巴結(jié)以檢查癌癥的婦女，可能會(huì)患上淋巴水腫--它阻塞了體液，會(huì)導(dǎo)致臂部和手部疼痛，并且產(chǎn)生難看腫脹。

    為了避免這一問題，醫(yī)生們曾建議婦女不要用患病的手臂去抱小孩、攜帶沉重的手提包或擦洗地板。甚至像高爾夫和網(wǎng)球這類運(yùn)動(dòng)也會(huì)引發(fā)擔(dān)憂。

    而女人們會(huì)想，"哦，天吶，我得好好照料這只手臂才行，"施米茨說。

    對于易于患上淋巴水腫的婦女們來說，練習(xí)舉重不是個(gè)好主意，盡管它可以改善情緒和肌肉質(zhì)量，提升骨骼強(qiáng)度，還能調(diào)節(jié)體重。

    施米茨早在幾年前就通過一個(gè)小型的研究對以上說法提出了質(zhì)疑，發(fā)現(xiàn)練習(xí)舉重不會(huì)導(dǎo)致淋巴腫脹惡化。此次是她進(jìn)行的第一次新的大規(guī)模和長時(shí)間的研究，為她的論點(diǎn)給出了明確的證據(jù)，而且還指出舉重對康復(fù)患者有益處。

    研究針對141名患上了淋巴水腫的乳腺癌康復(fù)患者。其中有一半人被告知不要改變他們的鍛煉習(xí)慣。其余的人在社區(qū)體育館內(nèi)參加每周兩次，每次90分鐘的舉重訓(xùn)練課程，共持續(xù)13周。

    他們穿著為患病的手臂定制的緊身服裝，逐漸提升舉起的重量，增加練習(xí)的次數(shù)。在此后的39周時(shí)間里，他們依靠自身將這一鍛煉堅(jiān)持了下去。

    這些婦女每月都會(huì)接受臂部檢查。一年后，練習(xí)舉重的人中淋巴水腫發(fā)作的人數(shù)比另一組要少--14%比29%.練習(xí)舉重者顯現(xiàn)的癥狀更少，而且力量更足。在兩組研究對象中，因?yàn)槟[脹而引起的臂部尺寸的變動(dòng)率相近。

    "我覺得舉重真的很管用。它不僅增強(qiáng)了我的力量和靈活性，而且也讓我的平衡感和協(xié)調(diào)性有了提高，"來自費(fèi)城郊區(qū)的研究參與者，66歲的卡萊爾。法伯說。"這的確給了女人們希望。"

    另一位參與者是56歲的蓋伊。麥克阿瑟，來自新澤西州的史密斯場，她在研究結(jié)束后仍堅(jiān)持去練習(xí)舉重。

    "我第一次被診斷有淋巴腫脹的時(shí)候，他們告訴我說我最多不能舉超過5磅的東西，"她說。但舉重訓(xùn)練沒有引起任何問題，而且讓她感覺更棒了。

    盡管研究中沒有做評估，但練習(xí)舉重也會(huì)省錢，德克薩斯大學(xué)安德森腫瘤中心的溫迪。德馬克沃納菲瑞德，在這期醫(yī)學(xué)雜志的一篇評論中寫道。在此次研究中，她指出，在練習(xí)舉重的一組中，因?yàn)榱馨退�腫發(fā)作去看醫(yī)生或物理治療師的次數(shù)僅有77次，而另一組有195次之多。

    研究的另一部分是評測舉重訓(xùn)練能否幫助乳腺癌康復(fù)患者阻止淋巴水腫的出現(xiàn)；施米茨說，結(jié)果很快就能得到。

    但乳腺癌康復(fù)患者也不要急沖沖地就去練習(xí)舉重，那樣可能會(huì)出問題。

    施米茨建議：

    -找一位有資質(zhì)的健康專家?guī)椭�你正確地練習(xí)。

    -開始先慢一些，制定一個(gè)計(jì)劃循序漸進(jìn)。

    -在練習(xí)時(shí)穿一件合適的緊身衣。