Results Point to New Ways to Measure – and Improve – Quality of Life Among Survivors 

PHILADELPHIA – In addition to building muscle, weightlifting is also a prescription for self-esteem among breast cancer survivors, according to new University of Pennsylvania School of Medicine research. Breast cancer survivors who lift weights regularly feel better about bodies and their appearance and are more satisfied with their intimate relationships compared with survivors who do not lift weights, according to a new study published in the journal Breast Cancer Research and Treatment.

Survivors’ self-perceptions improved with weight lifting regardless of how much strength they gained during the year-long study, or whether they suffered from lymphedema, an incurable and sometimes debilitating side effect of breast surgery.

“It looks like weight training is not only safe and may make lymphedema flare ups less frequent, but it also seems help women feel better about their bodies,” says senior author Kathryn Schmitz, PhD, MPH, an associate professor of Epidemiology and Biostatistics and a member of Penn's Abramson Cancer Center. “The results suggest that the act of spending time with your body was the thing that was important –– not the physical results of strength.”

The new insights come from a randomized controlled trial that tested the impact of twice-weekly weight lifting for 12 months on survivors’ health and emotional status. In the first report from the trial, published in the New England Journal of Medicine in August, Schmitz and colleagues found that lymphedema sufferers who lifted weights were less likely to experience a worsening of their arm-swelling condition.

But the benefits extend further: Survivors who participated in regular weight-lifting during the trial had a 12 percent improvement in their body image and satisfaction with their intimate relationships over the 12 months of the study, compared with a 2 percent improvement reported by the women in the control group of the study. Both groups of women benefited emotionally from the weight lifting in the study, called the Physical Activity and Lymphedema (PAL) trial.

Unlike many medical study questionnaires that ask about general quality of life factors, the one used in this study was developed specifically for – and by -- breast cancer survivors. Called the Body Image and Relationship Scale, the questionnaire was developed with the help of survivors who had participated in previous clinical trials. The new data are drawn from questionnaires completed by 234 breast cancer survivors at the beginning and end of the trial.

“They told us the basic quality of life questionnaire didn’t cover what was important to them,” Schmitz says. “They told us what was changing with regular weight lifting and what they cared about, including feeling more proud of their bodies, feeling more comfortable in their own skin, feeling more empowered emotionally because they were more physically powerful, feeling sexier, feeling more like they could wear sleeveless things, feeling more comfortable having people touch their upper bodies, and some of them reported their sex lives improved.”

To Schmitz’s surprise, no such quality of life questionnaire existed when she initiated the PAL trial, so she and her team designed the Body Image and Relationship Scale. “There has been an aching need for this assessment tool, not just here, but internationally,” Schmitz says. “The survey has already been translated into five other languages – Spanish, Italian, Portuguese, Hebrew, and Swedish – and efforts to use it in clinical practice are underway. These are the issues that women have reported that they cared about for a long time but nobody was ever asking them the question.”

Other study authors included Rebecca M. Speck, Cynthia R. Gross, Julia M. Hormes, Rehana L. Ahmed, Leslie A. Lytle and Wei-Ting Hwang.

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