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Topic: vigorous exercise before lumpectomy

Forum: Just Diagnosed — Discuss next steps, options, and resources.

Posted on: Jul 17, 2008 07:19PM

Faith1 wrote:

I am wondering if there is any risk in exercising vigorously (specifically swimming at a pretty intense level) before my 1 cm not in situ cancer is removed by lumpectomy. There is no evidence yet of cancer in nodes-I will not know until the surgery. But a couple lymphs have been swollen since my needle biopsy and when I swim the lymph area I can feel is tender. Will intense exercise of my arm effect any kind of spreading if the cancer if it is in a lymph node? Or can intense exercise of the arm make the cancer spread more quickly to the lymph node? Is anyone informed on this? Swimming right now is my solace and swimming hard really helps me let out the tension of this super intense time. Has anyone been advised on this subject? Thanks

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Jul 17, 2008 08:02PM Shirlann wrote:

Hmm, hopefully Beesie will pop back in, she is truly our resident genius. But truly, this has not come up very often.  I understand completely the joy and uplifting of your regular excercise and also do not have any specific info concerning this.  This is a very interesting question, I will see if I can find Beesie, she is up on everything.

In any case, good luck with the lumpectomy, mine was nothing.  I know not all the lumpectomies are the same, but I walked in, hoped up on the table, they numbed me with novocaine, took it out in about 10 minutes, sewed me back up, I waited about an hour in the out-patient recovery room, and went out to lunch with my husband.  Very few nerves in your breast, so there is little pain, for MOST of us.  As always, if your lump is very large, or deep, all bets are off.  But mine was truly nothing.  If it wasn't for the seriousness of the whole thing, I would rather do this than go to the dentist.  Remember, you don't poop, pee, eat, walk, laugh or sit on your breast, it is a very good place to have surgery.

I will go find Beesie for you.

Gentle hugs, Shirlann 

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Jul 17, 2008 08:14PM, edited Jul 17, 2008 09:33PM by Liz08

Faith-

you can't assume that you have cancer in your lymph nodes because they're swollen after the biopsy. You did comment that  the nodes have been swollen since the biopsy which may mean that they are reacting to trauma such as the biospy otherwise known as "reactive hyperplasia".  Lymph nodes can swell from a tiny cut or even from shaving under the arm because they are very sensitive and it's their job to fight off infection.  

I just found my "post biospy instructions" "no heavy lifting or strenuous exercise for 24 hours, otherwise, you can resume normal activities after this procedure."

As far as exercise, verbally I was told it was OK  to exercise (I did running, walking and hand weights) but told  to wait a few days after the biospy.  As Shirlann said may be Beesie can answer some of this better. 

I had a hard time with my lumpectomy which I had back in February and am still having alot of pain but everyone is different.

Best of luck.

Dx: 1/16/08, Stage T1mic, DCIS, < 1mm microinvasion, ER-/PR-, Her2+, 0/1 nodes

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Jul 17, 2008 10:57PM Beesie wrote:

Hmmm..... I've never seen a question about pre-surgery exercise before.  I've done a bit of searching and can't find anything specific to this question.  Here is the closest thing to an answer that I found and it's actually from this site:  http://www.breastcancer.org/treatment/comp_med/ask_expert/2005_03/question_13.jsp

What I do know is, just as Liz mentioned, you shouldn't assume that you have lymph node involvement simply because your nodes have been swollen since your biopsy.  Swollen nodes can be a sign of lymphatic invasion but there are lots of other things that can cause nodes to swell.  As for exercising before surgery, I don't think the concern is the possibility of spreading cancer - logically I don't think that could happen and I interpret the answer in the link above to be saying that - but I think the concern might be that you already have swollen nodes and you may cause more pain and swelling by doing the vigorous exercise.  I don't know whether this might make your surgery, and particularly checking your lymph nodes (are you have an SNB?), more difficult, but I could imagine that this might be a problem.  And I think straining an area that is already sore, especially before you go in for surgery, might impact how fast you heal afterwards.  But I'm just guessing here.  My suggestion is that you ask your doctor.   I would be interested to hear what he or she says about this.

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage I, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke

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Jul 18, 2008 09:58AM Liz08 wrote:

Faith-

you may want to check out pubmed and see if there's any research on this topic.  I remember researching "seeding" of cancer cells during biospy and some studies said it was possible and some studies said it does not happen. It compared needle biopsies to excissional biopsies.  I asked my oncologist this question and she said that we're not sure because of inconclusive studies as the ones I mentioned earlier.  In my opinion I think that seeding is a strong possibility along needle tracks during a biopsy but as far as exercise I just don't think that could spread the cancer.  I think that if the doctors would think you could spread cancer through exercise after a biopsy, then they would say to avoid exercise until you atleast have the results if your biopsy comes back malignant or benign.    You may also want to post this question on John Hopkins ask an expert forum which is open to questions on many weekends.  Let us know what your doctors tell you, I'm curious as to their answer.

Dx: 1/16/08, Stage T1mic, DCIS, < 1mm microinvasion, ER-/PR-, Her2+, 0/1 nodes

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Jul 18, 2008 10:09AM Liz08 wrote:

Instead of working I trying to find info on this topic.  Here's some info I found on from :

http://www.cancer.org/docroot/CRI/content/CRI_2_4_6x_For_Women_Facing_a_Breast_Biopsy.asp 

Does A Biopsy or Surgery Cause Cancer to Spread?

In nearly all situations, surgery does not cause cancer to spread. There are some important exceptions, such as tumors in the eyes or testicles. Doctors who are experienced in taking biopsies of cancers and treating them with surgery know how to avoid the danger in these situations.

The chances of a needle biopsy causing a cancer to spread are extremely low. In the past, larger needles were used for biopsies, and the chance of spread was higher.

One common myth about cancer is that it will spread if it is exposed to air during surgery. Some people may believe this because they often feel worse after the operation than they did before. It is normal to feel this way when you start to recover from any surgery. And sometimes, no one knows that the cancer has spread until it is seen during surgery. Because of this, some people may link surgery with widespread cancer. However, cancer does not spread because it has been exposed to air. If you delay or refuse surgery because of this myth, then you may be harming yourself by passing up effective treatment.

But can't find anything on exercise.

Dx: 1/16/08, Stage T1mic, DCIS, < 1mm microinvasion, ER-/PR-, Her2+, 0/1 nodes

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Jul 18, 2008 12:48PM AnneW wrote:

You exercised hard before you knew you had cancer. And the cancer has been there for years, growing slowly. Your tissue has healed up from the biopsy. I would think that the exercise will allow your circulatory system and lymphatics to clean up any debris and promote further healing.

I say, swim on!

Anne

2002 IDC stage 1, grade 1, rads & AI

Dx 9/18/2007, ILC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2-
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Jul 19, 2008 03:45PM Faith1 wrote:

thanks for all your responses on this and words of support. I will look into the 'pubmed' site and also 'john hopkins ask' sites. I will ask also my doctor.

I guess I really do not understand how the lymph system works. I guess I had two concerns.

1- If these two swollen increasingly very sensitive lymph nods are indeed infected with cancer that exercise would increase the circulation of possible 'seed' cells through my system as I am increasing a lot my bodies normal blood flow & circulation.

and the second concern is from this situation.

From Biopsy to lumpectomy it will be a month. During that time a couple lymph nodes have become increasingly swollen and now very sore. I had stopped swimming a month before biopsy and started up again and have been pushing myself to get back to the level I was at a month ago. When I swam one day I felt one of the very swollen nodes actually sting at some point during the end of a semi-hard swim (like the sensation of sweat in a cut-but I had no cut-it was at the site of the two swollen lymphs). This concerned me that maybe somehow the strain on the lymph nodes increased need to flush hard exercising muscles (if that is a function of the lymphs?) would be compounded with the job fighting the infection of the breast cancer and might be pushing these little nodes to the bursting point. That was what was in my mind with the little persisting stinging sensation.

Anyway the stinging sensation went away after a day- where I did take it easy on the swimming for a couple days. At this point I feel the little nodes now faintly ache all day. I guess in swimming your so much 'listening to your body' that it made me consider that the lymph's aching might be exacerbated by the semi-hard swimming. (I swim 1&1/2 miles at a go).

I guess I just don't understand I guess the function of the lymph system and need to read up.

as far as what is going on with me -I know that the 1-2cm lump I have is cancerous and the cells are poorly formed. During the lumpectomy next week they will inject a dye and biopsy the first lymph node and go from there during the procedure. I had an MRI and just found out that there is also a close small area 1cm of concern they need to biopsy near the other lump before surgery. Because of my concern about swollen lymph nodes I am anxious to get into surgery as quickly as possible. I was told that it is common though that the time between biopsy and lumpectomy can take a month. Does that sound standard?

thank you for your feed back. I really appreciate that you all are taking the time to give support. i will let you know if I find out more about exercising before a lumpectomy. Faith


Dx 7/1/2008, IDC, 1cm, Stage IIIa, Grade 3, 7/27 nodes, ER+, HER2+
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Jul 31, 2008 10:27PM Sophia21 wrote:

Hi Faith

 I totally understand where you're coming from. Last Thursday I was diagnosed by core biopsy that I have DCIS and I am numb.  The surgeon that I will be seeing is on vacation till the 12th so the wait is long and scary. I too think what if things are spreading and am afraid to exercise.  I miss doing that too.  I see that it isn't uncommon to wait several weeks before things are removed. I do not have a lump but it was found because of microcalcifications.  They know its intermediated grade and with some necrosis which again freaks me out.  But it is small and caught early.  So did you decide to exercise and how are you feeling?  Good luck and my prayers are with you.

Sophia 

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Nov 20, 2008 02:13PM, edited Nov 20, 2008 02:17PM by Faith1

i wanted to fallow up on this post. I initially asked if exercise pre-surgery would increase risk of cancer spreading.I posted initially July 17, 2008.

June 10th when I found my 1.6 cm breast lump by hand I had no swollen lymph nodes under my arm. June 18 when I went in for a diagnostic mammogram and sonogram I had no swollen lymphs to the touch, and no indication from the sonogram tech that I had swollen nodes. (I am not %100 sure if she ran the sonogram over my armpit-she did not run it over the other breast at all!)

June 26th I had a biopsy. After the biopsy my under arm lymph nodes started to swell and become sensitive. 

When I went to the surgeon on July 7th at least  two lymph nodes under my arm were sensitive, soft, and swollen. I pointed them out to the surgeon and told him that pre-biopsy I had no swollen nodes. He said that it was probably a response to the biopsy-my body responding to the invasiveness of the biopsy procedure, a normal lymph response. 

Between my biopsy on June 26 and my surgery on July 24  the lymph nodes under my arm continued to swell and become hardened. I could in the end feel five swelling and hardening and I felt two actually tear open ( it was found in my surgery that two had indeed 'extra-nodal extensions) I actually felt them tear open when I was swimming-it felt like salt in a cut- tiny stings. This is when I posted my question here about whether exercise  the spread of the cancer. After the biopsy and up until my surgery the tumor site went from completely  insensitive to the touch-to heavy prodding and poking- to becoming more and more swollen and sensitive to the touch. 

July 24, a month after the biopsy, I had surgery-a lumpectomy. I  mentioned the growth of my lymph nodes to the pre-op nurse and she said that was not normal and concerning and asked if I had alerted my surgeon. I told her I had alerted my surgeon two weeks after the biopsy- but he felt the soft swollen nodes and felt it was normal post-biopsy swelling. He is a top surgeon in the field so I felt ok about that.

I did not call my surgeon and tell him that more nodes were swelling and hardening because of his reassurance, and because my surgery was within 2 1/2 weeks from when I met with him. I had tests to complete before I could have surgery, and was told it was normal time to wait- a month- between biopsy and surgery.

I have since read they use to do surgery and biopsy all at once. I understood this was done as a precautionary measure, as older biopsy methods were thought to possibly drag cancer cells out of the tumor into the breast when they were taking the biopsy sample. I understand too that they don't do biopsy and surgery in one procedures now so much. In my case maybe it would have been an advantage to have had the older procedure.

 At any rate for me, within a month from biopsy I had 5 hard nodes under my arm. When I had my lumpectomy I had 7/27 lymph nodes involved. I have stage 3A, T2, N2, M0 , with Grade 3, Her+, Esro+  %50 proliferation rate cancer, lymph/vascular involvement. Very aggressive. I am 41. I have a very aggressive cancer at any rate.

So basically I went in one month from a lump with no sensitivity and no swollen nodes, to (after a biopsy) what seems a completely reacting cancer system. 

 I am following up just to inform others, and to say that if you find your lymph nodes after biopsy swelling and hardening, go in immediately and push to get your surgery date sooner. 

 For me, after most of my tests were done-none of them checking under my arm for lymph nodes-I had a sonogram scheduled the day before my surgery. There was another lump  (benign it turns out) that they were investigating and were going to hold my surgery up-in order to biopsy this second lump. I was so worried about my swollen hardening lymph nodes at this point that I begged the sonogram doctor- to look at them with the sonogram. She reacted immediately. She had me pushed into surgery the next day because of what she saw. She was on the phone all night making it happen.

SO don't let it go if you find your nodes swelling and hardening after biopsy. Don't let it go an extra day. 

It would be nice to know how long after a biopsy you should expect normal lymph node swelling, and when it is not normal. I wish I had known to go back to my doctor and push for a sooner surgery.

I hope this informs other women to fallow up immediately if your nodes are getting hard after having a biopsy.

I did swim up till surgery and after healing, and at first during chemo. The  doctors said post surgery and during chemo that it would be a benefit to swim, it would cut down on risk for lymphedema and help build stamina for getting through the chemotherapy regime.

As to the pre-surgery post-biopsy exercise the doctors told me they thought it would not effect the cancer spread at all. None were well versed on that for sure.  My cancer is of such an aggressive type it is hard to know if it was just the aggrivation of the biopsy  that cause my cancer to inflame and spread so quick, or if the hard work-out/exercise of my arm in the pool  had put any extra strain on my lymph system and weakened it the invasion of the cancer. My doctors did not think so. One doctor said the exercise cleaned out the lymph system, helped flush out toxins. I am just not sure how that flushing effects a spreading/ 'non-flushable' toxin such as cancer. It would be good to know if there is any research on this. 

My lymph nodes got worse over the month's time. I felt them swollen in the pool most. But that could have been because I was 'feeling' my body more during exercise, and my lymphs could have been 'flushing' out my arms toxins and running into the cancer in my armpit at the same time. I was more sore and swollen under my arm after swimming. It was during swimming too that  I felt the two lymph nodes under my arm tear open that I described above. That happened after I asked doctors if I could swim and they said no problem.  It was such a scary feeling though that I decided to let up on the swimming hard after that.  It would be nice to seem some studies done about post biopsy-pre surgery exercise to really know what is going on. 

best,

 Faith 

Dx 7/1/2008, IDC, 1cm, Stage IIIa, Grade 3, 7/27 nodes, ER+, HER2+