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.

    乳腺癌的康复患者一直以来都在收到各种毫无价值的建议。过去的几十年里，许多医生警告说，举重或者即使是搬动重物，都可能引起臂部的肿胀酸痛。新的研究表明，练习举重实际上可以帮助避免这一问题。

    "曾有多少代妇女被告知说不要搬弄重物啊？"当波士顿丹娜-法伯癌症研究中心的埃里克。温纳博士，看到新的研究所作出的出人意料的结论后，这样悲叹道。"事实上，妇女做提举运动对臂部损伤甚少，因为她们能有更好的肌肉紧张度。"

    这项研究由宾夕法尼亚大学的训练学家凯瑟琳。施米茨领衔，并受到联邦政府的资助。研究结果发表在了周三出版的《新英格兰医学期刊》上。

    美国有超过240万名乳腺癌康复患者，这项研究意味着他们的生活品质将大为改观。施米茨说，与癌症治疗相关的臂部肿胀，目前被看做是许多小症状之一，可以通过训练得以改善，而不是恶化。

    "五十年前，我们告诫患有心脏病的人们不要再做任何锻炼，"而受疼痛困扰的人们也就此呆在床上等着康复，施米茨说。"这种建议的意向是好的，但却彻底背离了事实。"

    那些腋下接受放射或移除淋巴结以检查癌症的妇女，可能会患上淋巴水肿--它阻塞了体液，会导致臂部和手部疼痛，并且产生难看肿胀。

    为了避免这一问题，医生们曾建议妇女不要用患病的手臂去抱小孩、携带沉重的手提包或擦洗地板。甚至像高尔夫和网球这类运动也会引发担忧。

    而女人们会想，"哦，天呐，我得好好照料这只手臂才行，"施米茨说。

    对于易于患上淋巴水肿的妇女们来说，练习举重不是个好主意，尽管它可以改善情绪和肌肉质量，提升骨骼强度，还能调节体重。

    施米茨早在几年前就通过一个小型的研究对以上说法提出了质疑，发现练习举重不会导致淋巴肿胀恶化。此次是她进行的第一次新的大规模和长时间的研究，为她的论点给出了明确的证据，而且还指出举重对康复患者有益处。

    研究针对141名患上了淋巴水肿的乳腺癌康复患者。其中有一半人被告知不要改变他们的锻炼习惯。其余的人在社区体育馆内参加每周两次，每次90分钟的举重训练课程，共持续13周。

    他们穿着为患病的手臂定制的紧身服装，逐渐提升举起的重量，增加练习的次数。在此后的39周时间里，他们依靠自身将这一锻炼坚持了下去。

    这些妇女每月都会接受臂部检查。一年后，练习举重的人中淋巴水肿发作的人数比另一组要少--14%比29%.练习举重者显现的症状更少，而且力量更足。在两组研究对象中，因为肿胀而引起的臂部尺寸的变动率相近。

    "我觉得举重真的很管用。它不仅增强了我的力量和灵活性，而且也让我的平衡感和协调性有了提高，"来自费城郊区的研究参与者，66岁的卡莱尔。法伯说。"这的确给了女人们希望。"

    另一位参与者是56岁的盖伊。麦克阿瑟，来自新泽西州的史密斯场，她在研究结束后仍坚持去练习举重。

    "我第一次被诊断有淋巴肿胀的时候，他们告诉我说我最多不能举超过5磅的东西，"她说。但举重训练没有引起任何问题，而且让她感觉更棒了。

    尽管研究中没有做评估，但练习举重也会省钱，德克萨斯大学安德森肿瘤中心的温迪。德马克沃纳菲瑞德，在这期医学杂志的一篇评论中写道。在此次研究中，她指出，在练习举重的一组中，因为淋巴水肿发作去看医生或物理治疗师的次数仅有77次，而另一组有195次之多。

    研究的另一部分是评测举重训练能否帮助乳腺癌康复患者阻止淋巴水肿的出现；施米茨说，结果很快就能得到。

    但乳腺癌康复患者也不要急冲冲地就去练习举重，那样可能会出问题。

    施米茨建议：

    -找一位有资质的健康专家帮助你正确地练习。

    -开始先慢一些，制定一个计划循序渐进。

    -在练习时穿一件合适的紧身衣。