Physical Activity and Lymphedema (PAL) Trial


The Physical Activity and Lymphedema (PAL) Trial was a one year randomized controlled exercise intervention trial funded by the National Cancer Institute. The study recruited 295 breast cancer survivors from the Philadelphia metropolitan area, 154 who were at risk for lymphedema, 141 who had lymphedema at the start of the study. The study had two goals. For the women who already had lymphedema at study entry, the goal was to determine whether a slowly progressive weight-lifting regimen was safe and would not worsen their lymphedema. For the women at risk for lymphedema at the start of the study, the goal was to determine the safety of slowly progressive weight-lifting and learn whether the exercise would impact the development of lymphedema. Other goals included evaluating participants' changes in body image, quality of life, muscle strength and body fat.

The women in the treatment group were provided with gym memberships and 13 weeks of supervised twice weekly small group training, usually at YMCAs near their homes. The results of the study have changed the clinical advice women are given after breast cancer treatment. In the past, women were told not to use the arm affected by breast cancer treatment even to carry a purse. The results of the PAL trial indicate that such advice is unneeded. In fact, the study showed that progressive weight-lifting might be better than not exercising an arm at risk for or with lymphedema after breast cancer, and may actually play a role in preventing the condition. Several key findings from the study include:

  • 50% reduction of the likelihood of lymphedema worsening among women with lymphedema
  • 70% reduction of the likelihood of arm swelling increases among women who had 5 or more lymph nodes removed
  • Improved strength
  • Improved body image
  • Reduced body fat

The purpose of this website is to provide those interested with further resources about the PAL intervention and the resulting research publications. Included on this site are: