“The patients have improved overall,” said Dr. Lucía González Cortijo of the early results. A group of breast cancer patients at Hospital Universitario Quirónsalud Madrid is training with bow and arrow to reduce the swelling and discomfort of lymphedema, a condition that can develop after lymph nodes are removed from the armpit.
González Cortijo, coordinator of the Breast and Gynecological Cancer Unit at Hospital Universitario Quirónsalud Madrid and founder of the Fundación La Vida en Rosa, said patients who were beginning to notice swelling in the arm or hand improved during the program, with some no longer experiencing symptoms. Those whose lymphedema was already established reported less heaviness in the arm and better mobility.
Why Lymphedema Can Follow Breast Cancer Surgery
Breast cancer often spreads first to the lymph nodes in the armpit. Years ago, surgery for the primary breast tumor also removed axillary lymph nodes — in some cases more than 30 — which disrupted lymphatic drainage in the arm and, over time, led to lymphedema: swelling of the arm and hand that, once established, is generally irreversible.
“The arm swells, creating pressure and pain for the patients,” González Cortijo said. “In some cases they suffer chronic skin infections that have to be treated with preventive penicillin.”
Lymphedema has become less frequent in recent years because most patients no longer require complete removal of the axillary nodes. Surgeons now perform a selective biopsy of the sentinel node — the first lymph node where a tumor would spread — and if that node is clear, no further nodes are removed.
How the Arqueras Rosas Program Runs
The foundation launched the Arqueras Rosas — “Pink Archers” — activity at the Club de Arqueros de Pozuelo, enrolling patients with lymphedema in an archery training program. Archery strengthens the dorsal and pectoral muscles and the arms, and training the strength of the arm, chest wall and shoulder has been shown to help prevent lymphedema or reduce its symptoms once established.
Participants complete quarterly training programs, meeting once a week under the guidance of a federally licensed archer. After finishing a program, they can keep training one day a week using bows loaned by Fundación La Vida en Rosa.
For patients who have had lymph nodes removed from the arm, doctors recommend not carrying weight with the affected arm.
Measuring Arm Volume Before and After Each Quarter
The program is running alongside a study to quantify its benefit. Before training begins, physiotherapist Laura Canal of the service of Plastic, Aesthetic and Reconstructive Surgery at Quirónsalud Madrid measures the circumference of the arm and forearm on both the side that had lymph nodes removed and the healthy side, providing an objective baseline of volume. The same measurements are taken at the end of each quarterly program to assess any reduction in lymphedema. So far, 11 patients have been enrolled in the study.
The goals are raising awareness among patients that effective lymphedema prevention is possible with different tools and care, with archery one of the most recommended physical activities; and reducing arm volume and the sensation of heaviness in patients whose lymphedema is already established.
Questions Readers Ask About the Program
Where does the archery training take place? At the Club de Arqueros de Pozuelo, where Fundación La Vida en Rosa enrolls patients in the Arqueras Rosas program.
How often do participants train? Once a week during each quarterly program, guided by a federally licensed archer; afterward, participants can continue one day a week with bows loaned by the foundation.
How is improvement measured? Therapists measure the circumference of the arm and forearm on both the affected and healthy sides before the program starts and again at the end of each three-month program.
How many patients are in the study so far? Eleven, according to physiotherapist Laura Canal of the service of Plastic, Aesthetic and Reconstructive Surgery at Quirónsalud Madrid.
Related reading
