EXERCISE was associated with reduced cancer-related lymphedema risk, with meta-analysis showing a 29.0% relative reduction overall.
What This Meta-Analysis Found
A systematic review and meta-analysis evaluated whether exercise affects the incidence of cancer-related lymphedema in people at risk of, or living with, lymphedema after cancer treatment. Investigators searched six electronic databases for exercise intervention studies published through May 2025. Eligible studies compared exercise with no exercise and reported lymphedema outcomes.
Across 17 studies published between 2002–2024, involving 2,739 individuals, exercise was associated with a lower risk of developing cancer-related lymphedema compared with non-exercise. Using random effects models, the pooled relative risk was 0.71 (95% CI: 0.53–0.96). The authors rated the overall certainty of evidence as low.
Cancer-Related Lymphedema and Who Was Studied
Most included studies focused on upper-limb lymphedema after breast cancer, accounting for 15 of 17 studies. Two studies evaluated risk of lower-limb lymphedema. The evidence base therefore primarily reflects people at higher risk of breast cancer-related lymphedema, although exploratory subgroup analyses suggested potential benefit beyond the breast cancer setting.
The review also explored whether effects differed by patient and intervention characteristics. Subgroup analyses examined upper- versus lower-limb lymphedema and extent of lymph node dissection, comparing fewer than five nodes dissected with five or more.
What It Could Mean for Clinical Practice
Exploratory subgroup findings supported participation in any or all exercise modes, including programs without supervision, suggesting a potentially flexible prevention approach for patients at risk of cancer-related lymphedema. However, the authors emphasized an urgent need for rigorously designed trials to clarify effects across cancer types, patient risk profiles, and exercise approaches.
This analysis is also notable for how it frames common clinical concerns about recommending exercise to patients worried that activity could trigger or worsen swelling. In the included trials, exercise was evaluated against no exercise with lymphedema outcomes reported, and the pooled estimate favored exercise for reducing cancer-related lymphedema incidence. While the authors judged certainty as low, the direction and magnitude of effect may support clinicians in discussing exercise as part of survivorship care for people at risk of cancer-related lymphedema, alongside individualized monitoring and patient education. The review’s subgroup findings further suggest that benefits were not restricted to one specific exercise approach, reinforcing a pragmatic message that different modes and levels of supervision may be reasonable in real-world settings, pending more definitive trials.
Reference
Plinsinga ML et al. A systematic review and meta-analysis evaluating the effect of exercise on the development of cancer-related lymphedema. JNCI Cancer Spectr. 2026;doi:10.1093/jncics/pkag013.
