The Relationship Between Lower-Extremity Lymphedema and Physical Activity in Endometrial Cancer

Lower-Extremity Lymphedema and Physical Activity in Endometrial Cancer Survivors

Understanding the Connection Between Movement and Lymphedema Risk

Lower-extremity lymphedema (LEL) is a common and often distressing condition among endometrial cancer survivors. Swelling, discomfort, and reduced mobility can affect quality of life long after treatment ends. As survivorship care continues to evolve, researchers are examining whether physical activity may influence the likelihood of developing LEL. The study below explores how different levels of physical activity relate to self-reported lower-extremity lymphedema in women treated for early-stage endometrial cancer.

Study Overview: Physical Activity Levels and LEL Prevalence

Study Population and Data Collection

In a recent study, researchers sought to describe the prevalence of self-reported lower extremity lymphedema (LEL) by different physical activity (PA) levels and to examine if higher levels of PA are associated with lower odds of self-reported LEL among endometrial cancer survivors. Women treated for assumed early-stage endometrial cancer between 2006 and 2021 were invited to complete the Lower Extremity Lymphedema Screening Questionnaire (LELSQ) and the Physical Activity Frequency, Intensity, and Duration (PAFID) questionnaire. Responses of PAFID were converted into metabolic equivalent of task minutes per week (MET-min/week), and participants were categorized into different PA levels: meeting (≥500 MET-min/week) versus not meeting PA guidelines; low active (<500 MET-min/week), active (500–1000 MET-min/week), and high active (>1000 MET-min/week); and PA quartiles.

Physical Activity Categories and Lymphedema Prevalence

Among 1077 included, the prevalence of LEL was 48 %, 32 %, and 32 % among the low active, active, and high active survivors, respectively.

Active survivors had 40 % lower odds of lower-extremity lymphedema compared to low active survivors.

Interpreting the Association Between Physical Activity and LEL

Compared to the low active, the active survivors had 40 % lower odds of LEL, but no further reduction was observed among the high active survivors. According to PA quartiles, higher PA levels were associated with lower odds of LEL, but not in a linear dose-response way. The findings suggest that regular PA according to the current PA guidelines is associated with decreased the odds of self-reported LEL among endometrial cancer survivors; however, causality of association needs to be verified in a longitudinal setting.

What This Means for Endometrial Cancer Survivorship Care

The findings highlight an important consideration for survivorship planning: regular physical activity, aligned with current guidelines, may be associated with lower odds of lower-extremity lymphedema. While causation has not been established, the relationship between movement and symptom prevalence underscores the importance of evidence-based lifestyle guidance in post-treatment care. Continued research will help clarify how structured physical activity can be integrated safely and effectively into long-term survivorship strategies.

FAQs About Lower-Extremity Lymphedema and Physical Activity in Endometrial Cancer Survivors

1. What is lower-extremity lymphedema (LEL) in endometrial cancer survivors?

Lower-extremity lymphedema (LEL) is swelling in the legs caused by impaired lymphatic drainage, which can occur after treatment for endometrial cancer. It may result from lymph node removal or radiation therapy and can affect mobility and quality of life.

2. How common is lower-extremity lymphedema after endometrial cancer treatment?

In the referenced study of 1,077 endometrial cancer survivors, the prevalence of self-reported LEL ranged from 32 % to 48 %, depending on physical activity level.

3. Does physical activity reduce the risk of lower-extremity lymphedema?

The study found that survivors meeting physical activity guidelines (≥500 MET-min/week) had 40 % lower odds of self-reported LEL compared to those who were low active. However, the relationship was not linear, and causation has not been confirmed.

4. How much physical activity is considered beneficial?

Participants were categorized as meeting guidelines at ≥500 MET-min/week. This aligns with widely recommended physical activity standards for general health. The study suggests that meeting, but not necessarily exceeding, these guidelines may be associated with lower odds of LEL.

5. Is more exercise always better for reducing lymphedema risk?

No clear dose-response relationship was observed. While active participants had lower odds of LEL than low active participants, higher activity levels did not show additional reduction beyond meeting guidelines.

6. Can physical activity prevent lower-extremity lymphedema?

The study identified an association between physical activity and lower odds of LEL, but causality has not been established. Longitudinal studies are needed to determine whether physical activity directly reduces LEL risk.

7. Why is survivorship research important in endometrial cancer?

As endometrial cancer survival rates improve, understanding long-term side effects such as lymphedema becomes critical. Research on physical activity, quality of life, and survivorship outcomes helps guide evidence-based care recommendations.

---

About Women’s Cancer Research Foundation:

The Women’s Cancer Research Foundation (WCRF) is one of the most active research organizations in the nation. We are dedicated to studying and evaluating novel treatments for women afflicted with breast, ovarian, endometrial, and cervical cancers. The WCRF persistently endeavors to make a difference in women’s lives by offering them hope, strength, and progress.