When old ideas are wrong

Last week, when I was reading the Star Tribune, my eye caught the headline, "For decades, breast cancer survivors got bogus advice not to lift weights." I didn't think much of it and quickly turned the page.

But there was something about the headline (was it the word "bogus?") that made me go back for a closer look.

I read the article, then found my copy of the New England Journal of Medicine and read the actual study entitled, "Weight Lifting in Women with Breast-Cancer-Related Lymphedema." You'd never know by the title there's a much bigger idea here.

The idea is, how often is medical advice wrong?

A little background first. When women get breast cancer, almost all will have a lymph node -- or several nodes -- removed from the armpit to look for spread of the cancer. Unfortunately, removing them may cause a leak in the lymph system, resulting in swelling of the arm. This condition is called lymphedema. This is a lifelong problem and it can be very uncomfortable and disfiguring.

For years, cancer-information Web sites and plenty of physicians have recommended that women with this condition should not lift weights, children or heavy groceries for fear of making it worse. Unfortunately, women who follow this advice miss out on the positive benefits of weight-lifting, especially increased bone density.

So someone finally asked the question that needed to be asked: Is this true?

To find out, researchers at the University of Pennsylvania, working on a National Cancer Institute grant, enrolled 141 women into a randomized clinical trial, the gold standard of testing. The results? Slowly progressive weight lifting didn't make the swelling worse.

Instead, it resulted in fewer exacerbations of lymphedema, women's symptoms and their strength improved. In other words, they only got better by doing just the opposite of what they've been told to do.

And this is what really got me thinking. How often do patients follow advice that's simply wrong?

Years ago, people were told they shouldn't exercise after a heart attack. People with back pain should lie down and rest. Neck pain? Put a neck collar on. Sprained ankle? Immobilize it.

Though all of these recommendations seem logical, they're wrong; we now know that just the opposite is true. How do we know that? We study these long-held beliefs. We ask tough questions. We have open minds and we admit when we're wrong.

Now my question is: How many more of our common, well-intentioned recommendations are wrong? Stay tuned; there are many more studies to discuss.

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