It needs a lot of support! Basically my macro rig is tabletop based. I have a custom made lightbox designed to stand on my table and I use a Gorillapod (anyone who doesn't have one of these better get some spare cash and get one! A gorillapod is kind of like a 50mm prime, you don't have one and you think you're doing ok, then one day you get one and you don't know how you lived so long without it!) I also use a series of platforms to support the tubes so there is no stress on the lens mount. As most of my pics are of static objects, I have all the time in the world to set the shot up and the whole thing is perfectly still for long exposures!
If anyone doesn't know what a gorillapod is, see here:
Joby Gorillapod SLR - Flexible tripod for SLR cameras
As for lifting the camera with these tubes attached, carefully. Very carefully. One hand lifts the camera, the other is halfway down the tubes, no need to put any stress on the lens mount if it can be avoided