• University of Exeter

Helping patients recover from breast cancer treatment: a programme to prevent shoulder problems

Learn to identify patients at high risk of pain and disability after non-reconstructive breast cancer surgery and how to help them

1,368 enrolled on this course

  • Duration

    4 weeks
  • Weekly study

    2 hours

Learn how breast cancer treatment can cause shoulder pain and how to overcome it

This course will equip you with an in-depth understanding of the side effects of breast cancer surgery and, more specifically, shoulder pain that is experienced by many women.

You’ll find out more about the types of exercises that should be prescribed through the PROSPER (the Prevention of Shoulder Problems) programme, as well as how to support breast cancer patients to do them.

Learn how to identify women at risk of shoulder pain after non-reconstructive breast cancer surgery

Rehabilitation following breast cancer treatment is important to help women return to full active lives.

This course will teach you how to identify women prone to shoulder pain following their treatment as well as how to prescribe the PROSPER programme to reduce the impact of the surgery’s side effects.

Improve your ability to care for breast cancer patients

Through the PROSPER programme, you’ll explore ways to deal with cancer treatment related problems such as cording and fatigue, as well as strategies to support breast cancer patients and help them get back to a physically active life and regular exercise.

You’ll also learn how to monitor and manage women’s post-surgery progression and rehabilitation.

Apply research-based findings from the PROSPER exercise programme

The PROSPER programme has been developed by experts and tested in a large clinical trial by research and clinical staff at the University of Oxford and Warwick. They found that women who followed the programme had better arm function and lower pain scores compared to women who received usual care.

You’ll not only learn how to identify women at risk of shoulder problems following breast cancer treatment and prescribe the programme, but also how to deal with several other cancer treatment related problems.


  • Week 1

    Introduction and background to the course

    • Introductions

      Find out who the training has been developed for and meet the team who developed this course.

    • Introducing the PROSPER programme

      What is the PROSPER programme, who is it for and how was it developed?

    • Breast cancer and related shoulder problems

      What is breast cancer and common side effects of treatment.

    • Why this approach?

      In this section, we will discuss the rationale behind the PROSPER programme.

    • The PROSPER programme in detail

      Looking at the PROSPER programme in more detail

    • Week 1 summary

      What have you learnt in week 1

  • Week 2

    Getting started to deliver the PROSPER programme

    • Welcome to Week 2

      In Week 2 we will take you through the PROSPER programme initial assessment. Then, we will introduce the idea of behavioural change with a focus on Motivational Interviewing.

    • Conducting the initial assessment

      Overview of the first session; Introducing the PROSPER programme to patients; Emphasising the benefits of exercise

    • Conducting the initial assessment: physical examination

      Assessing pain and surgical wounds; Screening for lymphoedema; Looking for signs of cording;

    • Conducting the initial assessment: range of movement

      As part of the physical assessment, you will assess your patient's range of movement.

    • Dealing with distress

      Dealing with your patient in distress

    • Changing behaviour

      We introduce behaviour change techniques and Motivational Interviewing.

    • Week 2 summary

      What have you learnt in Week 2

  • Week 3

    Exercise prescription and progression (part 1)

    • Welcome to Week 3

      What will we be looking at?

    • The PROSPER programme exercises

      Overview of the PROSPER programme exercises

    • Physical activity

      Advice on physical activity is a core component of the PROSPER exercise programme. We will discuss how best to advise patients.

    • Behavioural strategies

      Overview; Goal setting and action planning; Assessing and targeting confidence to exercise

    • Management of complications

      This activity will consider how to manage the complications that may occur as a result of surgery.

    • Week 3 Summary

      What have you learnt this week?

  • Week 4

    Exercise prescription and progression (part 2) and putting it all together

    • Week 4 overview

      Week 4 overview

    • Prescribing the PROSPER programme strength exercises

      In this activity we will look at what should be covered in the 2nd face-to-face session as well as the PROSPER programme strength exercises.

    • The 3rd PROSPER programme face-to-face session

      We now consider the 3rd face-to-face session as well as how to approach flexible future appointments and discharge.

    • Developing the service in your place of work

      Developing the clinical pathway; Resources to gain stakeholder buy-in; Building a business case; Case example

    • What to do now

      We will consider how you may further your skills.

    • Week 4 summary

      Mini-test; Take the poll; End of course reflections; Conclusions

Learning on this course

On every step of the course you can meet other learners, share your ideas and join in with active discussions in the comments.

What will you achieve?

By the end of the course, you‘ll be able to...

  • Describe the impact of breast cancer treatments on shoulder and arm function
  • Identify women at high-risk of shoulder problems following breast cancer treatment
  • Demonstrate how to deliver the PROSPER programme to women following breast cancer treatment
  • Explore common breast cancer treatment related problems and how to manage them
  • Engage with behaviour change strategies to help patients to exercise regularly and be more physically active

Who is the course for?

The Prevention of Shoulder Problems (PROSPER) programme was designed to be delivered by physiotherapists working with patients at higher risk of shoulder problems after breast cancer treatment.

This course is designed for those physiotherapists working with patients at risk of shoulder problems after breast cancer treatment.

However, other health professionals can also benefit, learn new skills, and help their patients recover post breast cancer treatment.

Who will you learn with?

Esther is a physiotherapist and researcher at the University of Oxford. She is Deputy-Director of the Centre for Rehabilitation Research.

Beth Fordham is a health psychology researcher. Beth aims to use psychological theory and practice to improve quality of life in physical and mental health conditions.

Who developed the course?

University of Exeter

The University of Exeter is a Russell Group university. It combines world-class research with very high levels of student satisfaction.

Endorsers and supporters

content provided by

University of Warwick

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