Exercise reduces arm pain in women recovering from breast cancer

A new study recommends a physiotherapy-led exercise programme to relieve symptoms of arm and shoulder pain in breast cancer surgery patients.

In what is the largest trial in this patient group to date, 392 participants were asked to complete questionnaires on their arm function, pain, and overall quality of life over a 12-month period, with half being selected to participate in the exercise PROSPER programme as part of their care routine.

Women in the exercise group reported fewer arm disability symptoms after 12 months, as well as lower pain intensity and better physical quality of life than the usual care group.

The structured PROSPER rehabilitation programme was conducted by researchers led nationally by the University of Warwick with University Hospitals of Coventry and Warwickshire NHS Trust, and the study authors, published in The BMJ, are calling for wider adoption of the PROSPER programme in cancer rehabilitation to improve the wellbeing of women recovering from breast cancer surgery.

In non-reconstructive breast cancer surgeries, patients can be left with shoulder and arm problems, including chronic pain, restricted movement and arm swelling, with past research showing that as many as one-third of women recovering from breast cancer surgery can struggle to return to everyday tasks such as driving or lifting shopping.

Professor Julie Bruce of Warwick Clinical Trials Unit at the University of Warwick, and principal investigator on the PROSPER trial, said that the PROSPER programme was to aid women in the early stages of recovery, as there are already pain clinics for further down the line with shoulder restriction and chronic pain problems.

Co-author Professor Alastair Thompson, professor, and section chief of breast surgery at Baylor College of Medicine’s Dan L Duncan Comprehensive Cancer Center commented: ‘After breast cancer surgery, arm and shoulder disability impacts the functioning and quality of life for many women. Using physiotherapy led exercise program introduced a week or so after surgery, led to better upper limb function, less pain and lower costs, up to a year later without any adverse impacts. This randomized trial demonstrates the benefits of early, supported exercise after breast surgery should become standard practice in women treated for breast cancer.’