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Largest UK breast cancer physiotherapy trial to be led by Warwick

What is expected to be the biggest UK study on the effect of physiotherapy on women after breast cancer surgery is to be led by Warwick Medical School in partnership with University Hospitals Coventry and Warwickshire (UHCW) NHS Trust.

The Warwick Clinical Trials Unit, which is part of the University of Warwick, has been awarded £1.4milion to conduct the trial. Funded by the National Institute for Health Research (NIHR) it will explore whether physiotherapy has a beneficial impact for women having treatment for breast cancer.

Principal research fellow, Dr Julie Bruce said: “We are delighted that the NIHR have supported this important research. Up to two-thirds of women who have breast cancer surgery can experience shoulder problems and chronic pain after their treatment. This trial will help us understand the best way to treat women and may prevent the need for further treatment.”

Called the PRevention Of Shoulder ProblEms TRial (PROSPER), the results will inform national guidelines about the best way to follow-up and support women who have had surgery for breast cancer.

Usual NHS care for these women is to be given leaflets which include exercises that they can perform after their operation. The PROSPER Trial will compare the progress of women who receive this ‘usual care’ with those who are prescribed an individualised exercise programme by a physiotherapist.

The study will follow the progress of 350 women for one year after their treatment, starting at three breast cancer centres in September 2015. The trial will then be expanded to cover between 10-12 hospital sites from early 2016.

Experts at the University will analyse the results of questionnaires completed by the women to assess the best way to treat women at risk of shoulder problems due to their breast cancer treatment.

Dr Bruce said: “Women tend to be discharged from hospital on the same day as their surgery, and are therefore unlikely to have a session with a physiotherapist. We want to investigate whether providing physiotherapy support after surgery will remove the need for treatment further down the line and allow women to return to full function and normal daily activities. This could both alleviate patient discomfort and demand on NHS resources at a later date.”

Pauline Kelly, senior research nurse at UHCW NHS Trust, said: “Shoulder problems following breast cancer surgery can seriously impact on a woman’s quality of life. We are delighted to participate in a study that we hope will help alleviate these issues in the future.”

The three pilot centres are University Hospital Coventry & Warwickshire, Churchill Hospital, Oxford and New Cross Hospital, Wolverhampton. Warwick Medical School is collaborating both nationally and internationally to deliver the PROSPER Trial, working with colleagues in the MD Anderson Cancer Centre, Houston, Texas, Royal Marsden Hospital, London, and the University of Oxford to create what is expected to be the largest trial of its kind ever conducted in the UK.

Women eligible to take part will be those with newly diagnosed breast cancer and due to have an axillary clearance, a process where all or most of the lymph nodes in the armpit are removed. Women due to have radiotherapy or who have a history of shoulder problems, such as stiffness or arthritis, may also be eligible.

Warwick Clinical Trials Unit was set up in 2005 as part of Warwick Medical School and received full registration status from the UKCRC in November 2007. It is an academic clinical trials unit with expertise in the design and conduct of trials, particularly of complex health states and interventions. The trials unit major strands of work are: cancer; emergency and critical care; frailty; mental health; musculoskeletal disorders and pain; trauma and orthopaedics and clinical trials methodology.

Notes to Editors:

This project was funded by the National Institute for Health Research HTA Programme (project number 13/84/10).

1. The National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme funds research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 700 issues published to date. The journal’s 2013 Impact Factor (5.116) ranked it two out of 85 publications in the Health Care Sciences and Services category. All issues are available for download, free of charge, from the website. The HTA Programme is funded by the NIHR, with contributions from the CSO in Scotland, NISCHR in Wales, and the HSC R&D Division, Public Health Agency in Northern Ireland. www.nets.nihr.ac.uk/programmes/hta

2. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).


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For further details contact Nicola Jones, Communications Manager tel: 024 761 50868/ 07824 540863 or N.Jones.1@warwick.ac.uk