Multidisciplinary Rehabilitation Programme for Breast Cancer

The study recruits breast cancer survivors who are already on chemotherapy or are going to start chemotherapy. Subjects will be asked for their preference to attend physiotherapy and educational class (for intervention group) or decline for it (for control group). For intervention group, subject will attend 24 sessions of physiotherapy (exercise class) and 10 sessions of educational class over 12 weeks. The supervised 1-hour group exercise class will be conducted twice a week. Educational class will be once a week, with topics covering physical activity, management of fatigue, lymphoedema, neuropathy, brain fog, return to work, stress, nutrition, sexuality, psychosocial and caregiver issues. Subjects in control group will be asked to exercise on their own in the 12 weeks. 12 weeks later, all subjects will attend a 2-hour survivorship transitional class, with topics covering cancer surveillance and follow up, addressing fear of recurrence: symptom and support, neuropathy/ fatigue/physical impairment/ brain fog, physical activity and diet, screening for colorectal and cervical cancers, return to work and community resources. During the class, a screening questionnaire will be administered to identify further physical, rehabilitation and psychosocial needs and to triage these patients to relevant hospital and community services. Outcome assessment will be done at pre-intervention, after intervention, 6 months and 1 year after the intervention.

Sex

Female

Minimum age

21 Years

Maximum age

80 Years

Inclusion Criteria:

1. Females between 21 - 80 years old;
2. Breast cancer patients before or already on the treatment of chemotherapy, targeted therapy, and/or radiotherapy;
3. Be able to provide consent and complete questionnaires;
4. Be able to walk independently in the community without use of gait aids.
5. Breast cancer patients who are suitable for exercise.

Exclusion Criteria:

1. Pregnant;
2. Uncontrolled hypertension (Resting BP \>160/90 mm Hg), or history of recurring or persistent hypotension in the past 2 months;
3. History of recent myocardial infarction or unstable angina (within the past 6 months);
4. Significant valvular disease i.e. severe aortic stenosis and moderate-severe mitral regurgitation;
5. Patient with end stage organ disease (e.g. ESRF, end stage COPD);
6. Tumor infiltration of axial or weight-bearing bones with risk of pathological fractures or compression of the spinal cord;
7. Patient with recent stroke within the past 6 months;
8. With other neuromusculoskeletal disorders such as osteoarthritis of such severity as to limit ability to participate in group exercise classes;
9. Already participating in regular physical activity (150min of moderate or 75min of vigorous physical activity/week);
10. Deemed inappropriate by primary oncologists.

• DERIVEDChandran G, Tang N, Ngo ELP, Huang S, Tong SI, Ong JX, Chew E. Comparing the efficacy of a multi-dimensional breast cancer rehabilitation programme versus a home-based exercise programme during adjuvant cancer treatment. BMC Cancer. 2024 Mar 21;24(1):361. doi: 10.1186/s12885-024-12080-5. PMID 38509471