Breast Cancer Rehabilitation Course

The PORi Breast Cancer rehabilitation course instructs participants in the clinical skill sets and techniques needed to effectively deliver well-structured, specialized oncology rehabilitation therapy to breast cancer patients in any phase of their cancer treatment and beyond. The clinical skill sets and techniques instructed in PORi are based on the PORi Body Systems Approach, which includes integrated treatment models designed to include Myofascial Trigger Point Release, Joint Mobilization, Neural Mobilization, Lymphatic Manual Drainage, Pain Mitigation and Functional Restoration.

The integrated clinical techniques and the breast cancer patient management system are placed in the context of understanding the physiological and anatomical effects of cancer treatments including specific surgical interventions, chemotherapy regimens, radiation therapy, and adjuvant medications.

Careful study is made of the impact of cancer treatment on the Epidermal, Dermal, Myofascial, Skeletal, Lymphatic, Vascular and Neural Systems, and the treatment protocols instructed by PORi relate to the optimal resolution of signs and symptoms within these body systems.

All of the clinical skill sets and techniques instructed within the PORi Oncology Rehabilitation Curriculum are derived from evidence-based clinical applications within the scope of Physical Therapy and Occupational Therapy practice. One of the more defining elements of PORi, presented alongside PT/OT evidence-based clinical application, is the necessary physiological and anatomical knowledge unique to the oncology patient population, which is required by qualified practitioners to accurately and safely implement oncology-specific treatment plans and realistic goal-based outcomes for this patient population.

Live and/or Video Patient Presentations

Running over 28hrs, the PORi Breast Cancer Rehabilitation continuing education course includes patient case presentations of patients who have undergone a variety of treatments for breast cancer and present with a variety of conditions and side-effects relating to their cancer treatments. For virtual courses, patient presentations will run from between 60 minutes and 90 minutes via pre-recorded videos of patient treatments, technique demonstrations and patient interviews. In live courses or live lab supplementary courses, a patient case presentation can run as long as 3 hours and participants are given the opportunity, with guided supervision from the instructor, to perform subjective and objective evaluations on these patients, as well as practice the appropriate techniques (presented in the course) on the patients during these lab sessions.

Course Requirements

Course participants must attend 90% of scheduled course hours
Each participant must sign in and out of the course each day
Each participant must complete the online post course exam

Examination
Within 7 days of the completion of the course, participants are required to complete a 90 minute written examination. There may also be a participant competency exam of 2 separate patient volunteers (arranged by PORi). Course participants will interview patient volunteers that will call in during the course and there will be a multidisciplinary clinical management implementation discussion. Understanding of techniques of oncology rehabilitation therapy and their application as well as an understanding of the effects of cancer treatments on the body’s systems will be tested. A passing grade (75%) is required for Continuing Education Units to be issued. Participants who do not pass the exam will be eligible to sit a supplementary exam.

Target Audience for the Course
Qualified and Licensed Physical Therapists (Physiotherapists), Occupational Therapists, Physical Therapy Assistants, and Certified Occupational Therapists are the target audience for the course.

Ratio of Instructor to Participants
In-person courses with live patient labs are limited to 16 people. All other course formats are variable depending on the facility hosts and instructor preference.

Breast Cancer Rehabilitation - Course Objectives
Upon successful completion of the course, participants will be able to:

Explain the components of breast cancer diagnosis and how the identified biological markers inform the Staging and Grading of patients’ breast cancer.
Understand & Explain how Staging and Grading inform breast cancer treatment pathways, which subsequently inform rehabilitation pathways of management for patients undergoing surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and hormone-based therapies.
Describe the unique, clinically relevant, aspects of breast cancer-related tumor resection surgeries, including all myocutaneous and free flap surgeries.
Discuss prehabilitation and rehabilitation guidelines and treatment pathways for effective management of surgical oncology patients across the scope of breast cancer-related surgeries.
Describe three different types of radiation therapy treatment applications for patients with breast cancer, and the prehabilitative and rehabilitative management of adverse side effects of radiation therapy, including radiation induced fibrosis.
Discuss PTs/OTs roles in the clinical management of chemotoxicities, including management of myelosuppression, chemo-induced peripheral neuropathy, cardiotoxicity, cancer related fatigue, hormone changes, and cancer related cognitive changes in patients undergoing breast cancer-specific chemotherapy regimens.
Explain the difference between the key treatment goals of patients with breast cancer receiving systemic chemotherapy regimens, targeted treatment regimens, and immunotherapy treatment regimens.
Describe salient signs and symptoms of breast cancer disease progression and be able to effectively evaluate for differential diagnoses with bone metastases, lung & liver metastases, and brain metastases.
Describe how to use the PORi management system to provide a continuum of care across the primary phases of breast cancer treatment and into long term survivorship.
Implement breast cancer-specific patient evaluations and design safe and appropriate breast cancer-specific plans of care according to evidence-based guidelines, screening systems, and clinical tests presented in the course.
List four anatomical/physiological body systems to be included in the evaluation and treatment of oncology patients using the PORi Body Systems Approach.
Effectively implement PORi’s Body Systems Approach to perform safe and effective rehabilitative treatment for patients with breast cancer across all phases of medical care, including surgery, chemotherapy, radiation therapy, and adjuvant treatment.
Apply legislative and clinical frameworks for patients with breast cancer to advocate for the need for early prehabilitative and rehabilitative intervention to mitigate life-long sequelae of survivorship challenges.
Demonstrate effective skilled care-based documentation of a patients with breast cancer undergoing multiple elements of acute, subacute, and chronic treatment phases, and how these fit into the US-based healthcare system and insurance-based outpatient/inpatient settings.
Implement strategies and utilize tools aimed at ensuring a well-balanced therapist approach to breast cancer care that enhances wellness, resilience, and reduces risk of burnout onset among therapists working in oncology rehabilitation settings.

Breast Cancer Rehabilitation

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PORi CORE: Breast Cancer Rehabilitation - Course Outline

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