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Prehabilitation for cancer

Find out more about prehabilitation, including what it is and what to expect if you go through the process.

What is prehabilitation?

Prehabilitation, also known as ‘prehab’, is a programme of support for people who are preparing for cancer treatment. The timing and duration of prehabilitation will vary depending on the type of treatment you are receiving e.g. surgery, chemotherapy, etc.

Not all NHS hospitals offer prehab, but the number is growing thanks to the increasing evidence of its benefits. Simply put, the aim of prehab is to improve your physical and emotional well-being to help your fitness for cancer treatment.

What does prehab involve?

Prehab programmes can differ between hospitals some of the main types of support you may receive include:

  • Your weight.
  • Your diet.
  • Exercise/physical activity.
  • Your general health, e.g., quitting smoking, alcohol.
  • Your mental health.

Why is prehab important?

Research into prehab has shown there are many benefits for people with cancer.

These include:

  • Fewer side effects or improved ability to cope with any side effects from treatment.
  • Less time spent recovering in hospital.
  • Being fitter may increase the treatments available to you.
  • Better health in the long term.

The principles of prehab can be applied to your recovery or rehabilitation (‘rehab’).

What happens? The 4 principles of prehab

1. Screening

Screening involves a series of measurements or questionnaires that help to understand what support you may need.

This may include checking your weight and what you eat and drink, how active you are, and your mental health/emotional well-being.

Everyone should be provided with advice on a healthy, balanced diet, tips on being physically active and steps to look after your mental health. If extra support needs are identified, you will receive an assessment.

2. Assessment

The results of your screening will determine whether you have more complex needs that require assessment by other specialist teams. This can include dietitians, physiotherapists, occupational therapists and exercise specialists.

The assessments will help your team decide what your individual needs are and how best they can support you through treatments.

These treatments are known as ‘interventions’, which may involve adapting the general information you received during screening to meet your specific needs.

3. Intervention

Based on your assessments, your team will decide what type of ‘intervention’, or support, you need. This can range from general health and wellbeing advice to something more complex or specialist.

Some of these interventions will include referrals to other healthcare professionals and specialists – for example, if you have other health conditions that could impact your cancer treatment.

4. Monitoring

During prehab, your cancer team will need to keep track of your progress with any changes you’ve made to your lifestyle or any interventions that have been put in place.

This careful monitoring will help them to record the benefits you may be experiencing. It will also contribute towards the evidence for prehab and therefore help more people with cancer in the future.

When should you start your prehab?

Prehab can start any time after your diagnosis and ideally as soon as possible. This will give you more time to make positive changes to your lifestyle and for any interventions to take place, before you start treatment.

How long should prehab last?

There is no minimum or maximum amount of time a prehab programme will last for. It all depends on the time between your diagnosis, when you begin the programme and when you start your treatment. For some people, prehab may only last a few weeks, but even a small amount of time can make a difference.

How can I access a prehab programme?

Unfortunately, not everyone will be offered prehab by their cancer treatment centre. There’s a lot of ongoing research and work to change this, but the availability is different across the UK. You’ll need to speak to your cancer team to see what’s available in your area.

What should I do if I can’t have prehab?

Not having prehab doesn’t mean you can’t have treatment for cancer. You will still have the best available treatment that you’ve discussed with your specialist.

Your cancer team can provide you with all the information you need before your treatment. They can also signpost you to any local services or initiatives that offer support.

You can also benefit from making some healthy changes yourself. The most reliable information can be found through the NHS and cancer charities. Just make sure you keep your cancer team up to date with any changes you’ve made.

Our information on healthy eating and keeping active will help you along the way. You can also use our Living with cancer web pages to learn more, access free recipes and download or order some of our free booklets.

Getting involved with research

Many cancer centres are involved in research studies across many areas, including prehab. If you’re interested in finding out more, you can speak to your cancer team.

You can also visit the Be Part of Research to search for clinical trials taking place in your area.