Prehabilitation and cancer treatment
Prehabilitation aims to get you as fit and healthy as possible before, during and after cancer treatment.
What is prehabilitation?
Prehabilitation means getting you as ready for treatment as you can be. It is also called prehab. For cancer treatment, it usually involves advice and support from your cancer team about:
- physical activity or exercise
- healthy diet and weight
- stopping smoking
- drinking less alcohol
- mental health and well-being.
Research shows that making changes in these areas can help you during cancer treatment and as you recover.
Prehabilitation can start as soon as you are diagnosed, or sometimes even before diagnosis.
It might feel difficult to think about making changes when you have just been diagnosed with cancer. But your healthcare team will suggest things that are realistic and suitable for you. They can give you help and support. Even small changes can make a big difference to your treatment and recovery.
When is cancer prehabilitation used?
Prehabilitation is often linked to surgery. But it can help people having other types of cancer treatment, such as:
If there is a prehabilitation service within your hospital or local area, then you can be referred by your clinical nurse specialist (CNS) or someone else within your multidisciplinary team (MDT).
If there is no prehabilitation service at your hospital, a nurse such as your key worker or CNS will assess you to find out what help and support will benefit you. This will probably include a holistic needs assessment (HNA) to talk through your needs and concerns. You then agree on a plan for your care and support needs.
Related pages
Does prehabilitation work
Prehabilitation focuses on 3 main areas:
- nutrition
- mental well-being
- physical activity.
By making positive changes in these 3 areas, prehabilitation has been shown to:
- improve general fitness and nutrition before treatment
- reduce anxiety and improve mental health and well-being
- help you recover from the effects of treatment
- reduce the length of hospital stay, if you are having surgery
- reduce the risk of complications from having cancer treatments
- develop a feeling of taking control of health and recovery
- improve quality of life for the future
- help to stop smoking
- help to stop drinking or drink less alcohol.
What prehabilitation involves
If you are referred to a prehabilitation service, you will have an appointment called an initial assessment. This determines how the professionals in the prehabilitation service can help you.
At the assessment, you will complete some questionnaires. You may also have some physical tests, such as a 6-minute walk test (6MWT). This test measures how far and how long you can walk for in 6 minutes.
Prehabilitation support and advice varies depending on what you need. You may have support from 1 or more of the following healthcare professionals.
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Dietitian
A dietitian may meet with you to assess your diet (nutrition) and your weight. They can advise you on the types of food that will help you during treatment, recovery and beyond. They can give you support to gain or lose weight to get you as fit for treatment as possible.
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Physiotherapist
A physiotherapist may meet with you to talk about increasing your physical activity. They may give you exercises to do at home or information about exercise sessions you can join.
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Occupational therapist
You may meet with an occupational therapist. They can tell you about help with moving around or activities such as housework, dressing, washing and cooking. They can also provide support and equipment to help you manage at home.
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Counsellor or psychologist
You may also meet with a counsellor or psychologist. They can help with any anxiety and depression.
Depending on the type of cancer treatment, you may need more support. This can include the following:
- Information and support if you need to manage a urostomy or stoma after surgery to the bladder or bowel.
- Meeting with a physiotherapist for specific exercises for your type of surgery or cancer treatment. You do these exercises to prevent complications.
- Information and guidance about pelvic floor exercises to help recovery before and after treatment to the pelvic (lower tummy) area.
- Group education sessions about specific cancer treatments, such as surgery to remove the prostate gland (prostatectomy).
- Meeting with a counsellor or psychologist before treatment – especially if cancer treatment will cause big, or permanent, physical or emotional changes to your life.
Changes you can make before cancer treatment
There are things you can do at home to help improve your general health before you have cancer treatment:
- If you smoke, stopping has many benefits.
- Follow information and advice about healthy eating.
- Follow guidance about being more physically active.
- If appropriate, drink less alcohol – you can find information about alcohol and drinking guidelines at drinkaware.co.uk
- Review other health conditions and regular medications.
Learn more about prehabilitation
We have more information that can help if you are getting ready for cancer treatment or want to learn more about prehabilitation.
Watch our prehabilitation videos. Learn about making small changes to your everyday life to help get ready for cancer treatment.
Listen to our podcasts. Della, Clive and Jenny, who are living with cancer, share their thoughts and experiences of prehabilitation:
- Listen to Della and Clive's podcast (13 minutes).
- Listen to Jenny's podcast (8 minutes).
Ongoing support
You might have follow-up appointments to check how your prehabilitation is going. Your family, friends or carers can help support your prehabilitation. We have more information about looking after someone with cancer.
You may also find it helps to talk to others going through similar experiences. You may want to join a support group or our Online Community.
For healthcare professionals
If you are a healthcare professional, use our guide to find prehabilitation resources. This explains the support available from Macmillan and from other trusted organisations.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our general surgery information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Perioperative care in adults. NICE guideline [NG180]Published: 19 August 2020 https://www.nice.org.uk/guidance/ng180/chapter/Recommendations
Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. NICE guideline [NG158]Published: 26 March 2020 Last updated: 02 August 2023 https://www.nice.org.uk/guidance/ng158
Powell, R., Davies, A., Rowlinson-Groves, K. et al. (2023) Acceptability of prehabilitation for cancer surgery: a multi-perspective qualitative investigation of patient and ‘clinician’ experiences. BMC Cancer 23, 744. https://doi.org/10.1186/s12885-023-10986-0
Date reviewed
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The language we use
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We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
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We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
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