Getting ready for treatment (prehabilitation)

What is prehabilitation?

Prehabilitation means getting your body into the best condition possible to cope well with treatment. This includes:

• Good diet and nutrition.
• Taking physical activity and exercise. Moderate physical activity, such as walking, gentle cycling or mowing the lawn can improve your physical fitness. Check first with your medical team which types and intensity of exercise are safe for you.
• Looking after your mental wellbeing and managing stress.

Depending on your circumstances, prehabilitation could include getting help to stop smoking or using e-cigarettes (vapes) or to reduce your alcohol intake. It can also involve managing any other medical conditions, such as anaemia and diabetes.

After my diagnosis was confirmed, I didn’t have much time to prepare for treatment as I moved to first-line treatment in a matter of days. However, even small steps, like staying active, reaching out for support and getting the information you need can help.

Corrin, diagnosed with diffuse large B-cell lymphoma

The NHS website has advice, information and resources to help you live well and make healthy lifestyle choices. 

Any time and effort you put into preparing yourself for treatment mentally and physically will pay off. It can make such a difference to how you tolerate treatment and recover from it.

Charlotte Bloodworth, Lead Haematology Clinical Nurse Specialist

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How might I benefit from prehabilitation?

There are lots of possible benefits of prehabilitation, including:

• a shorter stay in hospital
• fewer side effects of treatment
• faster recovery
• fewer post-treatment complications
• improved overall physical and mental wellbeing.

Macmillan Cancer Support’s report: Principles and guidance for prehabilitation within the management and support of people with cancer outlines three key benefits of prehabilitation for people diagnosed with cancer and their caregivers:

• A sense of empowerment, purpose and control.
• Greater physical and psychological wellbeing, which might reduce side effects of treatment. In turn, this can help you to live well before, during and after treatment.
• Positive long-term health benefits of leading a healthy lifestyle.

You can download the full report from the Macmillan Cancer Support website.

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How can I get myself ready for treatment?

Taking general good care of your physical and mental health can help to prepare you for treatment. The hospital you’re being treated at might have information about local services or programmes that could help you. There is also a list of resources on this page.

Personalised prehabilitation care plan (PPCP)

Your medical team might suggest a prehabilitation programme before you start treatment. However, in some cases, treatment needs to start straightaway.

Getting information from your medical team about your planned treatment can really help by giving you a sense of empowerment, understanding and control.

Corrin, diagnosed with diffuse large B-cell lymphoma

You and your medical team work together to look at your personal prehabilitation needs. They can then give you advice on how to meet these. You might hear this called a personalised prehabilitation care plan (PPCP). 

Typically, you have an initial assessment so that you and your medical team can work together to identify your needs, make a plan (regime) and set goals. The regime can last anywhere from a week to 2 months. Often, it lasts around 4 to 6 weeks.

Throughout your prehabilitation, you have regular follow-up appointments to check-in with your medical team, ask any questions you might have, and get advice and support.

What if I'm not offered a prehabiliation programme?

You can talk to your medical team if you’re not offered a prehabilitation programme. Although prehabilitation programmes aren’t suitable for everyone, your medical team can still advise you on how best to get ready for treatment. Even if you are not on a prehabilitation programme, you will still be offered the best possible treatment for you.

If you are not in a situation to be able to engage in a formal prehabilitation programme, anything you do to help with your physical and mental fitness is likely to be positive – even something like a daily walk, if you can manage it.  

Corrin, diagnosed with diffuse large B-cell lymphoma

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Where can I find prehabilitation resources?

Your hospital or treatment centre might have their own prehabilitation resources – you could ask a member of your medical team about any that are available to you.

There are also some resources online that are freely available. Check with a member of your medical team whether they are suitable for you and if there are any safety precautions you should take.

• Active Against Cancer (Harrogate and District NHS Foundation Trust)
• Personalised Exercise Rehabilitation in Cancer Survivorship (PERCS)
• Prehab4cancer (NHS in Greater Manchester)
• Prehab2Rehab Health Optimisation Service (Cardiff South West Primary Care Cluster)
• Prepwell information website service about prehabilitation
• Somerset Prehabilitation for Cancer (Somerset NHS Foundation Trust)
• Preparing for surgery – Fitter Better Sooner (Royal College of Anaethetists)

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