Cancer prehabilitation

Cancer prehabilitation helps you be in the best place you can be both physically and mentally before your surgery or treatment.

Things you might try to improve are

Becoming more physically active
Getting stronger
Sleeping better
Eating a well-balanced diet
Stopping smoking
Reducing how much alcohol you drink

Even if you only have a few weeks, making some small changes now can help.

Watch a series of videos about prehabilitation on the Macmillan website

This page has some useful information on, it can be used by anyone in the lead up to treatment. If you feel you need more personalised advice, ask your hospital team, they will be able to help you.

Benefits of cancer prehabilitation

Can help you prepare mentally
Help increase your physical fitness
Can reduce hospital length of stay
Can help reduce postoperative complications
Improves fitness
Improves nutritional health
Opportunity to stop smoking and reduce alcohol consumption
Help you stay independent and keep doing the things that are important to you.

Exercise and physical activity

Being physically active throughout your cancer treatment helps you stay fit and strong.

By taking part in regular physical activity, you will:

Keep your muscles strong.
Have more energy.
Keep your heart and lungs healthy
Feel less tired.
Feel better overall and might cope with surgery or treatment more easily.
Help manage any side effects of treatment
Help support a healthy weight
Increase confidence and self esteem
Improve flexibility and balance
Reduce the risk of cancer coming back
Improve your overall quality of life

Try and keep as active as you can before, during and after your treatments. This might vary depending on how you feel but remember something is better than nothing.

How much should I be doing?

The UK Chief Medical Officers recommends all adults aim for:

150 mins of moderate activity a week, this is activity that causes you to breath a bit deeper, but you could still hold a conversation. Your heart will be beating a bit faster.

75 mins of vigorous activity a week, this is activity where you are breathing harder and you would not be able to hold a conversation, your heart will be beating much faster.

AND

2 strength sessions per week. These could be using weights such as dumbbells or kettlebells, resistance bands or bodyweight exercises.

Types of aerobic activity

Walking
Jogging
Swimming
Playing tennis
Dancing
Going to a gym class
Following a work out at home.

Depending on how active you are at the moment it might take you a bit of time to build up to this amount, that is ok. Set yourself small goals each week, to keep building up the amount of activity you are doing.

If you are already achieving this, well done! Keep it up! Before your treatment starts, try and increase the intensity you are exercising at, this can help you increase your fitness, by making your heart and lungs work harder.

Throughout the course of your treatments, you may have to alter the types of activity you do. For example, during chemotherapy or just after surgery, swimming would not be recommended, but you could use a static bike or go for a walk instead to keep yourself moving.

Every time you exercise make sure you start with a warm up, as this helps your body gradually increase your heart rate and increase the blood going to your muscles. Then finish with a cool down, to let your heart rate come back down slowly.

How do I physically prepare for cancer treatment? – Cancer Research UK

Nutrition

Leading up to your treatment our aim is for you to be in the best possible condition, this includes eating a well-balanced diet to help nourish your body.

The most important message is to eat well, try and choose a variety of foods and well-balanced meals. These can help you feel better and maximise your energy levels. Eating well is something you can do for yourself which can positively affect your treatment outcome.

Trying to lose weight before cancer treatment is not generally encouraged, unless you have been advised to do so by a healthcare professional.

If you are struggling to eat due to a loss of appetite or other symptoms, please inform your healthcare team, so they can support you. Unintentional weight loss in a short period of time and lead to muscle loss and can affect how well you can cope with your treatment.

What should I eat to prepare for cancer treatment? – Cancer Research UK

How can I ‘eat well’

A varied diet is recommended, rich in nutrients to help support recovery.

Energy

Everyone needs a certain amount of energy daily, which we get from our food and drinks. If you have been losing weight recently, you probably aren’t getting enough energy from your diet. Try adding snacks or nourishing drinks, like milk-based drinks which will add some extra calories.

Protein

Protein is a food responsible for building up muscle and supports healing. It can be found in variety of foods.

Good sources are:

Lean meats like chicken, turkey
Reduced fat beef/mince
Fish
eggs
Beans and pulses
Nuts
Greek yoghurt
Tofu
Cow’s milk
Soya milk
Meat alternatives such as Quorn.

Protein should be eaten across the day, rather than in 1 main meal. Try adding a source of protein to every meal, as well as snacks.

If you are losing weight some higher protein snacks you could try, such as:

Greek/Skyr style yoghurt and fruit
Hard boiled eggs
Small handful of nuts/seeds
Glass of cows or soya milk – if preferred flavour with coffee powder / Horlicks / milkshake powder/ chai powder/ or blend with frozen fruit and yoghurt to make a smoothie.
Pitta and hummus
Mini cheeses – choose low fat unless trying to gain weight

GOV UK – Eatwell guide

Is there anything to avoid?

Generally, we would say no, this time is generally more about what you can add to your meals and diet, rather than what to take away.

If you have any allergies or intolerances avoid these, you can always ask your prehab team if you need some other ideas.

If you have other health conditions, like diabetes that is difficult to control, speak to your healthcare team, they may be able to help you and refer you on to a Dietitian.

Sugar is commonly thought of as something to avoid during cancer treatments. This would be very difficult to do and is not recommended. However, try choosing foods rich in nutrients rather than high in sugar, these will have more benefits to your health.

Fluids

If you haven’t much of an appetite, try smaller portions but increase the number of times you eat for more of a little and often approach.
For most people, unless told otherwise, aim to maintain your weight and include a variety of fruits and vegetables, starchy carbohydrates including wholegrains where possible, as well as regular protein into diet.
Consider what you can add, rather than take away.
If exercising more, you might benefit from timing exercise so that you can have something to eat 1-2 hours before, and soon after, this helps fuel your workout and supports muscles to recover after.
This information sheet has more information about portion sizes.

Wellbeing

This might be quite a stressful time for you, you may be feeling a mixture of emotions, from stress and uncertainty. You might be finding it hard to focus and find your memory is ‘like a sieve’.

This is all quite normal during cancer treatment, you are not alone in these feelings. Here are somethings that can help.

How do I mentally prepare for cancer treatment? – Cancer Research UK

Your wellbeing

Family and friends – speak to them and make them aware of how you are feeling, it can help them understand more how to help you.
Wellbeing apps – these can include practical resources to help with relaxation, breathing and mindfulness.
Local services – there are lots of charities in the local area that can offer support or run support groups, speaking to other people going through the same journey can help.
Research also shows that exercise can help your mental wellbeing, treat exercise like a medication for your mental health. Plan times throughout the week to get your exercise done.

If you have a mental health condition

People with a mental health condition can find coping with a cancer diagnosis harder due to the extra stress this causes. Getting support during this time can help you get through your treatment and improve quality of life.

If you are usually supported by your local mental health team, inform them of your cancer diagnosis.

Useful information

Prehabilitation

Myywellbeing space – Videos discussing each area of Prehabilitation, with a workbook to help guide you through lifestyle changes.
Prepwell – General pre surgery advice including diet, exercise, smoking cessation and wellbeing.
Macmillan Prehabilitation videos
Preparing your mind before surgery – The Royal College of Anaesthetists