Prehabilitation before cancer treatmentBMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5120 (Published 14 August 2019) Cite this as: BMJ 2019;366:l5120
- Ceinwen Giles, director of partnerships and evaluation1,
- Steven Cummins, professor of population health2
- 1Shine Cancer Support, Poole, Dorset, UK
- 2London School of Hygiene and Tropical Medicine, London, UK
“Prehabilitation” prepares people for cancer treatment by optimising their physical and mental health through needs based prescribing of exercise, nutrition, and psychological interventions. It is being promoted as a way to improve treatment effectiveness and cancer survival. Prehabilitation aims to foster a sense of control and purpose in people preparing for cancer treatment through interventions that develop psychological and physical resilience.
A recent report sets out principles and guidance on prehabilitation, with the aim of advancing cancer care, informing service provision, and changing practice and behaviour.1 The report, published by Macmillan Cancer Support in partnership with the National Institute for Health Research cancer and nutrition collaboration and the Royal College of Anaesthetists, suggests that prehabilitation should underpin the whole cancer pathway. Any intervention that seeks to reduce harm, improve emotional and physical resilience, and improve long term health is to be welcomed. NHS leaders need to think seriously, however, about several barriers to implementation, as well as the overall merits of the approach.
Firstly, prehabilitation may shift the burden …