New prehabilitation guidelines to improve cancer outcomes
Southampton researchers have co-developed new national guidelines on preparing patients for cancer treatments.
Prehabilitation prepares people physically and mentally for cancer treatments. It ensures they are as healthy as possible beforehand. This is achieved through exercise, a healthy diet and psychological support.
Research shows that people with cancer who have prehabilitation have better treatment outcomes. This includes fewer complications, a faster recovery and shorter stays in hospital.
The new guidelines, published by Macmillan Cancer Support, will help ensure people with cancer receive good quality prehabilitation.
Researchers at the NIHR Southampton Biomedical Research Centre worked with leading organisations to develop the guidelines. These include Macmillan Cancer Support, the Centre for Perioperative Care, NIHR Cancer and Nutrition Collaboration, and World Cancer Research Fund.
Working together to improve care
The new guidelines are called ‘Prehabilitation for people with cancer: clinical and implementation guidelines’.
They provide updated recommendations on how best to design, develop and deliver prehabilitation. They cover prehabilitation delivered both before and during cancer treatment.
The guidelines are the result of a review of reports and evidence of good practice in this area. They will support healthcare providers, commissioners, researchers, and policy makers. This will help guide pathway redesign, business cases and improve service delivery.
They cover exercise and nutrition, psychological support and prehabilitation implementation. They also include behaviour change and technology, health economics and business cases.
Professor Mike Grocott, NIHR Southampton BRC Director and co-chair of the guidelines, said:
“For the first time, these guidelines give us research-based recommendations to guide the care of people with cancer who are undergoing prehabilitation.
“The guidelines offer clear advice on how to deliver prehabilitation: from bedside advice on screening, assessment and treatment, to practical input on implementation of a service and successful business cases.”
Informed by research
Our BRC researchers have led trials of prehabilitation for patients having cancer surgery.
These trials demonstrated prehabilitation's safety, feasibility and effectiveness. They included WESFIT and SAFEFIT.
They showed prehabilitation resulted in shorter hospital stays and economic benefits. This led University Hospital Southampton to set up the first NHS-funded clinical service.
Prehab4cancer in Greater Manchester is another example of a service that was reviewed. Over one year, 550 ward and 146 critical care bed days were released. The savings from this covered the costs involved in setting up and delivering the service for a year. It also made it sustainable going forward.
June Davis, Lead Nursing and Allied Health Professional Advisor at Macmillan Cancer Support and co-chair of these guidelines said:
“Macmillan Cancer Support has been at the forefront of the development of prehabilitation services over the last seven years. We know from listening to people with cancer and clinicians what a difference good preparation for cancer treatment and surgery can make. We are delighted to be a lead partner in the development of these new guidelines.
“We would now like to see cancer prehabilitation widely adopted across the healthcare system to benefit people with cancer, in preparation for and recovery from cancer treatment, to improve their experience of care and sense of control, whoever they are and wherever they live.
“To make this a reality, we hope that everyone engaged with the design and provision of services will embed prehabilitation into cancer pathways, across community, primary and secondary care, to ensure all patients benefit from the positive impact of prehabilitation.”