Study on ‘prehabilitation’ calls for cancer patients to get advice on diet and exercise

By Jane Kirby, Health Editor2nd July 2019News EnglandCancer, Health and Wellbeing, Long Term Care / Conditions, News England, NHS, Primary Care / GP's

Cancer patients must be given one-to-one advice on diet and exercise in order to boost their chances of recovery and survival, health experts have said.

A new report found that following a healthy diet, putting limits on alcohol and regular exercise help cancer patients deal with gruelling treatment and can cut side effects.

The new study on “prehabilitation” was put together by Macmillan Cancer Support, the Royal College of Anaesthetists, the National Institute for Health Research Cancer and Nutrition Collaboration.

It is based on evidence which shows cancer patients can have improved survival, suffer fewer side effects and can recover more quickly if they are in good physical and mental shape.

Among the principles are healthy eating with lots of fruit and veg, limiting alcohol to 14 units a week or less, keeping to a healthy weight, stopping smoking and taking regular exercise of 150 minutes a week if possible.

People with cancer can also boost their mental health and wellbeing through accessing services designed to help them, including support on managing on a lower income or getting back to work, the report said.

It said: “People are less vulnerable to the side effects of cancer treatment if they are as healthy as possible, physically and psychologically.

“Prehabilitation enables people with cancer to prepare for treatment by promoting healthy behaviours and prescribing exercise, nutrition and psychological interventions where appropriate to a person’s needs.

“Prehabilitation may, in some cases, allow people with cancer to access treatments that were not previously available to them.”

The study includes evidence from studies indicating that being physically active after a cancer diagnosis is associated with increased survival time and reduced risk of disease progression.

It added: “Research has found that people with highest distress levels, when compared with those with the lowest, experienced increased rates of death from specific cancers, especially colorectal and prostate, suggesting a need for better psychological management in cancer patients to help alleviate their distress.”

On nutrition, it said people with cancer are at particularly high risk of malnutrition because both the disease and its treatments affect them so much.

June Davis, adviser for allied health professionals at Macmillan Cancer Support, said: “Being diagnosed with cancer can turn life upside down and many people experience anxiety and uncertainty whilst they wait to start treatment.

“Prehabilitation supports people during this difficult time to prepare both physically and mentally for treatment, reclaim a sense of control and improve their health in the long term.

“We want to see prehabilitation implemented soon after diagnosis so that people living with cancer feel empowered to improve their health and get the personalised care they need.

“To make this a reality, we urgently need the Government to invest in the NHS workforce so that there are enough professionals with the right skills and resources to deliver this care now and in the future.”

Professor Mike Grocott, from the Royal College of Anaesthetists, said: “Prehabilitation offers people with cancer personal empowerment at a time when they often feel that they have little control over what is happening to them.

“As a consequence, we see better quality of life as well as improved resilience to the effects of cancer treatments resulting in fewer complications. All this adds up to happier patients experiencing real health benefits.”

Dr Lucy Allen, head of collaborations at the National Institute for Health Research, said: “Put simply, being physically, nutritionally and psychologically ‘unfit’ is associated with increased risks and complications during treatment.

“The challenge therefore is to identify those who are at risk and prepare them ahead of their treatment in an attempt to reduce their risks and complications, and improve their response to treatment.”