Prehabilitation (prehab) means getting ready for your cancer treatment in whatever time you have before it starts. Evidence shows that the benefits of Prehab can be seem in as little as 2 weeks. It is a programme of support and advice designed to help improve your physical and mental wellbeing. It covers three particular parts of your health:
- what you’re eating and your weight
- physical activity or exercise
- mental wellbeing
Focusing on these three areas before your surgery or treatment starts can help you to leave hospital earlier, reduce the risk of side effects and help you to feel more in control of your health and wellbeing.
Also, if you stop smoking and cut down on alcohol, the benefits to your cancer treatment, recovery and overall health could be even greater.
Fitter patients who are able to improve their health and activity levels before treatment recover more quickly. What you do now can have a really big impact on your recovery.
The information below will help you to reflect on areas in your life that may benefit from change as well as providing you with some ideas on how you can improve your physical and mental wellbeing prior to treatment.
For more information and advice on prehab, please speak to your Clinical Nurse Specialist who will be happy to help and refer you to the Cancer Prehab Programme if appropriate.
A downloadable version of the guide can be accessed HERE
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Physical Activity
You can help yourself to get ready for cancer treatment by being more physically active. Being more active and exercising is one part of prehab.
You might not have been physically active for a long time and starting now might feel impossible. But it can help to keep in mind that many people who felt the same have managed to do it and felt the benefits.
How much physical activity you can do and at what level, differs from person to person. Aim for two and a half hours of moderate, or one and a quarter hour of vigorous activity per week, as well as some strength building exercises like weight training or yoga, twice a week.
Being physically active boosts your energy levels, helps with anxiety and depression and reduces your risk of heart disease and type 2 diabetes.
How can I be more active?
- Making small changes to your daily routine and creating new habits can help you to get more active and stay active.
- What counts as being active may surprise you – you can be active at home, at work, and when travelling.
- Even if you’ve been inactive for years, any amount of physical activity is good for you. Being active will benefit your body and mind.
It is safe and recommended to exercise when you have cancer. It is also important to be more active in whatever time you have before cancer treatment but you need to do physical activities that are right for you. If you have not exercised for a while or have any concerns about your health please speak to your GP or healthcare team for advice on your situation.
Top tips to increase your physical activity levels when waiting for treatment:
- Move more and sit less. Find ways to get up and move around during the day;
- Go for a walk at lunchtime
- Be active during TV ad breaks
- March on the spot when waiting for the kettle to boil
- Park further away from the supermarket entrance
- Do housework and chores. They can count as physical activity too!
- Take the stairs instead of the lift. It’s good for your legs and heart.
- Walk every day. Use a device or app to track your steps and progress, and attempt to walk a little further or faster every few days.
- Do something you enjoy! Choose an activity that suits you, such as cycling, swimming, resistance training, exercise classes, etc.
- Do strength and resistance exercises twice a week. Use weights, bands, or household items to build and maintain muscle mass.
- Use free apps to motivate and guide you, such as:
- NHS Active 10 walking tracker app
- NHS Couch to 5k app
You can keep track of what and how much activity you are doing on the timetable provided HERE. You can use this diary to discuss your physical activities with your health care team or the cancer exercise specialist in your local council.
Exercise videos
Click the links below to view a range of pre-recorded exercise videos.
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Nutrition
Following a cancer diagnosis, you might go through a period of uncertainty and anxiety. This can lead to a loss of appetite and weight.
Eating a healthy balanced diet can help you cope with cancer and its treatments. Our aim is to ensure you are at your healthiest in preparation for treatment, therefore it is important that you eat well. Having the right nutrition is one of the things that you can do for yourself that can reduce side effects of treatment and support a faster recovery.
Having a variety of food and well-balanced meals can maximise your energy levels and make you feel better. It also includes drinking plenty of fluids. Doing this can help you to achieve and maintain a healthy weight.
The ‘Eatwell Guide’ shows the different food groups and quantities we should consume to have a healthy, balanced diet.
A printable version is available HERE
How does eating a varied diet help?
Weight problems are common for people with cancer. This could mean being either underweight or overweight at the time of diagnosis or after some cancer treatments.
Eating a varied diet, together with being physically active, can help you to keep to a healthy weight.
Being underweight at the time of diagnosis can affect how well you cope with and recover from treatment.
Obesity may cause some cancers and can impact on the treatment options available to you. This is why it is important to have a healthy diet, before, during and after cancer treatment. Losing weight prior to treatment should be avoided unless it has been specifically recommended by your Consultant / Surgeon.
Having a healthy balanced diet can also:
- help with wound healing, for example after surgery
- help our immune system to work well and cope better with infection
- cope better with the treatment and its side effects
- reduce the risk of other conditions such as heart disease or diabetes
- Help you feel less fatigued, stronger, healthier and have more energy
A balanced diet means eating foods from all the food groups that your body needs. But for many people with cancer, eating and drinking well can be a struggle.
Your healthcare team can discuss ways to support you with eating and drinking. And there are things you can do to help yourself.
What can you do?
There are small steps you can take to eat a more varied diet:
- Keep an eye on your weight
- Use a scale to weigh yourself. Report any dramatic weight changes to a health professional.
- You can use a range of resources available to help you plan your meals and make healthier food choices. Eat well – NHS (www.nhs.uk)
- If you have a poor appetite or difficulty swallowing and have lost weight without trying, talk to your GP or ask your healthcare team to refer you to a dietitian. They can give you advice on changes to your diet that are right for you
- Check your food choices, to ensure that you are getting enough nutrients.
- Keep a food diary and compare your food choices with what is suggested on the Eat Well diagram (HERE). You can do this through apps or using whatever method works for you.
- Keep an eye on portion sizes.
- Learn about healthier, balanced options
- Read food labels to get an idea of how balanced food is. Some food labels are coloured code green, orange or red. A mostly green label means it’s a healthier choice.
- You can use the free NHS food scanner app to find healthier foods.
- Consider the impact your food choices can have on your health or weight
- A diet high in sugar can lead to weight gain. So try to think about healthier options.
- Plan your meals to avoid choosing foods high in fat, sugar or salt when you’re hungry.
- Educate your family and friends
- It is important that your loved ones understand the importance of a healthy diet before and after your cancer treatment. This is especially so if they normally cook for you.
- Share this information with your partner, carer, other family members and friends. Together you can make the changes needed in your diet.
If you experience any difficulty swallowing (known as dysphagia) that is impacting on the foods or drinks you take, please inform your Clinical Nurse Specialist (keyworker) or a member of your healthcare team and ask them to refer you to the Speech and Language Therapist. Swallowing difficulties can significantly affect your quality of life so it is important to seek specialist help.
For further information on swallowing difficulties click following link
You can also find additional information via the links below
Eating well and keeping active
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Emotional Wellbeing
A cancer diagnosis can affect how you think and feel. Common feelings include worry, anxiety, and depression. It is important to recognise these feelings and get help when needed.
Preparing yourself emotionally for treatment can be challenging, especially when facing a sudden cancer diagnosis. It’s normal to experience various feelings during this time, and managing stress is crucial. People have different ways of coping, such as seeking information, problem-solving, using distraction, minimizing, using humour, or talking things through with someone they trust.
Try to keep in mind that a big part of what you’re feeling during this time is a normal response to a very stressful life experience. It is also a way of coming to terms with it.
Getting ready for treatment and focussing on your mental health before treatment starts will:
- help you feel prepared
- stop the feelings of anxiety or depression from getting worse
Research shows that exercise and being physically active can also help your mental health.
What can you do?
There are small steps you can take to improve your mental health.
- Check out and make use of available resources
- The Macmillan Information and Support Service is here to help – whether you have been diagnosed with cancer, or you are a family member, carer or friend. For more information about what the services offers and how to get in touch, click on the link below.
Macmillan Health and Wellbeing Service – South Eastern Health & Social Care Trust (hscni.net)
- Join a patient support group for your cancer type. Many people find they benefit the most from peer support when dealing with cancer.
- Think about how you coped in difficult situations before and use the same strategy
- Use previous ways of coping. This can be painting, dancing, gardening or knitting. It can help to distract yourself or to express difficult emotions.
- Avoid habits that will make your mental health worse. For example, drinking too much alcohol or caffeine, staying up late and overworking.
- Reach out for support
- Talk to someone you trust, such as a friend or relative. Many people find that talking about their difficult feelings makes them feel better.
- Talk to your GP or specialist nurse if you’re not coping. They can refer you to a counsellor or psychologist who can teach you ways to deal with stress. These include help with breathing, muscle relaxation, meditation, hypnosis or mindfulness.
- Be kind to yourself
- Reflect on what you’re feeling and keep a diary of your experiences. Focus on the things you can control and change.
- Use mental health apps to help with anxiety, depression or sleeping problems. Using apps can be a way of supporting yourself in difficult moments.
- Treat exercise like your medication
- Be physically active daily and exercise regularly to get the best possible outcomes.
- Plan times of the day throughout the week when it will suit you best to exercise and when you are more likely to do it.
Top tips for taking care of your emotional wellbeing:
- Talk to someone you trust
- Open up when you feel ready to – it can help to talk to people who have similar experiences
- Practise mindfulness by paying attention to the present moment; to your own thoughts and feelings; and to the world around you
- Find a relaxation practice that works for you.
Many people find it difficult to talk about cancer and how they are feeling. Your healthcare team are there to help and can refer you to a specialist if needed.
Watch the video below to learn more about techniques to help you manage when feeling stressed
A printable copy of these techniques can be accessed HERE
Further Emotional Support Information and Useful Links
Help with how you’re feeling | Macmillan Cancer Support
Free counselling for people with cancer | Macmillan Cancer Support
https://www.cancerresearchuk.org/about-cancer/treatment/prehabilitation/look-after-mental-wellbeing
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Other Healthy Lifestyle Changes
Stopping Smoking
Stopping smoking before your cancer treatment is strongly advised. It can help your body respond to treatment and heal more quickly, it may also reduce the likelihood of treatment interruptions and the risk of cancer coming back.
If you are having surgery, as part of your treatment, stopping smoking will help to:
- Reduce heart, lung and wound related complications
- Reduce wound healing time
- Reduce your length of stay in hospital
- Reduce associated symptoms from treatment
- Improve your quality-of-life following treatment
We know that stopping smoking can be hard. Smoking can be part of a well-established routine, which can be difficult to break but thousands of people stop smoking every year in the UK, and you can do it too.
Here are our top tips to get you started
- Decide when to do it. Making a plan increases your chances of doing something. Decide on a date when you will stop smoking and stick to it.
- Be prepared. Think about what could get in the way of you stopping smoking. For situations that you might find difficult, plan what actions you’ll take to help yourself. For example if you are socialising with friends who smoke.
- Ask for help. Although it is hard, you don’t need to go it alone. Talk to your free local stop smoking service or your doctor. They can give you help and advice.
- Tell people you’re stopping. Friends and family can then support and encourage you and celebrate your smoke free milestones.
- Keep trying. It takes most people a few tries before they manage to stop smoking for good. If you don’t succeed at first, think about what worked and what didn’t, and what you could do differently next time. Your stop smoking service, doctor or pharmacy can help you find a method that works for you.
- Focus on your motivation. Remember why you decided to stop smoking and what the personal benefits are for you – try leaving sticky notes for yourself or set reminders on your phone.
- Change your routine. If you’re used to smoking at certain times, try doing things differently to break the link between a certain time or activity and you smoking. For example, if you normally smoke after a meal, try going for a walk or doing something you enjoy instead.
- Keep your mind and hands busy. Even with stop smoking tools, you’ll probably still feel the urge to smoke sometimes. Try doing something else to distract you, like exercising, watching TV or reading. It may help to hold something in the hand that normally holds your cigarette.
Talk to your healthcare team about the specialist help that is available. For further information about the Smoking Cessation Service in the South Eastern Trust visit our website by clicking on the link below.
Smoking Cessation – South Eastern Health & Social Care Trust
Reducing or Stopping Drinking
Reducing your alcohol intake can also have a positive impact on your response to treatments and help your body prepare for any surgery you might be undergoing as well as recover from surgery and other treatments. Drinking more than 4 units per day (equivalent to 2 pints of beer or large glasses of wine) doubles your risk of complications after surgery.
To keep health risks from drinking alcohol at a low level, it is recommended that men and women should not exceed 14 units per week and it is advisable to spread your drinking over three days or more. Please refer to the Alcohol Units Guide below on the number of units in each drink.
This can be difficult during times of stress. Your health care team is keen to support you so if you need further help or advice with reducing your alcohol intake, please discuss this with your clinical nurse specialist.
Useful Links
Getting help with drug or alcohol problems | nidirect