Prehabilitation (prehab) is designed to help you prepare for cancer treatment by improving your physical health, nutrition, and mental wellbeing. Prehab focuses on three key areas:
- Physical activity– Regular exercise to boost fitness and strength
• Nutrition & weight – Eating well and maintaining a healthy weight
• Mental wellbeing – Managing stress and supporting a positive mindset
Getting ready for cancer treatment can feel daunting, but the Prehabilitation Toolkit is here to make things a little easier. This simple, easy‑to‑follow guide helps you take small steps to improve your fitness, nutrition and emotional wellbeing before treatment begins. These changes can help you feel stronger, cope better with treatment and recover more quickly. Created with patients and healthcare professionals across Northern Ireland, the toolkit includes practical tips, short videos and helpful resources you can start using right away. It’s designed to give you confidence, support and a sense of control at a time when you need it most.
Benefits of Prehab can be seen in as little as 2 weeks. Prehab;
• Helps you recover faster and may reduce hospital stay
• Can reduce treatment side effects
• Boosts strength, fitness and energy
• Gives you more control over your health and recovery
• Supports mental wellbeing and reduces stress
Stopping smoking and reducing alcohol can further improve your outcomes.
Small steps today can make a big difference to your recovery.
For more advice, speak to your clinical nurse specialist or a member of your healthcare team.
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Physical Activity
Being physically active before and during cancer treatment can help improve your strength, reduce fatigue, and support your overall wellbeing. Even small increases in activity can make a difference.
How Much Activity Should You Aim For?
Aerobic Activity
- 150 minutes of moderate activity each week, or
- 75 minutes of vigorous activity each week
(You can break this into shorter sessions, such as two 10‑minute walks a day.)
Examples: walking, swimming, cycling, dancing, gardening, aerobics, running.
Strength Training
- 2 days per week
Helps maintain muscle strength, bone health and daily function.
Examples: weights, resistance bands, stair climbing, carrying shopping bags, body‑weight exercises.
Balance Training
- 2 days per week
Improves stability and reduces the risk of falls.
Examples: tai chi, yoga, Pilates, balance exercises.
Why Staying Active Helps
- Supports your heart, lungs, and mental wellbeing
- Helps maintain muscle mass
- Can reduce fatigue
- May help you tolerate treatment better
- Helps keep your joints and bones strong
It is safe and recommended to exercise when you have cancer, including during treatment, unless advised otherwise by your healthcare team.
When to Be Careful
Avoid exercise and seek advice if you have:
- A fever
- Risk of bleeding
- Very low blood counts
- Severe fatigue
- Severe pain
Always speak to your GP, Clinical Nurse Specialist (CNS) or healthcare team if you are unsure.
Tips to Increase Your Activity
- Make small changes to your daily routine:
- Walk during lunch
- Stand or move during TV ad breaks
- March on the spot while the kettle boils
- Park further away from the entrance
- Choose stairs instead of the lift
- Try to walk a little further or faster every few days
- Use activity trackers or free NHS apps such as Active 10 or Couch to 5K
- Choose activities you enjoy—swimming, cycling, dancing, yoga, Pilates etc.
- Include strength exercises twice a week using weights, bands, or household items
Useful Resources
You can access a range of exercise videos and guidance from Macmillan Cancer Support
Your local Council Leisure Provider may also offer specialist exercise programmes and support from trained professionals.
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Nutrition
Receiving a cancer diagnosis can be a difficult and emotional experience. It’s common for stress and uncertainty to affect your appetite and cause unintentional weight loss. Eating well before and during treatment can help you feel stronger, improve your recovery, and support your overall health.
Why Good Nutrition Matters
A healthy, balanced diet can help to:
- Support healing – especially after surgery
- Strengthen your immune system and reduce infection risk
- Improve how well you cope with treatment and its side effects
- Reduce the risk of other conditions, such as heart disease and diabetes
- Boost energy levels and reduce fatigue
Healthy Eating Tips
Eat a Balanced Diet
- Choose a variety of foods from all food groups.
- Aim for regular meals to maintain energy levels.
- Stay well hydrated to support normal body function and temperature control.
For more guidance, visit the Eatwell Guide:
www.food.gov.uk/northern-ireland/nutritionni/eatwell-guideMonitoring Your Nutrition
- Keep track of your weight
- Weigh yourself regularly and report any unexpected changes to your healthcare team.
- Review your food choices
- A food diary and the Eatwell Guide can help you understand your eating patterns and portion sizes.
- Choose healthier options
- Check food labels and use tools like the NHS Food Scanner App.
- Plan ahead
- Avoid skipping meals or relying on high‑sugar snacks when very hungry.
- Involve family and friends
- Help those who cook for you understand your nutritional needs.
If you have been given personalised dietary advice, continue to follow the guidance from your consultant or clinical nurse specialist.
If You Have Lost Weight Unintentionally
Speak with your clinical nurse specialist or healthcare team. You may need support from a dietitian.
Ways to Increase Calories and Protein
- Eat small, frequent meals, every 2–3 hours
- Choose full-fat dairy (milk, yoghurts)
- Fortify milk with skimmed milk powder (unless advised otherwise for kidney conditions)
- Add cheese, butter or cream to meals
- Include nourishing snacks, such as milky puddings, malt loaf (e.g., Veda), cheese on crackers, or buttered crumpets
- Avoid “low‑fat”, “diet” or “sugar‑free” products
- Bring snacks and drinks to appointments in case of delays
- Report symptoms such as nausea, constipation or poor appetite to your healthcare team
*If you have chronic kidney disease only use fortified milk under the guidance of your dietitian.
Swallowing Difficulties
If you are struggling to swallow (dysphagia), please inform your clinical nurse specialist or healthcare team. You may be referred to a Speech and Language Therapist. Getting help early can greatly improve your comfort and quality of life.
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Emotional Wellbeing
A cancer diagnosis can affect how you think and feel. It’s completely normal to experience emotions such as worry, fear, stress, or low mood. Preparing emotionally for treatment and looking after your mental health can help you feel more in control and reduce anxiety or depression.
Preparing Emotionally for Treatment
People cope with cancer in different ways. You might find it helpful to:
- Look for information and ask questions
- Use problem‑solving or distraction
- Talk to someone you trust
- Use humour or activities you enjoy
Taking time to focus on your emotional wellbeing before treatment can help you feel more prepared.
Steps to Support Your Mental Health
- Use available support
- The Macmillan Health and Wellbeing Service Macmillan Health and Wellbeing Service – South Eastern Health & Social Care Trust offers guidance and emotional support for people with cancer and their families.
- Local patient support groups can connect you with others who understand what you’re going through.
- Use coping strategies that have helped you before
Think about what has helped you during tough times in the past—for example:
- Art, gardening, reading, or other hobbies
- Reducing alcohol or caffeine
- Keeping a healthy sleep routine
- Avoiding overworking or late nights
A short video on calming techniques is available here Calming Skills
- Practise self‑compassion
The way you speak to yourself matters. Try gentle, encouraging statements such as:
- “I can get through this.”
- “I need time to calm myself.”
- “I have things to be grateful for.”
Helpful tools:
- Self‑Compassion: https://tinyurl.com/mwmr7uwu
- Building Resilience: https://www.ascert.biz/?s=Bend+dont+break
- Reflect on how you feel
Keeping a diary can help you recognise patterns, triggers, and things you can control. Mental health apps (e.g. Headspace, CALM) may support anxiety, mood, or sleep.
- Stay active
Physical activity is proven to boost mental health. Aim to:
- Be active daily
- Plan regular exercise throughout the week
- Reach out for support
Talk to someone you trust. Your healthcare team is also here to help and can refer you to specialist emotional support services.
Sleep Tips (Sleep Hygiene)
Good‑quality sleep helps with energy, mood, and coping. Try to:
- Keep the same bedtime and wake‑up time each day
- Create a calming bedtime routine
- Make your bedroom cool, dark, and quiet
- Avoid phones, tablets, or TV in bed
- Limit caffeine, alcohol, nicotine, and large meals 4–6 hours before bed
- Avoid daytime naps
- Manage stress using the techniques above
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Other Healthy Lifestyle Changes
Making small, positive lifestyle changes can improve your overall wellbeing and help your body prepare for – and recover from – cancer treatment.
Stopping Smoking
Quitting smoking before treatment is one of the most effective ways to support your health. Stopping smoking can:
- Improve how well your treatment works
- Help wounds heal faster
- Reduce the risk of treatment delays and complications
- Lower the chance of cancer returning
- Improve your long‑term health and quality of life
Tips to Help You Stop Smoking
- Choose a quit date and make a plan
- Think about what might make stopping difficult and how to manage it
- Speak to your GP or local chemist for free Stop Smoking support
- Tell family and friends so they can encourage you
- Keep trying – many people need a few attempts
- Remind yourself why you want to stop
- Change routines linked with smoking
- Keep your hands and mind busy with other activities
Specialist support is available through your Trust’s Smoking Cessation Service. Your Clinical Nurse Specialist or healthcare team can help you get started. For further information about the Smoking Cessation Service in the South Eastern Trust visit our website by clicking on the link Smoking Cessation – South Eastern Health & Social Care Trust
More information is also available at Stop Smoking NI
Reducing or Stopping Alcohol
Reducing how much alcohol you drink can help your recovery. Drinking more than 4 units per day can double your risk of problems after surgery.
To stay within recommended limits, men and women should drink no more than 14 units per week, spread over at least 3 days.
Examples of Alcohol Units
- Alcopop 275ml (4%) = 1.1 units
- Pint of cider (4.5%) = 2.6 units
- Pint of beer (4%) = 2.3 units
- Can of beer 330ml (5%) = 1.7 units
- Small bottle of wine 187ml (12%) = 2.3 units
- 35ml spirits (vodka/whiskey) = 1.4 units
- Bottle of wine 750ml (12%) = 9 units
- Bottle of spirits 700ml (40%) = 28 units
Tips to Reduce Alcohol Intake
- Eat a meal before drinking
- Choose smaller glasses
- Avoid topping up so you can track your intake
- Try not to drink alone at home
- Use soft drinks or alcohol‑free options
- Alternate alcoholic drinks with water
- Keep a diary of how much you drink
- Notice your triggers and plan alternatives
- Set a clear goal and stick to it
Lifestyle changes can be difficult especially during times of stress. If you need help, reach out to your clinical nurse specialist or healthcare team for more specialist support.
Top 10 Tips for Prehab and healthy lifestyle
- Move more – be as active as possible
- Look after your diet – aim for balanced, nutritious meals
- Keep hydrated – drink plenty of water
- Reduce or cut out alcohol
- Stop smoking
- Improve your sleep and manage your energy levels
- Talk to people about how you’re feeling
- Practice mindfulness and relaxation
- Set small goals and keep a diary to track your progress
- Don’t be afraid to ask for help