‘I’m doing belly crunches!’ Pre-hab cuts recovery times for cancer patients
Cancer patients are recovering quicker from surgery thanks to a first-of-its-kind exercise programme which also prepares them for their op.
For years medics have promoted the importance of rehab in getting patients back on their feet after surgery, but now ‘pre-hab’ has been shown to shorten hospital stays, reduce side effects and lead to overall better health.
The programme, which combines supervised training sessions with a dedicated mobile app, has been offered to lung cancer and Hepato-Pancreatico-Biliary (HPB) patients waiting for a procedure in north east London.
HPB includes diseases of the liver, pancreas, gallbladder and bile ducts.
Through a mixture of face-to-face sessions in hospital and via the app, a small team of nurses, physiotherapists and exercise physiologists support patients to improve their fitness levels, eat more healthily and prepare psychologically for surgery.
They can track patients’ symptoms, monitor weight loss and offer advice on how to quit smoking or cut down alcohol consumption with the long-term aim of stopping the cancer from returning in the future.
Surgery is the best treatment for lung cancer but often the disease is too advanced or patients are deemed not fit enough to undergo an op.
Barts Health clinicians recognised they had a large number of patients in the latter group and wanted to do more to get them into shape.
Thanks to funding from the North East London Cancer Alliance, they are projected to see around 300 patients in their first year
Without this programme I would still have lung cancer
Leonard a 66 year-old former construction worker from east London was recently diagnosed with lung cancer. He was invited to join the pre-hab programme and within weeks his lung capacity had improved by as much as 70% on some indicators.
He said: "I started out on the bike and then moved to the walking machine. I could feel my lungs getting stronger day by day. The doctors were over the moon. It really made all the difference.
"I desperately needed surgery but without these exercises there’s no way my body could take it.
"Without this programme I would still have lung cancer."
Tai, a retired kitchen assistant from Dagenham (pictured above), needed surgery to treat her liver cancer following unsuccessful bouts of chemotherapy. Too unwell for her operation, she was referred to the pre-hab service in December last year.
She said: "Every morning I would wake up in pain. I was tired and breathless and I didn’t know if I could even walk down the road.
"But the team said to me ‘you can do it’. It built up my confidence. I pushed myself and now, weeks on from surgery, I feel much stronger.
"I regularly walk to the chemist and my surgeon has challenged me to do 10,000 steps a day. I am even doing belly crunches!
"There’s no way I’d be in this position without my pre-hab team."
For the NHS this means making more hospital beds available for patients
Alice Finch, a specialist cancer physiotherapist who runs the service, said: "Pre-hab has significant benefits for patients, from getting them home sooner after surgery to reducing the risk of post-op complications.
"For the NHS this means making more hospital beds available for patients in need and lessening the long-term burden on services by promoting more active lifestyles."
The team hope to secure more funding to expand the service to other tumour groups and include the support of dieticians and occupational therapists.
Alice said: "The potential of the programme is huge and includes cancer patients undergoing chemotherapy and radiotherapy where improved fitness can cut side effects like weight loss and fatigue."