A new set of guidelines has been launched to help ensure better prehabilitation services for people living with cancer.
Research suggests that prehabilitation can provide a number of benefits, such as reducing some of the complications caused by cancer treatment [1,2,3] and speeding up people’s recovery as well as enhancing their quality of life [2]. This can all lead to shorter hospital stays and cost savings for the healthcare system [3].
Macmillan Cancer Support, working with leading organisations including the NIHR Southampton Biomedical Research Centre, the national Centre for Perioperative Care, the NIHR Cancer and Nutrition Collaboration and the World Cancer Research Fund provided expertise and engagement with extensive professional networks.
‘Prehabilitation for people with cancer: clinical and implementation guidelines’ provides updated recommendations on how best to design, develop and deliver prehabilitation before and during cancer treatment. It is the result of a review of reports and evidence of good practice in this area. The guidelines have been developed to support healthcare providers, commissioners, researchers, and policy makers to guide pathway redesign, business cases and improve service delivery.
The healthcare areas they cover are exercise and nutrition; psychological support; behaviour change and technology; prehabilitation implementation; health economics and business cases.
The NIHR Southampton Biomedical Research Centre has led clinical trials (WESFIT, SAFEFIT) demonstrating the safety, feasibility and effectiveness of prehabilitation for patients undergoing cancer surgery. The reduction in length of stay and economic benefits shown within these studies led to the establishment of the first NHS funded clinical service at University Hospital Southampton.
Prehab4cancer in Greater Manchester is another example of a service reviewed in this process that has delivered a positive impact of good cancer prehabilitation. Over one year, 550 ward and 146 critical care bed days were released for people with colorectal cancer, and the figures suggest that for every 1,000 people with colorectal cancer who receive the service there would be savings of an estimated £1.2 million, which would both cover the costs involved in setting up and delivering the service for a year and make it sustainable on a recurrent basis [4].
June Davis (pictured), 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 7 years, so 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.”
Professor Mike Grocott, director of the NIHR Southampton Biomedical Research Centre and co-chair of these 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.”
By working with leading healthcare providers and partners, Macmillan is helping to transform cancer care for the future, so everyone gets the best care the UK has to offer, whoever and wherever they are.
‘Prehabilitation in Cancer: Clinical and Implementation Guidelines’ can be found on the Macmillan Cancer Support website at: Prehabilitation resources for healthcare professionals | Macmillan Cancer Support.
This is just one example of the resources produced by Macmillan and their partners to help healthcare professionals provide more patients with the best possible care.
References
[1] Hirst N, Solomon MJ, McBride K et al. Prehabilitation including psychological interventions reduces overall postoperative complications following cancer surgery: a systematic review and meta-analysis of randomised controlled trials. Support Care Cancer 2025; 33: 1070 https://doi.org/10.1007/s00520-025-10118-3
[2] Molenaar CJL, Minnella EM, Coca-Martinez M et al. Effect of multimodal prehabilitation on reducing postoperative complications and enhancing functional capacity following colorectal cancer surgery: the PREHAB randomized clinical trial. JAMA Surg 2023; 158: 572-581. doi: 10.1001/jamasurg.2023.0198
[3https://scwcsu.nhs.uk/documents/61-gm-prehab4cancer-evaluation-report-final-003/file%5b4] NHS South, Central and West Commissioning Support Unit. Prehab4Cancer evaluation. January 2022
[4] https://scwcsu.nhs.uk/documents/61-gm-prehab4cancer-evaluation-report-final-003/file
