Can Prehab for Cancer Patients Really Reduce Hospital Stays?

This article discusses the positive impact of a specialised exercise, diet, and wellbeing programme on cancer patients undergoing surgery, highlighting how participation can reduce hospital stays and improve health outcomes. The initiative, known as "prehab2rehab," was evaluated by Public Health Wales and recommended for broader implementation across all cancer types in Wales.

Last updated: 21 October 2023 (BST)

Key Takeaways

• The "prehab2rehab" programme showed a reduction of three days in hospital stays for patients post-surgery.
• Patients who engaged in exercise classes experienced significant health improvements.
• The initiative is recommended for all cancer patients in Wales, not just those with colorectal cancer.
• Support services included dietary advice, psychological therapy, and access to specialist clinics.
• Engagement from a diverse range of patients remains a challenge, particularly from ethnic minority communities.

Understanding Prehabilitation in Cancer Care

Prehabilitation, often referred to as 'prehab', involves a series of interventions designed to prepare patients for surgery. This proactive approach focuses on enhancing physical fitness, nutritional status, and overall wellbeing before undergoing medical procedures. The "prehab2rehab" programme at Cardiff and Vale health board is a prime example of how such initiatives can be structured to support cancer patients effectively.

The Importance of Prehabilitation

Prehabilitation serves several critical purposes in the context of cancer treatment:

• Improved Physical Health: Prehabilitation helps patients improve their strength and endurance, making them better candidates for surgery.
• Enhanced Mental Wellbeing: Engaging in a structured programme can instil a sense of purpose and control in patients facing a cancer diagnosis.
• Reduced Hospital Stay: Evidence suggests that patients who participate in prehab programmes have shorter recovery times and hospital stays.

How the "prehab2rehab" Programme Works

The "prehab2rehab" initiative is designed to support patients from the moment cancer is suspected. This early intervention allows General Practitioners (GPs) to refer patients to the programme, providing a comprehensive support system until the day of surgery.

Components of the Programme

Participants in the programme benefit from a range of services tailored to individual needs, which include:

• Dietary Advice: Nutritional support to enhance overall health and recovery.
• Exercise Classes: Physical activity sessions provided at local leisure centres and gyms.
• Psychological Therapy: Support to help manage the emotional challenges of a cancer diagnosis.
• Access to Specialist Clinics: Coordination with various healthcare professionals, including cardiologists and pharmacists.

Results of the Study

The evaluation conducted by Public Health Wales revealed promising findings regarding the effectiveness of the "prehab2rehab" programme. Here are some of the report's key insights:

Hospital Stay Reduction

One of the most significant outcomes noted was the reduction in the average hospital stay for those who participated in the programme. The report indicated that patients who engaged in exercise classes for three or more sessions spent approximately three days less in the hospital following surgery compared to those who did not participate.

Enhanced Patient Flow in the NHS

This reduction in hospital stay not only benefits patients but also has implications for the National Health Service (NHS) as a whole. With ongoing challenges regarding waiting lists and capacity, improving patient flow through effective prehabilitation can enhance the ability of the NHS to manage planned care more effectively.

Challenges and Considerations

Despite the positive findings, the report acknowledged several limitations that must be addressed to enhance the programme's effectiveness:

• Limited Diversity: There was concern that few patients from ethnic minority communities engaged with the scheme, indicating a need for targeted outreach and engagement strategies.
• Single Cancer Type Focus: The majority of participants were diagnosed with colorectal cancer, limiting insights that could be drawn for other cancer types.

The Call for Broader Implementation

Given the promising results, health advocates and professionals are calling for the "prehab2rehab" programme to be expanded to include all cancer patients in Wales. Lowri Griffiths, Chair of the Wales Cancer Alliance, emphasised the importance of entering treatment as healthily as possible to improve overall outcomes. This call to action highlights the need for a systematic approach across all health boards in Wales to ensure that every patient can benefit from these supportive services.

The Role of Exercise in Recovery

Physical activity has been shown to play a vital role in the recovery of cancer patients. The exercise classes included in the programme not only provide physical benefits but also foster social connections among participants. These connections can significantly enhance emotional wellbeing during what can be a challenging period.

The Future of Prehabilitation in Cancer Care

The findings from the "prehab2rehab" programme suggest that prehabilitation could become a standard part of cancer care across the UK. As more health boards consider implementing similar initiatives, the focus will need to be on ensuring accessibility for all patients, particularly those from underserved communities.

Conclusion

Prehabilitation represents a significant advancement in the way cancer care is approached in the UK. By integrating exercise, dietary support, and psychological wellbeing into the pre-surgery process, patients can experience better outcomes and shorter hospital stays. As the healthcare community pushes for broader implementation of such programmes, the emphasis will likely remain on ensuring equitable access for all individuals diagnosed with cancer.

As we move forward, it will be essential to monitor the effectiveness of such programmes and adapt them to meet the diverse needs of the population. How might prehabilitation change the landscape of cancer treatment in the coming years? #CancerCare #Prehabilitation #NHS

FAQs

What is prehabilitation in cancer care?

Prehabilitation refers to a series of interventions aimed at improving a patient's physical and mental health before surgery. This approach helps patients prepare for the challenges of surgery and recovery.

How does the "prehab2rehab" programme work?

The "prehab2rehab" programme supports patients from the point of cancer suspicion, offering services like dietary advice, exercise classes, and psychological therapy until the day of their surgery.

What are the benefits of participating in a prehabilitation programme?

Participating in prehabilitation can lead to shorter hospital stays, improved physical fitness, better mental wellbeing, and enhanced overall health outcomes for patients undergoing surgery.

Why is early intervention important in cancer care?

Early intervention allows patients to engage in prehabilitation before surgery, which can optimise their health and readiness for treatment, potentially leading to better outcomes.

Are there any limitations to the findings of the "prehab2rehab" study?

Yes, the study noted limitations such as the focus on primarily one type of cancer and concerns about engagement from ethnic minority communities, which need to be addressed for broader applicability.