Prehabilitation

Adults are recommended to exercise at a minimum level each week. Research has shown that if you meet these requirements, then your risk of side effects from cancer treatment is reduced. It also aids in a quicker return to doing the things you love.

See the excercise guidelines on the NHS website.

If you already do exercise such as walking, then consider whether you are going at a pace that is classed as ‘moderate.’ For this, you should be able to hold a conversation but be slightly breathless.

If you are new to exercise, then have a think about what could work for you and would fit within your routine. You are much more likely to stick to an activity plan, if it is something you enjoy doing or fits into your day.

Exercise snacking is a useful way to gradually increase your activity during the day; things like doing step ups on the bottom stair every time you are passing or 10 sit to stands from your chair every time you go to stand up. Parking in the furthest corner of a car park or getting off the bus a stop early are other ways of gradually increasing how much you are moving.

If you enjoy watching TV then aim to get up and move at each advert break, or if you are a sports fan, do some exercise every time a goal is scored (or a penalty is given depending on the match!)

There are lots of tips on increasing your activity on the NHS Get Active website.

Walking is one of the best ways to exercise, and it is free. Tips to set yourself off with good walking habits can be found here.

The NHS have also developed an ‘Active 10’ app which can link with the step tracker on your smart phone. If you are feeling motivated to get running, then they also have the ‘Couch to 5K’ app which can help you along the way.

Please remember that the advice given here does not consider any other medical issues you may have, so before doing any new exercise, it is worth getting clearance from either your GP, oncologist, Surgeon, or Cancer Nurse Specialist (CNS).

Exercise is recommended during treatment such as chemotherapy as it is shown to reduce ay decline associated with the treatment as well as reduce side effects such as fatigue. However, there are a couple of instances where we would advise you not to exercise:

• If you have developed vomiting and/or diarrhoea, then you need to wait 48 hours after your symptoms have stopped before starting up any exercise again.
• If your bloods between chemo cycles have come back altered and they have postponed your next cycle, then give yourself chance to rest and wait until your next cycle before resuming any exercise programme. (If you feel able, then do continue with normal daily activities – it is the extra exercise you need to take a rest from).
• If you have a PICC line, then please do not exercise with that arm but do feel free to exercise with the other one. If you have a Hickman line, then you are not restricted with arm exercises. But please check with your oncologist.

If you are due to have surgery, then it is a clever idea to work on increasing your fitness and strength ahead of the date. Everyone deconditions after surgery because of the operation itself, as well as the reduced activity in the few weeks afterwards. Therefore, if you can increase your general fitness and build strength beforehand, then you will have a ‘safety net’ to make recovery easier.

It is important to ensure you are eating well, however there are factors that influence your diet and means you may not be able to follow ‘routine’ advice. If you have previously been given dietary advice for another condition, then please continue to follow this unless instructed otherwise.

Your cancer team will let you know if you need to make any changes to your diet and if necessary, refer you to a local dietitian.

If you have been told that you should lose weight ahead of your treatment, then the NHS website will give you some ideas of how you can do that in a healthy way.

This website from Macmillan gives advice for healthy eating following a cancer diagnosis.

It is important to take care of your mental health at any time in your life, but even more so after a diagnosis of cancer.

Research has shown that people with mental health symptoms are more likely to struggle with the recommended treatment and its side effects. It is therefore important to make sure you look after your mental wellbeing.

Cancer Research UK have put together information on mental health for cancer patients. 

Some tips for looking after your mental wellbeing can be found on the NHS website, but in summary:

• Be in the present, this could include doing mindful breathing exercises, yoga or a nature walk
• Aim to get good sleep
• Connect with others; either in person or over the phone. You could even go for a walk together and include some exercise at the same time
• Do something for yourself. If you have hobbies, then aim to continue them, or you could take up something new. Things like reading, gardening, photography, knitting, bike riding, researching your family tree......the possibilities are endless!

Macmillan have valuable resources on managing stress and anxiety.

Maggie's have breathing and relaxation techniques to help you to manage your emotions.

If you are feeling anxious about work/finances or if you are caring for someone and are worried about how you will be able to cope during your treatment, then Macmillan Information and Support are a good place to start. Your local support hub can be found at:

RLI Macmillan Centre, entrance to Medical Unit 1, near the general office

FGH Macmillan Centre, located on Level 4 off the main corridor opposite the RVS shop.

Their service hours are 8am - 4pm, Monday - Friday (excluding Bank Holidays) and they can also be contacted on:

• Telephone: UHMBT Macmillan Cancer Information and Support (landline): 01524 519578

• Mobile: UHMBT Macmillan Cancer Information and Support (mobile): 07972639424

• Email Macmillan at UHMBT: macmillan.info@mbht.nhs.uk

Further information can be found on the Macmillan page of our website.

Locally we have a charity called ‘Cancer Care’ and they can provide a range of treatment for people coping with cancer and bereavement. Their contact number is: CancerCare - 03330 150 628.

There are also free counselling sessions available via BUPA: Free specialist counselling for people with cancer | Macmillan Cancer Support

There are many benefits to stopping smoking. These include:

• Better Physical Health
• Better mental health
• Reduced risk of smoking related diseases
• More money in your pocket

When it comes to smoking and cancer treatment, research has shown that stopping smoking can improve your response to chemotherapy and radiotherapy, as well as reduce your risk of surgical complications.

There is support for those wanting to stop, both at a local and national level. Locally, we have the Quit Squad which can be contacted on 0800 3286297 or on the Quit Squad website.

Nationally, there is support from the NHS, Macmillan, and Cancer Research UK via the following sites:

NHS quit smoking

Macmillan giving up smoking support

Cancer Research Uk - how do I stop smoking?

There is also a free NHS App called ‘Quit Smoking’ which can be downloaded to your smart phone.

Cutting back on alcohol can have many benefits:

• Increase energy
• Lose weight
• Save money
• Health benefits such as; lower blood pressure and cholesterol levels, reduce your risk of a stroke and liver disease as well as improving both your mood and memory

The research around alcohol and cancer treatment, shows that alcohol can worsen the symptoms caused by chemotherapy and other drugs. These include nausea and mouth sores. Drinking alcohol is also linked to complications with wound healing, infections, and excessive bleeding.

Support can be found on the NHS website, which also has a free app which can be downloaded to your phone called ‘Drink free days.’

Locally, we have Inspire which can be accessed here.