• Individuals with lung cancer who undergo a prehabilitation program after diagnosis and throughout treatment may have better outcomes post-treatment.
• A prehabilitation program for lung cancer includes a regime of exercise, dietary changes, and psychological assistance.
• People who undergo prehabilitation experience improved survival, cope better with treatment, and have fewer complications from surgery, according to research.

A prehabilitation program may be the key to achieving the best results from lung cancer treatment, according to British lung cancer nurses Jackie Fenemore and Josie Roberts. In a newly released series of articles in Nursing Times, the two describe the benefits and practices of a prehabilitation program, which encompasses a regime of exercise, dietary intervention, and psychological interventions alongside medical treatment for lung cancer.

Prehabilitation offers “a way of introducing better health to aid recovery from treatment, a better chance to tolerate treatment and its side effects,” Fenemore told MyLungCancerTeam.

What Is Prehabilitation?

In part one of the series —Prehabilitation To Improve Lung Cancer Outcomes 1: Principles and Benefits — Fenemore and Robert outline what they deem the “four pillars” of prehabilitation:

• Eating high-protein nutritional supplements or foods
• Undergoing high-intensity endurance and strength training
• Stopping smoking
• Getting psychological support

Fenemore and Roberts note that every person’s needs are different, and it takes a supportive village to help a person process, cope with, and move forward after a lung cancer diagnosis. Receiving assistance from several medical professionals with nutrition, an exercise plan, and mental and emotional support can help a person maintain peak health as they undergo rigorous treatment.

In part two of the series — Prehabilitation To Improve Lung Cancer Outcomes 2: Putting It Into Practice — the authors explore how people with late-stage lung cancer also may benefit from prehabilitation with better health outcomes and improved quality of life. They advocate for the integration of prehabilitation into lung cancer services. “Introducing prehabilitation for late-stage lung cancer could improve patients’ fitness for systemic treatment, as well as health outcomes and quality of life for this group,” the authors conclude.

Is There Evidence That Prehabilitation Works?

In reviewing several studies on prehabilitation, Fenemore and Roberts found that individuals in the early stages of their treatment who underwent prehabilitation had fewer treatment-related complications and higher five-year survival rates. They also were better prepared for future treatment. “[Prehabilitation] has been offered for many years, and only more recently, we are seeing the benefits to patients [receiving treatments like] chemotherapy and radiotherapy,” Fenemore told MyLungCancerTeam.

Fenemore and Roberts wrote that prehabilitation programs for cancer recovery, such as Prehab4Cancer in England, have been promising for those undergoing cancer treatment including chemotherapy, initial diagnosis, and surgery. Such programs can help address nonphysical effects of cancer treatment including low mood, anxiety, and fatigue. Having an improved mood and more positive outlook can help people continue or resume daily living and self-care, depending on where they are in their treatment program.

For advanced-stage cancer, evidence is limited as to the effectiveness of prehabilitation, according to the series. Case studies, however, show how prehabilitation can potentially improve patient access to and suitability for treatments.

People living with lung cancer should seek guidance from their health care team regarding the best prehabilitation services for their particular diagnosis.