What is prehabilitation?

Prehabilitation or prehab means getting ready for cancer treatment in whatever time you have before it starts. It is a programme of support and advice that some NHS hospitals are using. It covers three particular parts of your health:

  • what you're eating and your weight

  • physical activity or exercise

  • mental wellbeing

Stopping smoking and cutting down on alcohol can also help. It helps while you're having treatment, with your recovery, as well as improving your overall health.

The video below is about the things you can do to improve your health and wellbeing before cancer treatment. It is for anyone affected by cancer. The video is around 6 minutes long.

We have more detailed information about the three parts of prehabilitation. 

How does prehabilitation help?

At diagnosis, your medical team checks for any problems you might have in the three areas above. Research shows that if you get support early on and are as healthy as possible before treatment starts, you are more likely to:

  • leave hospital sooner after cancer surgery

  • cope better with the side effects of cancer treatment

  • have fewer side effects

  • have more treatment options

  • have better long term health

Prehabilitation plays a role during your cancer care. That includes diagnosis, treatment and follow up. It then continues as rehabilitation as part of your personalised care and support planning (PCSP).

Feeling more in control

Following a prehabilitation programme can help you feel more in control of your physical and mental health. You can cope better during treatment if you feel more in control. By taking care of your diet, physical fitness and mental health, you can live well in the long term.

Is there prehabilitation in every hospital?

At the moment, not everyone having cancer treatment will have prehabilitation. Research shows that it is helpful for people having surgery. But researchers think it might also help people having other cancer treatments such as chemotherapy and radiotherapy.

You might have prehabilitation at your cancer hospital or a local leisure centre as part of a NHS programme. Your doctor may also ask you to join a clinical trial looking into prehabilitation.

Some hospitals only offer prehabilitation to people with certain types of cancers. This includes:

  • upper gastrointestinal cancers such as oesophageal and stomach cancer

  • lung cancer

  • bowel cancer

  • prostate cancer

What happens if I’m not offered prehabilitation?

Not having prehabilitation will not affect the type of treatment you have for your cancer. You will still have the best possible treatment.

You can talk to your doctor, specialist nurse or other members of your healthcare team before you start treatment. Tell them if you're worried about your diet, physical fitness or mental health. They can give advice or may refer you to a specialist.

You can also follow one of the prehab programmes available online. You can use the information and videos on these websites for free. Always check with your GP or healthcare team before starting.

How does prehabilitation work?

There are 4 stages to prehabilitation:

  • screening

  • assessment

  • intervention

  • monitoring


It’s important that the healthcare team looking after you finds out about any problems you might have as early as possible. This means that you might have screening at the same time as you are having tests to diagnose your cancer.

During screening, your team looks at:

  • your weight, whether you have had any weight loss or weight gain recently, as well as your eating and drinking

  • how physically active you are

  • your mental well being

Your team usually uses questionnaires such as the Holistic Needs Assessment (HNA) as part of prehabilitation screening. The HNA is a simple questionnaire that shows what needs you might have.


Depending on the results of your screening, your team may refer you to specific prehab teams. They can be in the hospital or community. The teams can include:

  • exercise specialists

  • physiotherapists

  • occupational therapists

  • dietitians

  • other NHS staff

These teams might ask you more questions about your needs or do special tests if they want to know more. For example, if your screening shows that you might not be very fit, you may have a physical fitness assessment. This might be a 6 minute walk test or a test that looks at how far you can walk, with the pace increasing gradually every minute.

And if your screening shows that you have problems with your diet, you may have a nutritional assessment.

The results of these assessments will show your prehab team:

  • what are your needs

  • how much support you might need

  • the best way to improve your physical, nutritional and mental health in the time before treatment


Your prehab team looks at your needs and plans interventions. There are 3 types of interventions you might have:

  • universal
  • targeted
  • specialist

You might need a mix of different types of interventions. Universal interventions might support some of your needs. But other problems might need targeted or specialist interventions. You may also move between interventions over time.

It is important that your prehab team knows how much you can do, as well as what your needs and wishes are. They will adapt your prehab activities accordingly.

Universal interventions

Universal interventions are for anyone with cancer and their families. It focuses on 3 lifestyle changes:

  • diet

  • physical activity

  • mental health

Your team might give you information on how to make changes in these 3 areas. Or they might signpost you elsewhere such as a website, app or videos.

In addition to these 3 areas, your team may also talk to you about:

  • stopping smoking

  • reducing the amount of alcohol you drink so it’s within the suggested limits

Targeted interventions

A targeted intervention is planned support from an expert. They are for people with cancer who are at risk of having long term side effects of treatment or have other health conditions.

Examples of targeted interventions include:

  • a referral to an exercise class if you need support with physical activity. This might be a group class or a one to one class

  • seeing a dietitian that can help with diet problems caused by your cancer or other conditions such as diabetes

  • seeing a healthcare professional that can help you deal with anxiety and low mood

Specialist interventions

Specialist interventions are for people with cancer who have complex needs, are going to have major treatment or have a disability.

Examples of specialist interventions include seeing a:

  • physiotherapist at the hospital if you can’t do much physical activity

  • dietitian who can prescribe food into a tube into your stomach if you have complex diet problems

  • a psychologist or psychiatrist if you have had a mental health problem before your cancer diagnosis


Monitoring your progress when doing the prehab activities is important. It helps the prehab team understand how the activities have been helping you and if they need to change anything.

How much monitoring you need depends on the type of intervention you have.

More information

You might find it useful to look at the following sections:

Related links