For Professionals

Cancer prehabilitation is defined as:

“A needs-based multimodal intervention, before and during cancer treatment. The aim of prehabilitation is to optimise physical, nutritional and psychological status, enhance readiness for and tolerance of treatments, and improve recovery and/or quality of life. Prehabilitation involves screening before needs-based assessment, enabling individualised prescription of exercise, nutrition and psychological interventions supported by behaviour change techniques”.

Macmillan, 2025.

Evidence has shown that cancer prehabilitation can yield the following benefits;

  • Better response to treatment
  • Quicker recovery
  • Reduced incidence and severity of treatment side effects
  • Reduced risk of post-operative complications
  • Reduced anxiety and improved mood
  • Improved energy levels
  • Patients take an active role in their cancer care
  • Lower chance of cancer recurrence
  • Improves general fitness and can lessen severity of other health conditions
  • Improves ability for patient to fulfil normal activities of daily living
  • Greater sense of empowerment over their treatment experience

As such, cancer prehabilitation, as a component of rehabilitation, should underpin the whole cancer pathway and is an approach we seek for all patients with cancer in Scotland.

___________________________________________________________________________

Implementing cancer prehabilitation

Insights form those with a lived experience of cancer

The Health and Social Care Alliance Scotland (the ALLIANCE) were commissioned by the Scottish Government and it’s Cancer Prehabilitation Implementation Steering Group to conduct a series of focus groups. The groups would inform the design and delivery of cancer prehabilitation services in Scotland. A report detailing the findings of the focus groups has been produced and it includes a series of recommendations. The Cancer Prehabilitation Implementation Steering Group (CPISG) has welcomed these recommendations and would encourage anyone who is developing a prehabilitation service to consider their role in implementing these recommendations. The CPISG has also set out how they are responding to these in a formal reply:

Cancer prehabilitation focus groups: Insights report
Cancer Prehabilitation Implementation Steering Group response to the ALLIANCE’s focus group recommendations

Reducing variation

To address unwarranted variation and ensure quality of care a series of resources have be created to support the sustained development and implementation of cancer prehabilitation across Scotland.

Resources:

The image opposite explains how these resources can be used alongside this website and e-learning opportunities to improve service provision.

Further resources and training opportunities

Finally, the PRosPer programme which can be found under the ‘Education and Training‘ tab includes a toolkit to support service development and evaluation.

The image explains how to implement prehabilitation in Scotland, Step 1: Follow the key principles for Implementing Cancer Prehabilitation Step 2: Refer people affected by cancer to this website and show them the pages most appropriate for their needs. Step 3: Increase local capacity by working with community partners i.e. refer people to Maggie's for prehab and encourage uptake/refer to Improving the Cancer Journey and Move More (or local equivalent). Step 4: Use the psychological therapies and support framework and the nutrition framework to expand reach and ensure quality. Step 5: Learn more about prehabilitation, rehabilitation and personalised care by completing additional learning such as e-learning for health's PRosPer programme.

Insights from established services

From Theory to Practice: An International Approach to Establishing Prehabilitation Programmes (external link), published in Current Anesthesiology Reports in February 2022 also gives suggestions on implementation based on experiences from three countries.