Prehab4Cancer is a transformation project which will facilitate up to 2000 people, living in Greater Manchester and East Cheshire, who are newly diagnosed with cancer, to engage in exercise, nutritional screening and have improved emotional well-being. The importance of preparation ‘Prehabilitation’ and active recovery pathways in cancer are being increasingly recognised by cancer patients and healthcare providers around the world.
Patients will be supported before and after cancer treatments (including surgery, chemotherapy and radiotherapy) and where applicable during treatment to have increased physical activity and fitness. Research suggests patients who undergo prehab should have improved clinical outcomes, including improved survival rates, greater tolerance to radical treatments and reduced post-operative complications. This should lead to reduced time spent in hospital or need for readmission to hospital.
The majority of participants within the prehab4cancer scheme will be seen by Level 4 cancer rehab trained personal trainers working within one of the GM Active local leisure organisations. Much of the interventions participants will engage in will be provided locally to where they life and will be personalised to their level of ability and their personal choices.
This programme recognises many of the secondary symptoms cancer patients experience including fatigue, low mood and feelings of anxiety. It builds on widely understood principles surrounding exercise positively contributing to the reduction of such secondary symptoms with the overall aim for patients to have improved quality of life, during and after treatment. This in turn supports people with cancer to recover faster from their treatment with resumed independence and the ability to perform their pre-morbid occupations including returning to work, self-care and other important activities of daily life.
We are working alongside Macmillan and the implementation of the Recovery Package, linking in with the Holistic Needs Assessments (HNAs) people diagnosed with cancer across the GM region are offered and utilising Prehab4Cancer to support people to live well with and beyond cancer.
This a test project and we are utilising the latest, emerging prehabilitation evidence to focus on patients treated within the colorectal, head and neck, lung and oesophago-gastric cancer pathways.
Prehab4cancer builds on the successful delivery of ERAS+, the enhanced recovery after surgery plus programme, which is being utilised by large numbers of surgical patients being treated in the majority of the hospitals across Greater Manchester. Within this programme patients are offered to attend surgery school to learn more about how best to prepare for surgery and have improved faster recovery from such treatment.
Our Poster Presentation from the 2018 Greater Manchester Cancer Conference
The Greater Manchester Cancer Prehab4Cancer Team
Dr John Moore
Dr John Moore is the Clinical Director for the Prehab4Cancer programme. He is the Medical Director on the ERAS+ programme and is the Clinical Head of Division for Anaesthesia, Peri-Operative Medicine and Critical Care Services at Central Manchester University NHS Foundation Trust. He is a Consultant in Anaesthetics and Intensive Care Medicine and a National Innovation Accelerator Fellow for NHS England.
John graduated in medicine from the University of Manchester in 1997 (MB ChB Hons). He took up his Consultant post at Central Manchester University Hospitals in Aug 1997. He became deputy CD and then CD for Adult critical care in May 2013. He has a widespread interest in the care of elective and emergency patients. He has a long-standing passion for QI, having been one of the joint developers of the National Tracheostomy Safety Project and is utilising his established and extensive innovation experience to contribute to the design, development and implementation of the Prehab4Cancer programme in Greater Manchester.
John is one of the Physical Activity co-chairs on the joint Macmillan and Royal College of Anaesthetist’s current ‘Fit for and after Cancer treatment’ FACT project, developing UK wide principles and guidance for prehabilitation in oncology.
Find John on Twitter @mysurgeryandme
Dr Karen McEwan
Dr Karen McEwan has been a GP for over 20 years and a Macmillan GP since 2012. She is a GP representative on 2 Greater Manchester Cancer Pathway Boards.
Karen has been instrumental in developing and implementing various innovation projects in Stockport, including tele-dermatology, symptomatic FIT pilot, Health and Well-being events for cancer survivors and a Multi-disciplinary breathlessness clinic. In addition to this, she has delivered multiple education events to primary care professionals.
Find Karen on Twitter here: @karen_mcewan17
Zoe Merchant is the Programme Lead for the Prehab4cancer programme. She is a specialist Occupational Therapist with over 10 years of physical and neuro-rehabilitation experience. Her previous posts have included setting up rehabilitation services for patients with a wide range of conditions, for which she was nominated for the NHS Leadership Academy ‘Emerging Leader’ award.
Zoe is a passionate Allied Health Professional (AHP) and a member of the Macmillan AHP Expert Group. She is registered with the HCPC and is a member of the Royal College of Occupational Therapists (including the Oncology Specialist Section). Zoe chairs a bi-monthly GM AHP advisory board focused on AHPs expert contributions to prehabilitation and rehabilitation.
Zoe is one of the main contributors to the patient engagement work stream within the joint Macmillan and Royal College of Anaesthetist’s current ‘Fit for and after Cancer treatment’ FACT project, developing UK wide principles and guidance for prehabilitation in oncology.
Zoe has recently been shortlisted for the AHA 2019 Macmillan AHP award for Leadership and innovation in cancer rehabilitation.
Find Zoe on Twitter @ZoeMerchantOT
Zoe Merchant talks about Prehab4Cancer as part of BBC Radio 5 Live’s “You, Me and the Big C” podcast – download it here.
Prehab4Cancer is co-designed with our patient engagement representatives. This is a mixture of people who have been treated for cancer themselves or those who have been a family member, carer or friend of someone with cancer, from the Greater Manchester area.
We aim to have at least one user involvement representative attending all meetings and events related to the design and delivery of this project.
We facilitated our first prehab4cancer patient engagement focus group in November 2018 where we were able to capture all the vital comments and contributions made visually in a mural created during this event. The outputs of this focus group has directly influenced the further design of our programme and helped us to understand patient and family members’ perspectives, key to the successful delivery of this project.
Greater Manchester is vibrant conurbation made up of a wide range of communities of people with diverse cultural and ethnic backgrounds. Our ongoing user involvement strategy focuses on engaging different groups of patients from across the region to offer valuable insight on how best to facilitate different members of society to engage in our prescribed prehab4cancer interventions.