Principles and guidance for prehabilitation

We have created principles and guidance for prehabilitation, to help you support people with cancer to live life as fully as they can.

What is prehabilitation?

Prehabilitation supports people living with cancer to prepare for treatment. It promotes healthy behaviours and prescribes exercise, nutrition and psychological interventions based on a person’s needs, to help them find their best way through.

When should it be implemented?

Prehabilitation should be implemented in the early stages of the patient pathway, ideally soon after diagnosis and well in advance of treatment for maximum benefit. It should be seen as part of the rehabilitation pathway, as a way to optimise a person’s health and wellbeing, maximising their resilience to treatment throughout the cancer journey.

What are the benefits?

Prehabilitation offers patients and care givers three main benefits:

  • Personal empowerment: A sense of control and purpose, which prepares people for treatment and improves their quality of life
  • Physical and psychological resilience: An opportunity to improve physiological function and psychological wellbeing, which offers resilience to the effects of cancer treatment, enhances the quality of recovery and helps people to live life as fully as they can
  • Long-term health: An opportunity to reflect on the role of healthy lifestyle practices after a cancer diagnosis, to promote positive health behaviour change.

Our prehabilitation guidance

We're delighted to have worked in partnership with the Royal College of Anaesthetists, the National Institute for Health Research Nutrition, and Cancer Collaboration. This is the first guidance of its kind in the UK and has been informed by experts around the world.

Additional resources

Prehabilitation podcasts

Podcasts by people living with cancer

Della, Clive and Jenny

Della, Clive and Jenny are three people living with cancer. In the podcasts below, they share their thoughts and experiences about prehabilitation.

Listen to Della and Clive's podcast >
Listen to Jenny's podcast >


Podcasts by experts

Professor Sandy Jack

Professor Sandy Jack, Professor of Prehabilitation at University of Southampton shares her views on developing the physical activity and exercise component of the prehabilitation guidance. She provides an overview of the consensus statements and her vision for prehabilitation for people living with cancer in the future.

Listen to the podcast >


Rob Copeland

Rob Copeland is Professor of Physical Activity and Health at The Centre for Sport and Exercise Science, Sheffield Hallam University. In this podcast, Rob shares his views on developing the psychological support and behaviour change component of our prehabilitation guidance. He also provides an overview of the consensus statements.

Listen to the podcast >


Dr Clare Shaw

Dr Clare Shaw, Consultant Dietitian at The Royal Marsden Hospital NHS Foundation Trust, shares her views on developing the nutrition component of our prehabilitation guidance and who was involved. She also provides an overview of the consensus statements.

Listen to the podcast >

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Comprehensive evidence review

Macmillan's Evidence Synthesis team has conducted a comprehensive synthesis of the last ten years of evidence. It is based on the framework and questions prepared by three expert groups during the scoping and development phase of our guidance.

Download the Comprehensive evidence review [Excel]

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