Early prehabilitation reduces admissions and time in hospital in patients with newly diagnosed lung cancer

Iain Philips*, M Deans, A Walton, J Mencnarowski, D McMillan, C Peacock, Maheva Vallet, L Allan, R Petrie, Peter S Hall, Melanie J Mackean, Mark Stares, C Reid, F O'Brien, T Plant, R Grecian, D Blues, S Haddad, C Barrie

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objectives Lung cancer is the leading cause of cancer death in the UK. Prehabilitation aims to maximise patient fitness and minimise the negative impact of anticancer treatment. What constitutes prehabilitation before non-surgical anticancer treatment is not well established. We present data from a pilot project of Early prehabilitation In lung Cancer.

Methods All new patients with likely advanced lung cancer were offered prehabilitation at respiratory clinic, if fit for further investigation. Prehabilitation included assessment and appropriate intervention from a consultant in palliative medicine, registered dietitian and rehabilitation physiotherapist. Four objective endpoints were identified, namely admissions to hospital, time spent in the hospital, treatment rates and overall survival. Outcomes were to be compared with 178 prehab eligible historical controls diagnosed from 2019 to 2021.

Results From July 2021 to June 2023, 65 patients underwent prehabilitation and 72% of patients underwent all 3 interventions. 54 patients had a stage 3 or 4 lung cancer. In the prehab group, fewer patients attended Accident and Emergency (31.5 vs 37.4 attendances per 100 patients) and fewer were admitted (51.9 vs 67.9) when compared with historical controls. Those receiving prehab spent a lot less time in the hospital (129.7 vs 543.5 days per 100 patients) with shorter admissions (2.5 vs 8 days). Systemic anticancer treatment rates increased in the short term but were broadly similar overall. Median survival was higher in the prehabilitation group (0.73 vs 0.41 years, p=0.046).

Conclusions Early prehabilitation appears to reduce time spent in the hospital. It may improve survival. Further work is required to understand its full effect on treatment rates.

Original languageEnglish
Number of pages5
JournalBMJ Supportive & Palliative Care
Early online date17 Apr 2024
Publication statusE-pub ahead of print - 17 Apr 2024


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