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Early prehabilitation in suspected locally advanced and metastatic lung cancer
  1. Iain Phillips1,
  2. Rebecca Petrie1,
  3. Lindsey Allan2,
  4. Peter Hall1,
  5. Abi Walton3,
  6. Debbie McMillan3,
  7. Catriona Peacock3,
  8. Lorraine Primrose1,
  9. Mahéva Vallet1,
  10. Julie Mencnarowksi3,
  11. Neil MacDonald4,
  12. Melanie Mackean1 and
  13. Colin Barrie1,3
  1. 1Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
  2. 2Department of Nutrition and Dietetics, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
  3. 3Oncology department, St Johns Hospital, Livingston, UK
  4. 4Merck Sharp & Dohme UK Ltd, London, UK
  1. Correspondence to Dr Iain Phillips, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, EH4 2LF, UK; iain.phillips{at}


Objectives The most common treatment for locally advanced and metastatic lung cancer is best supportive care. Patients with lung cancer are often comorbid with a high symptom burden. We wanted to assess whether early prehabilitation was feasible in patients with likely lung cancer.

Methods Patients were offered prehabilitation if they were attending the new patient respiratory clinic, had a CT scan suggesting stage III or IV lung cancer and undergoing further investigations. Patients receiving palliative care were ineligible. All prehabilitation patients were referred to a palliative medicine physician, registered dietitian and rehabilitation physiotherapist.

Results 50 patients underwent prehabilitation between June 2021 and August 2022. The median age was 72 years (range 54–89 years). 48 patients had lung cancer. 84% of patients attended all three interventions.

Half of the palliative care consultations focused on pain. Half of the patients seen had a change in medication. 25% of patients’ weights were stable, 32% required a food-first strategy and 33% required oral nutritional supplements. 57% of patients discussed managing breathlessness with the physiotherapist.

Conclusions Early prehabilitation is feasible alongside the investigation of locally advanced and metastatic lung cancer. Further work will aim to assess its impact on admission to the hospital, survival and treatment rates.

  • Lung
  • Hospital care
  • Supportive care
  • Respiratory conditions

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  • Contributors The project was conceived by IP, CB, NM and AW. The prehab intervention was carried out by JM, LP, AW, DM and CP. MVV and RP collected and analysed the data. MM, PH and LA contribued to the concept of the project and reviewed the manuscript.

  • Funding The EPIC project is a joint working project between NHS Lothian and MSD.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.