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Early prehabilitation reduces admissions and time in hospital in patients with newly diagnosed lung cancer
  1. Iain Phillips1,2,
  2. Maria Deans3,
  3. Abi Walton1,4,
  4. Mahéva Vallet2,
  5. Julie Mencnarowksi4,
  6. Debbie McMillan4,
  7. Catriona Peacock4,
  8. Peter Hall2,
  9. Fiona O’Brien4,
  10. Mark Stares2,
  11. Melanie Mackean1,
  12. Tracie Plant4,
  13. Robert Grecian4,
  14. Lindsey Allan5,
  15. Rebecca Petrie1,
  16. Duncan Blues1,
  17. Suraiya Haddad1 and
  18. Colin Barrie1,4
  1. 1Edinburgh Cancer Centre, Western General Hospital, Edinburgh, Scotland, UK
  2. 2Edinburgh University, Edinburgh, UK
  3. 3Cancer Information Team, Western General Hospital, Edinburgh, UK
  4. 4St Johns Hospital, Livingston, UK
  5. 5Department of Nutrition and Dietetics, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
  1. Correspondence to Dr Iain Phillips, Western General Hospital, Edinburgh, UK; iain.phillips{at}


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.

  • Palliative Care
  • Psychological care
  • Lung
  • Symptoms and symptom management

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  • X @LindseyAllan6

  • Contributors The project was conceived by IP, FO'B, JM and CB, with input from PH, MS and MM. The prehab intervention was carried out by DM, CP and AW. Data collection and analysis by MVV, MD, SH and DB. Manuscript first draft written by IP with contributions for coauthors.

  • Funding Funding for this project was received from MSD as part of a joint working project between MSD and NHS Lothian.

  • Competing interests The prehabilitation team received funding as part of a joint working project between NHS Lothian and MSD. IP received an honorarium for speaking about prehabilitation and for a round table discussion on cachexia.

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