Pioneering pre-surgery exercise sessions for cancer patients are set to be piloted at gyms and cancer support centres across the region in the first project of its kind in the UK.
The novel ‘prehabilitation’ programme, developed by a team of experts in anaesthesia, oncology, surgery, perioperative medicine and critical care at University Hospital Southampton NHS Foundation Trust, will be trialled as part of NHS England’s £200 million strategy for transforming cancer outcomes and survival.
It follows research published in 2014 by critical care consultant Professor Mike Grocott and his team into the effect of tailored exercise programmes on bowel cancer patients after chemotherapy and radiotherapy but before surgery.
By training on a bike three times a week, they found patients’ fitness returned to pre-treatment levels or improved within six weeks, but remained at post-treatment levels or dropped further in those who didn’t.
They followed patients for a year after their operations and found a reduction in length of hospital stay, readmission rates and cardiorespiratory complications and subsequently launched a wider Fit-4-Surgery project to trial a range of specific exercise programmes to improve outcomes at Southampton General Hospital.
Now, in partnership with the Wessex Cancer Alliance, Wessex Cancer Trust and council and community gyms, they have been awarded £2.3 million to look at whether or not the exercise sessions, along with psychological wellbeing support, can be taken out of hospital and delivered to more patients across the south.
The study will compare exercise sessions only, psychological support only or both together against current standard care for the level of effect on patients’ postoperative length of stay, quality of life, outcomes and one-year survival.
It will use UK-first clinical measures of quality of life, developed by NHS England and unveiled last week, which are designed to assess how well patients are living as opposed to focusing solely on clinical impact and how long patients live after treatment.
“We know that patients who are physically fitter recover better from surgery across a range of outcomes, so it is now important we try to increase access to some of the pioneering practices we have developed in Southampton,” said Prof Grocott, who is a professor of anaesthesia and critical care at the University of Southampton.
Dr Sandy Jack, an associate professor in clinical exercise science at the University of Southampton and study lead, said: “This is extremely exciting on several levels but, most importantly, it will widen access to something that we’ve shown changes patients’ wellbeing, fitness for surgery and initial outcomes.
“We will be using new measures to understand outcomes and this will be a unique partnership between the NHS, charities and the leisure industry to improve patient care."
She added: “In addition to that, it will be the first time such a study has formed part of NHS sustainability and transformation plans – so it really will be a new way of advancing care and access to it.”
The project is being run in collaboration with Royal Bournemouth and Christchurch Hospitals NHS FT, Poole Hospital NHS FT, Hampshire Hospitals NHS FT, Portsmouth Hospitals NHS Trust, Dorset County Hospital NHS FT and the Isle of Wight NHS Trust and supported by the Royal College of Anaesthetists.
Posted on Tuesday 24 October 2017