Your Prehabilitation Plan for Lung Cancer Surgery

*Please note: This slide show is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor about any questions you may have regarding a medical condition.

About prehabilitation for lung cancer surgery

You've probably heard of rehabilitation – treatment after an injury, surgery, or illness to recover and regain strength, mobility, and ability.

Prehabilitation is similar but starts before surgery or another treatment. The goal is to help boost your physical health, mental health, and nutrition before surgery.

About prehabilitation for lung cancer surgery

Lung cancer prehabilitation, or "prehab", helps you cope with surgery and treatment, spend less time in the hospital, and recover with fewer physical problems.¹

Prehabilitation can also help you do better if you have chemotherapy or radiation before surgery.

Why is prehab important?

Prehab is important because lung cancer surgery is a major operation which may require removal of part or a whole lung, with post-surgery chemo and/or radiation.

Prehab can also give you some control over how you feel, which can be very important during cancer treatments.²

The most common types of prehab for lung cancer surgery

The most common types of prehab are respiratory or breathing exercises, eating well, physical activity, dental and oral hygiene, and your lifestyle and well-being.² You can remember these with the word: READY.¹

Respiratory exercises in prehab

Respiratory, or breathing, exercises can reduce shortness of breath and help you breathe in more oxygen. These exercises can also lower your risk of surgical complications, such as infection.³

Respiratory exercises in prehab

Here are some simple exercises:

• First, breathe in through your nose, hold your breath for 3 seconds…

Respiratory exercises in prehab

…and then slowly breathe out through your mouth.

Respiratory exercises in prehab

• Next, huff out sharply through your mouth, like you are trying to steam up a mirror.

Respiratory exercises in prehab

• Finally, give a good, strong cough.

Do each exercise 3 times in a row. Try to do these exercise sets 3 times a day, such as morning, mid-day, and in the evening.²

Eating well during prehab

A balanced diet helps you stay as healthy as possible before surgery. In the U.S., the MyPlate guide can help with how much to eat of different types of food.⁴

Protein helps your body heal from surgery and other treatments. Good protein choices include lean meat, eggs, beans, and fish. Avoid eating processed meat like ham or bacon.

Eating well during prehab

Fruits and vegetables provide essential vitamins and nutrients for healing.⁵

Your doctor may also talk with you about drinking enough fluids and balancing your electrolytes, which are minerals that affect how your entire body functions.⁶

Physical activity in prehab

Activity is beneficial before surgery. If possible, do 30 minutes of physical activity a day.

Simple activities like walking, gardening, or riding a bike can help you prepare for surgery. Your doctor may also recommend physical therapy to help strengthen your body.²

How do I know I am exercising right?

Exercise can make you feel a little breathless, warm and sweaty. However, you should still be able to talk during exercise.

If you feel very uncomfortable, stop. Contact your doctor if you can’t catch your breath after resting for a few moments, feel dizzy, nauseated, or have chest pain.²

Simple exercises for prehab

Simple prehab exercises include marching in place, circling your arms, and twisting gently to the left and right. These are simple exercises that you can do at home while watching TV.

Simple exercises for prehab

You may also try standing up from a sitting position, rising on your toes 10 times, or doing squats or leg lifts with a chair for balance.

Your doctor or a physical therapist may give you a list of exercises or recommend a specific program for you.²

Dental and oral health

Dental health is also part of prehab. People with poor dental and oral health are more likely to develop complications such as pneumonia and other infections after surgery.⁷

Brush your teeth at least twice a day for two minutes and floss daily. If you have any tooth problems, ask your doctor if you need dental treatment before surgery.²

Your lifestyle and well-being

A healthy lifestyle before surgery can help you recover better.

If you drink alcohol, you may need to limit this before surgery to lower the risk of complications after surgery.⁸

If you smoke, stopping is an important part of prehab. It can reduce the risk of complications and help you live longer with better quality of life.

About 1 in 3 smokers diagnosed with lung cancer keep smoking.⁹ But research shows people who stop smoking when diagnosed have a better chance of survival.¹⁰

If you smoke, ask about help with quitting as part of your prehab.

A path to successful lung cancer treatment

Even if you have just a short time before lung cancer surgery, prehab can help. Each activity in your prehab program helps you prepare for better results from surgery and will help you enjoy a better outlook and quality of life after treatment.

References

1. Fenemore J, Roberts J. Prehabilitation to improve lung cancer outcomes 1: principles and benefits. Nursing Times [online]. 2021 Oct;117(10):30-33.
2. National Health Service. Prehabilitation – Prepare for your lung surgery. Last revised: November 2023 (Version 1).
   https://hospital.nhsgoldenjubilee.co.uk
3. Tiep B, Sun V, Koczywas M, Kim J, Raz D, Hurria A, Hayter J. Pulmonary Rehabilitation and Palliative Care for the Lung Cancer Patient. J Hosp Palliat Nurs. 2015 Oct;17(5):462-468.
4. U.S. Department of Agriculture. MyPlate.
   https://www.myplate.gov/eat-healthy/what-is-myplate
5. Kerneen N. Pre- and post-surgery nutrition. Midwest Orthopedic Specialty Hospital. Last revised: October 2016.
   https://www.mymosh.com/orthopedics/pre-post-surgery-nutrition
6. Neskey M. Nutrition and lung cancer. J Oncol Navig Surviv. 2020 Mar;11(3).
   https://jons-online.com/issues/2020/march-2020-vol-11-no-3/2840-nutrition-and-lung-cancer
7. Camus-Jansson F, Longueira-Diaz N, Salinas-Diaz B, Granic-Chinchón A, Cueto-Urbina W, Parra-Parra M, Lopez-de-Blanc SA. Preoperative oral practices and incidence of postoperative complications in hospital medical-surgical procedures: A meta-analysis. Med Oral Patol Oral Cir Bucal. 2023 May 1;28(3):e217-e228.
8. Oppedal K, Møller AM, Pedersen B, Tønnesen H. Preoperative alcohol cessation prior to elective surgery. Cochrane Database Syst Rev. 2012 Jul 11;(7):CD008343. Update in: Cochrane Database Syst Rev. 2018 Nov 8;11(11):CD008343.
9. Burris JL, Studts JL, DeRosa AP, Ostroff, JS. Systematic review of tobacco use after lung or head/neck cancer diagnosis: Results and recommendations for future research. Cancer Epidemiol Biomarkers Prev. 2015 Oct;24(10):1450-1461.
10. Caini S, Del Riccio M, Vettori V, Scotti V, Martinoli C, Raimondi S, Cammarata G, Palli D, Banini M, Masala G, Gandini S. Quitting smoking at or around diagnosis improves the overall survival of lung cancer patients: A systematic review and meta-analysis. J Thorac Oncol. 2022 May;17(5):623-636.