Tanya Wallington Cancer Specialist Physiotherapist Macmillan Professional Gloucestershire Care Services NHS Trust

Recovery & Rehabilitation Opportunity: we can now offer a complete package of care in Gloucestershire Diagnosis Treatment Recovery & Rehabilitation We have heard about some of the treatments that people affected by prostate cancer and colorectal cancer have and some of the side effects. Now in Gloucestershire, we have a complete package of care… that patients can be referred into Next Steps for rehab and recovery.

What does the evidence say? So why refer? What does the evidence say?

A 40% 57% Breast Colorectal 50% Prostate 30% Cancer Site Evidence Evidence Level Breast 40% 2.5 hours of moderate-intensity* activity per week = over 40% lower risk breast cancer-specific mortality, and breast cancer recurrence, compared with women active for less than one hour a week. A Colorectal 50% Risk of disease recurrence, cancer mortality was reduced by about 50%, with 6 hours of moderate intensity* physical activity per week. Prostate 30% 57% A lower risk of prostate-specific mortality of approximately 30% and a lower rate of disease progression of 57% with three hours per week of moderate intensity physical activity* Level A is a systematic review of RCT or high quality RCT/cohort studies with clear consistent results *moderate intensity physical activity - e.g. brisk walking, cycling on level ground, gardening, dancing to inc heart rate, get warmer, breath harder but still carry on a conversation.

Overall Well Being Level A Evidence: Activity Improves…. Bone Health Physical Function Fatigue Body Fat Composition Bone Health

Activity Cuts the risk of developing other health conditions by 20-50%* Coronary heart disease Stroke Diabetes mellitus Osteoporosis Obesity Some cancers Dementia *Level A Evidence

Research shows that if we: eat well move more good sleep relax All the level A evidence has been on activity alone but we do much more in cancer rehab. We look at health as interconnected and encourage people to make small changes in all areas of their lifestyle by: Eating well Moving more Getting good sleep Finding time to relax mind and body Rehabilitation and recovery can have a huge impact on overall health outcomes and wellbeing before and after treatment

Next Steps On The Road To Recovery Macmillan Next Steps NHS Cancer Rehabilitation aims to: Enhance Recovery from the physical and psychological consequences of cancer to improve health and wellbeing Prevent other health conditions, and Sustain Health by providing information, knowledge and skills to confidently self-manage Next Steps On The Road To Recovery People come to cancer rehab for a number of reasons: They may have a medical issue that needs addressing They may feel lost and abandoned after cancer treatment They may want to start to feel well again and self manage We offer 1:1 clinics to enhance recovery and deal with consequences of cancer We also prevent deterioration in health and sustain health using group programmes and education Anyone can refer – we have brought information

It’s a marvellous scheme I have nothing but praise.” “Cancer rehabilitation will help you out of a hole following a shocking experience - make the most of it. You may be terrified, you have been through hell, and it’s not easy. It’s a marvellous scheme I have nothing but praise.” Colorectal cancer patient