Hi Sam. Thanks for highlighting. I am unable to access “Scheduled for surgery? Prescription: exercise” either through my institution or Athens. May be because it is newly published … Thanks.

Thanks for the papers Sam. The one that I was most interested in, as it aligns with some of my current thinking, related to the subject of Psychological Interventions in Prehabilitation.

Of course, we speak often of exercise and nutrition, both of which I recognised as vital to my own experiences when going through successful cancer treatment seven years ago. But what impacted me most before and after surgery was the need for a resilience mentally, as well as physically.

For me at the time, there wasn’t a priority given to this aspect of preparation and I sought it out myself. And I am aware that because of my healthcare background, I had some understanding of how I could access it. Equally, most patients and public will naturally find this a minefield to navigate! And knowing how thinly spread services are at present, almost impossible under the NHS.

What stood out for me from the paper was the variety of interventions that could be routinely available – relaxation techniques, deep breathing, psychological education, counselling referral and personalized coping strategies. And yet less that 15% of trials seem to use this adjunct to prehab routinely.

I would be very interested in other SIG members experiences of their routine use in their everyday clinical settings. I wonder what % of cancer clinics use this approach for their patients every diagnosis?

And which interventions were found to be the most effective when combined with exercise and nutrition changes at a local level?

Certainly there is a need to share exemplars and practical steps for others to set up the triad of intervention and so benefit patients.

I was fortunate to support and input the team that published Preoperative Assessment and Optimisation for Adult Surgery including consideration of COVID-19 and its implications (June 2021), which can be found on the CPOC website. https://cpoc.org.uk/sites/cpoc/files/documents/2021-06/Preoperative%20assessment%20and%20optimisation%20guidance.pdf

The need for psychological screening was certainly recognised, and section 9 dealt with aspects of mental health and cognition assessment and preparation. Three years on, I wonder how well this guidance has been embedded and used?

And whether it has translated into a practical rational for help and psychological intervention?

Maybe food for thought and some further SIG members comments.