Prostate cancer prehabilitation (prehab)

How you are thinking and feeling is important before and during treatment.
Your mind and body are closely linked, and each can affect the other.

There is no right or wrong way to feel. You may feel calm, anxious, angry or hopeful — or a mix of emotions at different times.

Feeling worried or fearful is normal. If these feelings start to affect your day-to-day life, extra support may help.

You may find it helpful to:

• Talk to someone you trust, such as a friend, family member or healthcare professional
• Try to get a good night’s sleep — your therapy team can offer advice if sleep is difficult
• Stay active, even gentle activity like a short walk
• Do things you enjoy, such as reading, listening to music or relaxing
• Practise slow, controlled breathing to help you feel calmer
• Try relaxation or mindfulness techniques — the therapy team can support you with this

Further support

• Prostate Cancer UK specialist nurses: 0800 074 8383
• Living with prostate cancer (Prostate Cancer Foundation)
  Information and support for people living with prostate cancer, including wellbeing, treatment and recovery.

If your mood or emotions change and you would like support, speak to the oncology prehab team or your Clinical Nurse Specialist.

Alcohol and smoking

Alcohol can affect your health and may increase side effects from prostate cancer treatment. If you would like support to reduce your alcohol intake, speak to your GP or visit Turning Point.

If you smoke, stopping can help improve your overall health. Support to help you stop smoking is available through NHS stop smoking services.

Staying as active as possible helps keep your heart and lungs strong.
This helps your body cope better with current or future treatment.

Any activity that makes you slightly out of breath is beneficial. This can include:

• Walking
• Gardening
• Housework
• Dancing
• Structured exercise

Exercise can also:

• Improve strength and balance
• Boost mood
• Reduce stress
• Improve sleep

How much activity should I aim for?

It can help to aim for:

• Around 150 minutes of moderate intensity activity each week. You should be able to talk, but not sing, while doing the moderate intensity activity.
• Strengthening activity twice a week

Eating well helps you:

• Maintain energy levels
• Support exercise
• Build physical reserves before treatment

You do not need to cut out foods or take supplements unless advised by your care team.

All foods can be part of a healthy, balanced diet — it is about getting the proportions right.

The Eatwell Guide shows what a healthy diet looks like: The Eatwell Guide - NHS

If you are losing weight, underweight, struggling to eat, diabetic, or have been advised to lose weight, you may need to speak to a dietitian, as this general advice may not be suitable.

Tips for good nutrition

• Monitor your appetite and any eating problems — contact the team if you struggle
• Aim for 3 regular meals per day
• Include a protein source with each meal, such as meat, fish, eggs, cheese, beans, lentils, nuts, tofu or Quorn
• Aim for at least 5 portions of fruit and vegetables each day
  One portion is roughly the size of your clenched fist
• Stay well hydrated — aim for 6 to 8 glasses of fluid a day
• Limit alcohol and consider avoiding it in the weeks before surgery
• Cut down on salt and salty foods

• Abbeycroft Leisure
  Free 12-week membership may be available. Speak to your GP about referral.
• Mindful movement
  A gentle or mixed-ability oncology rehabilitation class at Bury Physio. Six free sessions are available and funded by Cancer Support Suffolk. These classes are for anyone that has cancer, before or after treatment. To book a place, contact the Macmillan Information Centre.
• Move Against Cancer
  Includes 5k Your Way — a monthly walk on the last Saturday of the month at Nowton Parkrun (9am)
• NHS Active 10 app
• Exercise at home | The Royal Marsden

• West Suffolk Prostate Cancer Support Group
  Email: wsuffolkpcsg@gmail.com
  Phone: 07941 863511
  Facebook: West Suffolk Prostate Cancer Support Group | Facebook
  Website: West Suffolk Prostate Cancer Support Group
• Tackle Prostate Cancer: https://tackleprostate.org
• Prostate Cancer UK
• Relate (relationships support)

Some prostate cancer treatments can affect bladder control and sexual health.

Strengthening your pelvic floor muscles can help with bladder control after surgery or radiotherapy. You can find out more in our guide to male pelvic floor exercises.

For sexual health support: provide.suffolksexualhealthservice@nhs.net

Treatment can sometimes cause side effects, including:

• Weight gain
• Fatigue
• Hot flushes
• Low mood
• Bowel changes
• Incontinence
• Erectile dysfunction

Speak to your specialist nurse for advice and referral to specialist services.

You may be at higher risk of side effects if you:

• Are overweight
• Smoke
• Drink alcohol regularly
• Do little or no regular exercise
• Have other medical conditions