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

2. 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.

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

4. 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.

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

6. 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

7. 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

8. 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

9. 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