Consultant in Intensive Care and Anaesthesia, Manchester University Hospital NHS Foundation Trust, Clinical Director GM Cancer Prehab4Cancer, University of Manchester, Manchester Metropolitan University, UK.
Programme Lead GM Cancer Prehab4Cancer/Specialist Occupational Therapist, UK.
Eur J Surg Oncol. 2021 Mar;47(3 Pt A):524-532. doi: 10.1016/j.ejso.2020.04.042. Epub 2020 May 1.
Patients undergoing major cancer interventions such as major surgical resection, chemotherapy, radiotherapy, and immunotherapy are prone to the adverse effects of their cancer, as well as to the side effects of the treatments designed to cure them. The Prehabilitation process supports cancer patients in preparing for the physiological challenges of their cancer treatments, whilst aiming to shorten recovery time, reduce peri-operative complications and improve compliance with non-surgical treatments. Prehabilitation will be most useful in older patients. Greater Manchester Integrated Care system is the first regional system in the UK to introduce delivery of system-wide, large scale physical activity supported multi-modal prehabilitation and recovery programme, Prehab4Cancer as a standard of care for cancer patients. It builds upon the successful implementation of Enhanced Recovery After Surgery + programme to improve surgical care in Greater Manchester. During this review we describe the journey to develop a system wide prehabilitation model for patients with cancer. Prehab4Cancer to date has focused on robust co-design, development, and implementation of an effective service model with attention paid to stakeholder engagement. This has led to receipt of high numbers of referrals from across Greater Manchester for the all the cancer groups involved. The successful implementation of the P4C pathway in GM presents a best practice model that might be adopted by other local and combined authority areas nationally.
接受重大癌症干预的患者，如大手术切除、化疗、放疗和免疫治疗，容易受到癌症的不良反应以及旨在治愈他们的治疗的副作用的影响。康复前准备过程支持癌症患者为癌症治疗的生理挑战做准备，同时旨在缩短恢复时间、减少围手术期并发症并提高对非手术治疗的依从性。康复前准备对老年患者最有用。大曼彻斯特综合保健系统是英国第一个引入全系统、大规模的物理活动支持的多模式康复前准备和恢复计划（Prehab4Cancer）作为癌症患者护理标准的区域系统。它建立在成功实施增强手术后康复+计划的基础上，以改善大曼彻斯特的外科护理。在本次审查中，我们描述了为癌症患者开发全系统康复前准备模式的历程。迄今为止，Prehab4Cancer 专注于稳健的共同设计、开发和实施有效的服务模式，并关注利益相关者的参与。这导致来自大曼彻斯特各地的大量转诊，涉及所有癌症群体。P4C 途径在 GM 的成功实施提出了一个最佳实践模型，可能被其他国家的地方和联合管理区采用。
