New Prehabilitation Unit in Wrexham helping patients prepare for major cancer surgery

A new state-of-the-art prehabilitation unit for cancer patients having major surgery has opened at the Wrexham Maelor Hospital.

The new unit aims to ensure that patients are fit enough to have their big operation which will also help reduce the risk of complications, improve their recovery and help patients go home earlier following the surgery.

A team of health care professionals including anaesthetists, physiotherapists, exercise physiologists, dietitians, occupational therapists and respiratory physiologists have all bee involved in designing and supervising a bespoke programme for each patient.

“Undergoing major surgery is physically, nutritionally and psychologically demanding,” said Consultant Anaesthetist, Dr Neil Agnew.

“Research shows that elderly patients with poor physical fitness as well as a poor nutritional state have a much higher risk of complications after major surgery.

“Patients undergoing major cancer surgery face additional demands as their surgical treatment is often combined with chemotherapy and radiotherapy.”

In 2019, Betsi Cadwaladr University Health Board held a pilot prehabilitation programme which followed 50 patients preparing for major cancer surgery in Wrexham.

It found that these patients on average were able to be discharged home two days sooner and had half the number of complication rates following surgery compared to patients not attending prehabilitation.

Patients were also more likely to maintain their new healthier lifestyle after surgery improving their long-term health.

Dr Agnew added: “The pilot was a success with patients of all ages really enjoying the sessions.

“Patients felt fully prepared mentally and physically. Due to the pandemic we were unable to continue with the supervised face to face sessions. Instead, we had to rely on telephone support which was not as effective.

“We were then able to restart the service on a small scale using the gym in Wrexham University as a temporary facility whilst developing our own bigger unit.

“We’re delighted to have opened our new Prehabilitation Unit which will be just for our patients.

“Helping patients get as fit as they can before surgery will make them stronger and feel more prepared. They will be less likely to suffer complications resulting in a quicker recovery.

“Also, with the new extra space it’s now possible to help a wider range of patients prepare for surgery.”

Patients listed for major surgery will be invited three times a week to the prehabilitation unit, which is based on the Wrexham Industrial Estate.

Their fitness programme starts a few weeks before their operation and includes a mix of regular supervised exercises, respiratory muscle training and improvements in diet and psychology sessions.

The Health Board CEO Carol Shillabeer and Chair Dyfed Edwards officially opened the prehabilitation unit along with patients and their families.

Current and past patients also attended the opening event, along with the Shooting Stars Charity which has supported the unit with funding.

One former patient, Jeremy Norton was invited to attend the gym before his bowel cancer surgery.

Jeremy 63, from Broughton, said: “I was diagnosed with cancer in December and my surgeon referred me to the prehabilitation unit.

“It was a time my life was upside down really, a time of great uncertainty, so I felt everything else felt out of control but by attending prehabilitation was something I could control and do something for myself to get me stronger and operation ready.

Jeremy Norton

“I was told about the process of attending the gym and the sessions also include therapy to learn how to eat well, sleep well and breath properly. I started my sessions the beginning January of this year just after I was diagnosed, up until my surgery at the end of February.

“I attended the prehabilitation unit three days a week for gym, tai chi and therapy sessions. They also checked all my stats, fitness level, and gave me exercises to do at home and gave me a breathing monitor. It gave me a lot of comfort knowing my health was being assessed the whole way through.

“It has made a huge difference to me, coming to prehabilitation not only gave me more strength and got me surgery ready but also meeting some other patients really helped, to see what others were going through.

“There’s a lot of humour and positivity in the room, and made me feel like I’m not on my own going through this.

“I knew what I put into this is what I’d get out, and I felt stronger and confident going into surgery. I was out of hospital after 5 days which I wasn’t expecting, and back in work after four weeks which I put down to prehabilitation, the strength it gave me helped the recovery process.

“I still use a lot of what I’ve learnt the breathing exercises helps me sleep, I’m watching what I eat and my anxiety is under control. What I’ve learnt will be part of my life now.”