Prehab gives cancer patients a boost

University of Auckland researchers Dr Hanna van Waart and Dr Marta Seretny are pioneering research in New Zealand on prehabilitation programmes for people with a range of cancers.

These programmes offer support to people soon after they have been diagnosed with cancer, aiming to build resilience before the stresses of treatment.

Prehab focuses on what people need, including guidance with exercise, nutrition, and social and psychological support.

International studies show people with cancer who have prehabilitation are likely to have shorter hospital stays, fewer post-surgical complications, tolerate and complete chemotherapy better, have less brain fog, less fatigue and a higher quality of life following treatment, the researchers say.

“It’s not going to mean people don’t need treatment for cancer, but their responses to chemotherapy, surgery and radiotherapy seem to improve,” says Seretny.

A senior lecturer in anaesthesiology, Seretny also works as an anaesthetist at Auckland Hospital – Te Toka Tumai, where she meets patients with new diagnoses and helps them prepare for surgery.

This opened her eyes to the window of opportunity – of several weeks and sometimes months – between a patient’s diagnosis and the start of their treatment for cancer.

“I started wondering if we could use that time to build people up and support them,” says Seretny.

An exercise scientist and senior research fellow in anaesthesiology, van Waart published groundbreaking PhD research in 2015 on the benefits of exercise for people who were undergoing chemotherapy for cancer.

The traditional belief was that people should rest during chemotherapy, but van Waart’s research showed exercise strengthens cancer patients during treatment and helps alleviate side effects of chemotherapy, such as pain, fatigue, nausea and vomiting.

“International studies that followed up patients over many years have found higher rates of disease-free survival and overall survival if people with cancer exercise during treatment and after.

“We’re seeing exercise is like a medicine. If exercise was a pill, we would prescribe this pill,” says van Waart.

The pair launched their research on prehabilitation in their own spare time, before van Waart received a post-doctoral fellowship from Cancer Society New Zealand in 2024.

Now, they lead a research team tailoring prehabilitation programmes to address the specific needs of people with three types of cancers – breast cancer, sarcoma and childhood cancers. Programmes for other cancers could be created in the future.

Seretny and van Waart have just started co-designing prehab for Māori women with breast cancer, as part of a bigger research programme, Whiria Te aka Matua, that recently received $5 million from the Health Research Council.

International research shows only about 40 percent of cancer patients take up offers of exercise programmes from hospitals.

“We want to find ways to deliver prehabilitation in such a way that more people are willing and able to take it up,” says van Waart.

Recent medical breakthroughs mean more people with cancer survive, but many have a “dismal” quality of life afterwards. Some continue to feel so exhausted after chemotherapy that they can’t return to work or a normal life, says Seretny.

The researchers, from the University’s Centre for Cancer Research, hope prehabilitation will help reduce people’s stress during cancer treatment and improve their quality of life afterwards.

“Rather than just treating the body, we’re treating the whole person and their whānau,” says van Waart.

The new prehabilitation programmes will be trialled in Auckland, before potentially being rolled out across the whole of Aotearoa.