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05 April 2019

Service development proves life-changing for patients

Three UH Bristol nurses are helping patients to improve their fitness so they can undergo life-saving surgery.

Surgery is often the only route of treatment for patients with upper gastrointestinal (GI) cancers and can bring life-saving benefits. However, many of these patients suffer with symptoms that damage their overall fitness such as jaundice and malnutrition, which means that they might be too high risk to undergo surgery.

But in 2017, upper GI clinical nurse specialists Ruth Harding, Carly Pillinger and Karen Clemett, set up a prehabilitation programme that helps patients improve their overall fitness so they are able to have this vital surgery. Ruth said: "Due to the nature of these cancers, patients are often diagnosed when their cancer is at an advanced stage, which means that surgery would be the only option. "About a third of this patient group would only be suitable to have surgery if they were fit enough."

Patients on the programme will work with a multi-disciplinary team to plan a fitness regime tailored to their abilities. "The aim is to plan exercises which work around the patients' fitness capabilities and lifestyle. It might be that the patient can take their neighbour's dog for a walk once a day, go to a Pilates class or simply walk to the shop. It's about increasing their heart rate and exercising to the point where they are hot and perspiring - this will ensure they are benefiting from the exercise. "We also have a dietitian who works with the team and helps patients with their diet, which can contribute to an overall improvement in fitness." During the programme, which usually lasts around six weeks, patients will receive a weekly phone call from one of the nurses who will discuss the progress of their fitness plan and also how they feel in themselves.

"Although the programme is predominantly about getting patients fit for surgery, part of the service is providing emotional support. Often the side effects of these cancers can be a strain on a patient's mental wellbeing. "As well as being able to provide emotional support, we can signpost to a variety of other services that may be helpful to the patient." 43 patients have been on the programme so far, 73% of those have improved their overall fitness to be able to be considered for surgery. "Those patients who are still unable to undergo surgery after the programme have fed back that they feel much better in themselves overall. Just the act of regularly exercising and having frequent contact with one of us helps to improve their overall wellbeing."


Upper GI nurse specialists