{
  "abstract": "Introduction The benefits of prehab for lung cancer patients are accepted but services vary across England; with financial constraints potentially limiting commissioning of new services. Locally we have a cancer prehab service involving telephone assessment and signposting to local health opportunities/exercise programmes. We also utilise rapid access to pulmonary rehabilitation (PR) for patients on lung cancer pathway with potentially curable disease but clinical assessment of ‘borderline fitness’ for surgery. PR offers a face/face programme with tailored therapy plan including optimisation of co-existent respiratory disease. Local PR has a 33% ‘drop out’ rate; capacity we prioritise for referred cancer patients aiming initiation within 7 days.Methods Retrospective study of patients referred for PR on lung cancer pathway June 2023 - Feb 2025. We collected PFTs, staging, performance status (PS) pre/post PR, surgical complications and total length of stay (LOS).Results 31 patients were referred for PR (11 male, 20 female, mean age 70.8, all initially assessed PS1–2), 27/31 confirmed NSCLC (3 benign, 1 radiological), 7 later upstaged to 3B/4 disease. 11/31 declined PR. PR averaged 7 face/face sessions/patient (median 6) with ave 69 days referral to surgery. Within PR group mean FEV1 72%/ TLCO 59% vs no PR 71%/ 56%. 19/20 PR group were confirmed NSCLC- 7/19 improved PS on tertiary assessment,13/19 remained the same. Within the no PR group, 8/11 NSCLC- 2/8 improved PS; 4/8 unchanged; 2/8 declined. 18/20 PR group had active treatment (8 surgery, 5 SACT, 5 SABR/radical radiotherapy) 2 declined. Within no PR group 7 surgery, 1 declined. All surgical procedures were VATS, with average LOS 6.1 days PR group vs 7.3 days no PR.Conclusions Many patients attending PR had improvement in PS (37%) over the diagnostic pathway with no PS decline (25% PS decline in refusal group) and an average lower surgical length of stay. We feel the preserved PFTs but clinical assessment of ‘borderline fitness’ points to significant deconditioning which may be improved by the intensive nature of PR.With current financial restraints we have found rapidly available capacity in an established respiratory service that could improve patients’ lung cancer treatment and outcomes.",
  "authors": [
    {
      "affiliations": [
        "Wirral University Teaching Hospitals, Birkenhead, UK"
      ],
      "name": "J Dunlop"
    },
    {
      "affiliations": [
        "Wirral University Teaching Hospitals, Birkenhead, UK"
      ],
      "name": "S Parkinson"
    },
    {
      "affiliations": [
        "Wirral University Teaching Hospitals, Birkenhead, UK"
      ],
      "name": "P Deus"
    },
    {
      "affiliations": [
        "Wirral University Teaching Hospitals, Birkenhead, UK"
      ],
      "name": "K Hughes"
    },
    {
      "affiliations": [
        "Wirral University Teaching Hospitals, Birkenhead, UK"
      ],
      "name": "A Wight"
    }
  ],
  "title": "P174 Utilising pulmonary rehabilitation services to deliver rapid intense prehabilitation for selected lung cancer patients on diagnostic timed pathways",
  "uid": "a56356c4-c05c-5142-a5ae-a9060edd768f"
}