Abstract: Background: An increasing number of randomised trials are providing evidence that an optimal lifestyle after cancer can improve disease-free survival and overall chance of cure. Despite this, very few oncology units have integrated lifestyle strategies as part of their adjuvant management. Materials and methods: This two-year project involved patient volunteers, personal fitness instructors (PFI) and healthcare providers, including primary care trusts (PCT) representatives. The first phase involved a MEDLINE, Proquest, EMBASE and Cochrane Library search for literature addressing the benefits of lifestyle after cancer1. These data provided a foundation for a lifestyle manual and supporting lifestyle website2. It also convinced the PCTs to extend funding for their “exercise prescription programme”, to include cancer rehabilitation. This required extra training for the PFIs to meet the standards determined within the 2001 Department of Health Exercise referral document3. A cancer rehabilitation course was therefore designed in conjunction with a national training organisation, which provides a level 4 accreditation for PFIs. Finally, a convenient sized hand-held file was designed with feedback from our volunteer groups. Results: This project has enabled us to successfully implement the UK’s first post-adjuvant lifestyle toolbox, and establish Europe’s first cancer rehabilitation training programme for PFI. Patients now receive an exit lifestyle interview, a prescription for an exercise programme supervised by a trained PFI in a local gym and a hand-held file containing a “Lifestyle after cancer manual”, explaining the benefits of healthy living advising “What to do more of” and “What to avoid”. Conclusions: An evidence-based exit lifestyle toolbox has now been established. All UK oncologists can now write exercise prescriptions for their patients’ exiting adjuvant therapies, and the training programme established in this project will ensure PFI have the necessary skills. The next stage in this project is to evaluate the impact of this strategy on patients’ lifestyle choices. References 1. Thomas R Evidence for Oncology Lifestyle Clinics? Clinical Focus on Can Med, 2008 (1) 2; 38-48 2. www.cancernet.co.uk, 2009 3. Exercise Referral Systems: A National Quality Assurance Framework Crown Copyright, 2001, www.dh.gov.uk

Robert J Thomas¹, Madeleine M A williams², Chandu Prasannan²

¹Bedford Hospital NHS Trust and Cranfield University, ²Bedford Hospital NHS Trust

Keywords: Exercise , Diet , Lifestyle , Toolbox , Patient Information