Cancer rehabilitation in the UK

What is cancer rehabilitation?

Cancer rehabilitation is help to recover strength, fitness, confidence and everyday function during and after cancer treatment. Support that starts before or early in treatment is called prehabilitation, or prehab. UK guidance from Macmillan and partners says "Prehabilitation is part of a continuum to rehabilitation", with exercise, nutrition and psychological support at its core [2].

Macmillan's 2025 clinical guidelines define prehabilitation as "a needs-based, multi-modal intervention delivered before and during cancer treatment to optimise physical, nutritional, and psychological health" [3]. Rehabilitation carries that work on after treatment.

What happens at each stage of cancer rehabilitation?

Before treatment the aim is to get ready (prehab); during treatment, to stay as active as is safe; after treatment, to rebuild fitness and strength. With secondary or advanced cancer, the aim is usually to keep you as independent and comfortable as possible.

Before treatment. Macmillan says prehabilitation "can start as soon as you are diagnosed, or sometimes even before diagnosis" [1]. See our guide to prehabilitation.

During treatment. US guidance from ASCO says "Oncology providers should recommend regular aerobic and resistance exercise during active treatment with curative intent" [10]. Cancer Research UK says "International guidelines say it is safe to be active during cancer treatment and after" [7]. See exercise during chemotherapy.

After treatment. For adults in general, the UK Chief Medical Officers advise at least 150 minutes of moderate activity or 75 minutes of vigorous activity a week, with muscle strengthening on at least 2 days [8]. Cancer Research UK uses the same targets for people with cancer, and says to check with your doctor before starting any exercise [7]. Build up gradually: an international expert roundtable says every survivor should "avoid inactivity" [9]. See exercise after cancer treatment.

Living with secondary or advanced cancer. UK guidance advises "caution where cancer has spread to bone and during treatment associated with reduced immunity or reduction in normal blood counts", and says "the advice of the oncology team should be sought" [2].

Request a match with a verified clinical exercise physiologist through The Health Nav

Who helps with cancer rehabilitation?

Your care is usually coordinated from your hospital by your clinical nurse specialist. Others who may help include physiotherapists, clinical exercise physiologists, cancer exercise specialists, dietitians, occupational therapists and psychological support. Not every hospital has every role, so ask who is available to you.

Our guide to your cancer rehabilitation team explains each role in detail.

• Physiotherapist. In Macmillan's words, "someone who gives advice about exercise and mobility" [5]. A protected title [17].
• Clinical exercise physiologist (CEP). Macmillan describes a CEP as "a healthcare professional who is an expert in screening, assessing and advising what physical activity is best for you and your situation" [5]. NHS Health Careers lists cancer care among the areas CEPs work in [20]. Read what a cancer exercise physiologist does.
• Cancer exercise specialist (Level 4 cancer rehabilitation instructor). Macmillan describes this as "a fitness instructor who is qualified to help people with cancer to exercise safely" [5]. One UK provider's Level 4 cancer rehabilitation course, for instance, is for fitness instructors or personal trainers who also hold a Level 3 exercise referral diploma [19]. UK guidance says specialist exercise support "may be delivered by chartered physiotherapists ... or by exercise physiologists or appropriately trained instructors" [2].
• Dietitian. Helps with eating, weight and side effects. A protected title [18].
• Occupational therapist. Can "advise you on how to pace yourself and manage tiredness" [5].
• Psychological support. One of the three core areas [2].

Is cancer rehabilitation available on the NHS?

Yes, but what you are offered depends on where you are treated. Macmillan says your specialist nurse or another member of your team can refer you "if there is a prehabilitation service within your hospital or local area" [1].

In England, the National Cancer Plan (4 February 2026) says: "From 2028, we will roll out a national digital-first prehabilitation offer to help all patients get healthier before they start treatment." It also says "Every patient will have a named neighbourhood care lead to co-ordinate their care and support after treatment" [4]. Scotland, Wales and Northern Ireland plan their own services.

How do I get referred, and can I self-refer?

Start with your clinical nurse specialist or another member of your cancer team; if you have no nurse specialist, ask your doctor whether there is one you can talk to [6]. Your GP can also refer you. You can go direct to some services, such as cancer support centres, community exercise classes and private specialists. Whichever route you take, tell your cancer team.

If long-term side effects stop you being active, Cancer Research UK says your healthcare team or GP "can refer you to a physiotherapist or another healthcare professional who specialises in working with people with cancer" [7]. Macmillan adds: "Some GPs, cancer treatment centres and support groups have exercise referral schemes. These can refer you to a cancer exercise specialist or a clinical exercise physiologist" [5]. See our guide to exercise referral.

Some support needs no referral. At Maggie's cancer support centres, which are free, "You don't need an appointment, just come in" [21].

Cancer exercise programmes and classes

Hospitals, leisure centres and charities in many areas run cancer exercise programmes, usually small supervised groups over a set number of weeks. Some take self-referrals. Our guide to cancer exercise programmes explains what to expect.

Does cancer rehabilitation work?

The evidence for exercise is good and growing, including two recent trials in specific groups. Results apply to the people studied, so they are not a promise for every cancer.

• Everyday outcomes. The right dose of exercise "could improve common cancer-related health outcomes, including anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life" [9].
• Fatigue. A 2012 Cochrane review of 56 studies found aerobic exercise "can be regarded as beneficial for individuals with cancer-related fatigue during and post-cancer therapy, specifically those with solid tumours" [14]. See cancer-related fatigue.
• Colon cancer after chemotherapy (CHALLENGE, 2025). In 889 people who had finished treatment for stage III or high-risk stage II colon cancer and were well enough to exercise but not yet active, a three-year coached exercise programme raised 5-year disease-free survival to 80.3%, against 73.9% with health-education materials [11, 12, 22]. See exercise and bowel cancer.
• Bowel cancer surgery (PREHAB, 2023). In 251 people having colorectal cancer surgery, four weeks of supervised prehab cut severe complications from 29.7% to 17.1% [13].

What should I check before paying for private cancer rehabilitation?

Check the person's job title and professional register, ask what they will assess and how they will keep your NHS team informed, and tell your oncology team before you start.

• Physiotherapists, dietitians and occupational therapists must be registered with the Health and Care Professions Council (HCPC), whose titles "are protected by law" [17, 18].
• Clinical exercise physiologists can join a voluntary register run by the Academy for Healthcare Science (AHCS), which is accredited by the Professional Standards Authority [15, 16]. You can check the AHCS register online.
• "Cancer exercise specialist" is not a title the HCPC protects [17]. Ask which cancer course the person has completed.
• CEPs and physiotherapists have different scopes of practice [15]. They work alongside each other; one does not replace the other.

Getting matched through The Health Nav

NHS rehabilitation is not available everywhere. The Health Nav can help by matching you with a verified clinical exercise physiologist who works alongside your NHS team, not instead of it.

You fill in a short request form, a member of our team calls you to understand what you need, and we match you with a verified clinical exercise physiologist. You see their profile and get a code to book your first appointment.

At the moment we match people with clinical exercise physiologists only, in person in parts of south-west London and remotely across the UK. Other team members, such as dietitians and physiotherapists, are reached through your NHS team or GP. Questions first? Email support@thehealthnav.co.uk.

Request a match with a verified clinical exercise physiologist through The Health Nav

Talk to your oncology team first

Before starting any new exercise or rehabilitation programme, talk to your cancer doctor, specialist nurse or GP, especially if you are new to exercise [5]. Tell them about any new or worsening symptoms. If your cancer has spread to bone, or your blood counts are low, get their advice before you exercise [2].

Common questions about cancer rehabilitation