I was asked recently, ‘Is there anything we can do to help BEFORE breast cancer treatment starts?’ and my answer is YES!!!!!

Your client has just received a breast cancer diagnosis – what can you do?

It’s a hugely overwhelming time – with often a couple of weeks between diagnosis and the start of treatment, whether that’s going to be surgery or neoadjuvant chemotherapy.

What does she need to do to prepare?

How can you help?

Let’s have a look at what the research shows and then make a plan…

We know now that breast cancer is the most is the most common malignancy and principal cancer-related cause of death in adult females in industrialized nations (Torre et al 2017). We also know that surgery is the most common intervention, and 90% of people diagnosed with breast cancer will have some sort of surgical intervention, but there are short, medium and long-term effects of all types of breast cancer treatment that often go under the radar or are under-treated. These might include pain, restricted shoulder mobility, lymphoedema, cardiac health issues, balance problems and pelvic health issues.

There are also whole-body issues to consider, such as fatigue, which is disproportionately higher in people with breast cancer compared to other cancer populations, and is reported by up to 95% of all patients during therapy (Hofman et al 2007)


We know that higher levels of preoperative aerobic fitness are associated with better surgical outcomes, including decreased postoperative complications. Essentially, the better shape you are going into surgery, the faster and less problematic your recovery will probably be.

Starting a prehab programme may be beneficial for both physical and mental recovery – I say ‘may’ because shockingly, the research on breast cancer prehab is very sparse, so we have to take the lessons of cancer prehab from thoracic/abdominal cancer studies.

What should a Breast Cancer Prehab programme include?

There’s a couple of different considerations – prehabbing body, mind and home.


If someone is not already exercising, this is a great time to start a walking programme and a shoulder mobility and strengthening programme.

It is also a great time to optimise thoracic mobility and breathwork, and to deal with any pelvic health issues, especially bladder and bowel issues. Anaesthetics and antibiotics, along with restricted movement, stress, disrupted sleep and possibly an incision site if reconstruction surgery is being done at the same time, can all take their toll on pelvic health. Pre-op is the best time to start good habits in all the domains of exercise – obviously these can be tapered up or down depending on the stages of recovery but getting into the ‘consistent exerciser’ mindset before surgery may be helpful in re-establishing movement habits afterwards, even if it means starting back with breathwork, pelvic floor exercises and foot/ ankle mobility – keeping the habit of movement is vital.


This is often a hugely stressful time, and from this moment on, everything is delineated as ‘before’ and ‘after’ cancer. An active stress management strategy, perhaps one that involves movement such as yoga or mindful walking can be really helpful, but there will also be the need for a stress management toolbox when movement isn’t an option – meditation apps, breathing exercises or a good old-fashioned notebook and pen to write down thoughts and worries can be good options. There are a few videos on my Youtube channel about mindfulness meditation that may be helpful – like this one


Stocking up the freezer with nutritious comforting food can make eating well easier. ( There’s a video interview with Alyssa Tait about the best types of food to include in the Breast Cancer Rehab course) Making sure there’s plenty of comfy clothes that aren’t restrictive around the neck, shoulder or waist – overhead tops aren’t great, so button up tops (put the affected arm in first!) can make life easier. Plenty of cushions and blankets to prop you up comfortably and a grabber to get things from the ground or overhead can make life simpler too.

If this is an area you are interested in learning more about, my online Breast Cancer Rehab course has a whole module dedicated to Prehab, and then moves along into everything YOU need to know to help women live well during and after Breast Cancer treatment. There’s also a closed Facebook group for additional resources and support and I’ve shared some of the guest expert interview videos on my Youtube channel, so you can preview some of the topics we explore.

Until next time

Onwards & Upwards,