Helping you to prepare for your treatment

Healthy habits may help you:

• tolerate treatment better.
• recover quicker.
• leave the hospital earlier if you need to stay there.
• have fewer side effects or problems during treatment.
• reduce worry and help with your mood.
• improve your energy levels.
• be more involved in your care.
• lower the chance of cancer coming back.
• get fitter and reduce the risk of developing other health problems.
• get back to doing your normal activities sooner.

What if I have not got a cancer diagnosis?

You may still receive advice about how to support your health and wellbeing while you have tests to either rule out or diagnose cancer. Starting healthy habits early can help you feel better and improve your fitness levels.

What is physical activity?

Physical activity is any movement that uses your muscles and more energy than when resting. It is not just about going to a gym or doing a workout. It can include things like going up and down stairs, gardening or going for a walk outside.

There are lots of easy ways to start being more active. Small changes can make a big impact.

Why is physical activity good for me?

Regular physical activity can help you feel better in lots of ways.

Being active can help you:

• feel less tired.
• feel less worried or sad.
• have fewer side effects from treatment.
• reduce the risk of cancer coming back.
• keep your body working well.
• support a healthy weight.
• strengthen muscles.
• improve your flexibility and balance.
• feel more confident.
• improve your overall quality of life.

Physical activity can also help reduce the risk of other illnesses such as coronary heart disease, stroke and type 2 diabetes.

Is physical activity safe?

If you are worried about being able to be active or you have long term health condition such as high blood pressure. Then please speak to your GP or health care team for advice before starting any physical exercise.

How much physical activity should I be doing?

Try to slowly increase your activity levels with the aim to build up to the guidelines below:

• 150 minutes of moderate intensity activity each week. This means doing things that make you feel warm, breathe a bit faster and get your heart beating faster, such as a brisk walking, swimming, or cycling.
• 75 minutes of vigorous intensity activity each week. This means doing activities that make your heart beat faster and make you sweat and out of breath, such as running or playing sports.
• Do muscle strengthening exercises twice a week. Things like lifting heavy shopping bags, gardening or specific exercises to make your muscles stronger.
• Try to reduce how much time you spend sitting or lying down, such as watching TV, sitting at a computer or taking the car for short trips.

Being more active and sitting less is a simple way to improve your overall health.

Where do I begin?

There are lots of ways to be more physically active. It is best to do something you enjoy and that fits in with your weekly routine.

This could be activities such as playing in the park with your children or grandchildren, using the stairs instead of the lift, going for a walk at lunchtime or doing some cleaning around your home. You will know how much and what type of physical activities feel right for you.

You can split your daily activity into short bursts, such as moving around for a minute or two at a time. It all adds up and helps you to stay active.

For more advice about physical activity, please visit the following websites:

Macmillan

https://www.macmillan.org.uk/cancer-information-andsupport/treatment/preparing-for-treatment/physicalactivity-and-cancer

NHS

With examples of exercises to do at home

https://www.nhs.uk/live-well/exercise/

SWAG Cancer Alliance

With details of multiple community-based exercise groups across Gloucestershire and exercise videos

https://www.swagcanceralliance.nhs.uk/prehabhome/prehab-exercise/

Eating well during cancer treatment

When you have cancer, eating the right foods can help you feel better.

• Eat a mix of foods (a balanced diet). This will help keep your energy levels up and support your body during treatment.
• Do not try to lose weight unless your doctor tells you. If you do need to lose weight, a dietitian should help you – please discuss with your cancer nurse specialist. This will help you to you stay healthy.
• If you are not eating much or you are losing weight, talk to your cancer nurse specialist. They can give you more support and advice and might need to refer you to a dietitian.

How to eat healthily

A healthy diet provides essential nutrients. Aim for a balanced diet with a variety of foods. This should include 3 meals and 1 to 2 snacks each day. Plan ahead to stay on track.

• Include starchy foods (carbohydrates) such as bread, pasta or potatoes at each meal. Starchy foods give you energy. It is also important to eat starchy foods before you exercise.
• Aim for 2 portions of protein (chicken, eggs, fish, beans) every day. Eat protein 90 minutes after you exercise to help your muscles recover. Protein will help to keep your muscles strong and help you to feel better.
• Have 2 to 3 portions of dairy (cheese, yogurt, milk, soy milk) daily. This gives you calcium and protein.
• Aim for 5 portions of fruit and vegetables every day as this will provide you with vitamins, minerals and fibre. Fresh, frozen, canned or dried fruit and vegetables all count. Fruit juices and smoothies count as 1 portion.
• Try not to eat foods high in fat and sugar (sweets, crisps, butter, oil). However, if your medical team says you need to gain weight, they might tell you to eat more of these foods.
• Aim to drink 6 to 8 cups of non-alcoholic fluids every day. Drink during and after exercise to replace lost fluids.

If you experience any of the following problems, please contact your cancer nurse specialist.

• Changes to your normal bowel routine.
• If you see any blood or mucus in the bowel movement.
• Changes in your weight or appetite.

Low fibre diets

Only follow a low fibre diet on the advice of your medical team. These diets can be short term, depending upon your treatment. Remember, low fibre does not mean no fibre. If you have any questions, please speak to your cancer nurse specialist.

Vitamins and minerals

• If you eat a mix of foods, you do not need to take vitamins or mineral supplements.
• High doses of vitamins and minerals can affect cancer treatment.
• If you cannot eat a balanced diet, you might be advised to take a supplement. This should be under the advice of a healthcare professional.

Vitamin D levels can often be low in the UK due to limited sunlight. If you are concerned about your levels, it is a good idea to speak with your healthcare team. You can also find more information about this on the NHS website: www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d

Food safety

Cancer treatment can weaken your immune system. This can make you more likely to get food poisoning. Avoiding certain foods and following good hygiene tips will help to reduce your risk.

Visit the website below for more tips: www.macmillan.org.uk/cancer-information-andsupport/impacts-of-cancer/healthy-eating-andcancer/food-safety-when-your-immunity-is-low

What to do if you are struggling with side effects of cancer or cancer treatment.

This page is for people who are eating well and not having problems with food.

If you have any of the problems listed below, speak with your cancer nurse specialist:

• You are losing weight.
• Food tastes different.
• You do not feel like eating.
• Other problems because of cancer and it’s treatment. Visit the Royal Surrey NHS Foundation Trust website, listed below, for helpful tips from the Cancer Centre team: www.royalsurrey.nhs.uk/dietandcancervideos/

Common cancer myths

There is a lot of confusing information about food and cancer. Common dietary myths include those around sugar, dairy and vitamin supplements.

The British Dietetic Association has put together a helpful resource about the common myths and the evidence surrounding these. Please visit the following website: www.bda.uk.com/resource/cancer-diets-myths-andmore.html

If you are thinking about changing what you eat, it is important to get the right information. Trusted sources include:

British Dietetic Association

www.bda.uk.com

Cancer Research UK

www.cancerresearchuk.org/about-cancer/causes-ofcancer/physical-activity-and-cancer

Macmillan

www.macmillan.org.uk/cancer-information-andsupport/treatment/preparing-for-treatment/physicalactivity-and-cancer/exercising-safely

World Cancer Research Fund

www.wcrf.org

For patients who do not have access to the internet, paper copies of the information from the above websites are available; please ask your cancer nurse specialist.

Emotional wellbeing advice

It is normal to feel upset or worried when you have a diagnosis of cancer. Dealing with the feelings that come with cancer can be just as hard as dealing with the illness itself. Different things can help at different times. For example:

• Talking to someone you trust.
• Using support from friends and family.
• Keeping active.
• Getting extra support from local groups or charities. Sometimes talking to someone outside of your friends and family can be helpful.

If you have feelings or thoughts that are really strong and hard to handle, you may want to:

• Talk to someone from our cancer psychology team, they are trained to help you. To request a referral, speak with your cancer nurse specialist, doctor or another healthcare professional.
• Speak to local charities that offer different forms of support, if that feels better for you.
• Speak with your GP. They might suggest some other care or prescribe medicines, if needed.

Organisations that can help:

There are many local groups that help people affected by cancer. They offer support, care and information to make things a bit easier.

For more information, speak to your cancer team or see the details below.

Charlie's Community Cancer Support and Therapy (Multiple locations across Gloucestershire)

Charlie’s can help you to live well with cancer.

They offer; support, free holistic therapies, activities and events:

Website: www.charlies.org.uk

Focus Support Centre

Oncology Centre, Cheltenham General Hospital

Focus offers information, help and advice for local cancer patients and their loved ones:

Website: www.gloshospitals.nhs.uk/ourservices/services-we-offer/cancer/focus/

Macmillan Information Hub

The Atrium, Gloucestershire Royal Hospital

The hub is a place to get information, support and signposting. It is open to anyone who has concerns about cancer.

This includes relatives, friends and carers.

Website: www.gloshospitals.nhs.uk/ourservices/services-we-offer/cancer/macmillan-cancersupport-information-hub

Maggie's (Cheltenham)

Maggie’s offers free one-to-one help and information from their professional team.

They also offer the opportunity to join groups and activities:

Website: www.maggies.org/our-centres/maggiescheltenham/

Other useful links

The Sherwood Forest Hospitals

This website includes resources for those struggling psychologically with a cancer diagnosis:

Website: www.sfh-tr.nhs.uk/services/cancer-psychologyservice/

Can EmpowerTM

Can EmpowerTM is an online resource. It can help you manage the psychological and emotional challenges of living with cancer:

Website: https://can-empower.org.uk/

Fruitfly Collective

Fruitfly Collective is a great hub for resources on parenting with cancer. It includes advice on talking to children:

Website: https://www.fruitflycollective.com/

Macmillan

Macmillan is also a great source of information about emotional wellbeing support. They offer a buddy system and other forms of online and phone support:

Website: www.macmillan.org.uk

Books

Ray Owen - Facing the Storm

This practical guide will take you through each stage of preparing for, enduring and recovering from a major life crisis and may help to better understand your emotional response. The book also suggests tools for dealing with situations.

Anne Johnson, Claire Delduca and Reg Morris - Flying Over Thunderstorms: Living Your Life with Cancer through Acceptance and Commitment Therapy

This workbook outlines an evidence-based approach to coping with the emotional side of a cancer diagnosis.

Alcohol

It is safest not to drink alcohol at all. Stopping or drinking less alcohol can make a big difference to your health.

If you do drink alcohol, try to keep to the guidelines for adults below.

• Do not drink more than 14 units of alcohol per week.
• Spread units of alcohol evenly across the week.
• Have a number of days where you do not drink any alcohol.

If you would like support to drink less alcohol, you can:

• Speak with your GP
• Contact Healthy Lifestyles Gloucestershire

Tel: 0800 755 5533

Website: www.hlsglos.org

• Visit the NHS UK

Website: www.nhs.uk/better-health/drink-less/

Smoking

Smoking makes it harder for your body to heal after surgery or cancer treatment. Stopping smoking has many important benefits if you are on a cancer journey. Many of the benefits happen straight away.

Stopping smoking is the healthiest choice you can make.

It is not always easy to stop smoking. There are lots of tools and resources to make stopping easier.

If you would like support to stop smoking you can contact:

Healthy Lifestyles Gloucestershire

Tel: 0800 755 5533

Website: https://hlsglos.org/stop-smoking/

Alternatively, you can speak to your GP.

Contact information

If you have any questions or concerns, please contact your clinical team to discuss.

This page has been written by:

Cancer Services

Alexandra House, Cheltenham General Hospital, Sandford Road, Cheltenham GL53 7AN