Prehabilitation uses the period before cancer treatment to build physical and psychological reserve through tailored exercise, nutrition and psychological support. COSA positions exercise as standard cancer care; several Optimal Care Pathways now name prehabilitation explicitly, while the Australian Cancer Plan calls for cost-effective, co-designed care backed by robust data. Access and funding remain inconsistent.
An overview of 20 systematic reviews spanning 137 randomised trials found low-to-moderate-certainty support for prehabilitation before surgery improving fitness, reducing complications and shortening hospital stay. Effects varied across populations, interventions and delivery models, while quality of life, readmission, mortality and psychological outcomes remained uncertain. Findings beyond surgery, and for multimodal programmes, remain limited.
Cancer-specific economic evaluation findings are mixed. A 2023 review of 16 exercise evaluations found favourable cost-effectiveness in half of the trial-based and five of six model-based studies, spanning treatment and survivorship. Cost–utility data for cancer prehabilitation specifically remain sparse, while delivery and implementation costs impact overall value.
Translation requires a nationally consistent prehabilitation pathway: introduce it early; screen functional, nutritional and psychological needs; triage patients to proportionate, tailored support; and build multidisciplinary workforce and coordination capacity. Co-designed evaluation studies should consider equity, adherence, implementation costs, and health-related quality of life measures collected over sufficient follow-up, from a comprehensive societal and health-sector perspectives to generate the data needed for MSAC consideration and potential MBS funding.