Around 7000 patients undergo curative lung cancer surgery each year in the UK. These numbers are rising annually as advances in surgical techniques mean that operations can now be offered to older and less fit patients. Unfortunately there has not been a parallel improvement in outcomes following surgery; nearly half of patients develop complications after surgery which can significantly impact upon quality of life and reduce long term survival rates after surgery. Such complications may negate any potential benefits from the surgical procedure.

Exercise programmes before lung surgery have been shown to improve patients’ physical fitness thereby reducing complications and time in hospital as well enhancing recovery after surgery. Similarly, nutritional supplements taken before and/or after surgery are known to improve recovery and add to the benefits of structured exercise programmes. Despite clear evidence for the benefits of ‘prehabilitation’, access to such programmes is extremely limited in the UK for logistical, administrative and financial reasons.

Our team has already created and piloted App-based programmes in the provision of pre-operative information, exercise and nutrition, specifically designed to prepare patients for lung surgery and improve their recovery. We have combined these into a new App called ‘Fit4Surgery 2’. This App supports individualised exercises for patients who can design a programme appropriate to their own fitness level, capacity and preferences. Videos demonstrate a range of strengthening, mobility, and cardiovascular exercises. Data collected within the App (including heart rate measured by a wearable device) are uploaded electronically. Clinicians have access to a web based portal with a summary of their patient’s progress. Personalised health information is also presented based on patient symptoms. Repeated nutritional assessments within the App allow for personalised nutritional advice. Embedded within the App are strategies to enhance motivation/adherence.

We believe that having access to the Fit4Surgery 2 App would enhance uptake and engagement with prehabilitation programmes by breaking down geographic, logistical and time related barriers which hamper the limited systems currently available. This would manifest in improved recovery, reflected by improved quality of life and a reduction in number and impact of complications after lung cancer surgery.