Background Active Together is a clinician-led cancer prehabilitation and rehabilitation service for adults with colorectal, lung, or upper gastrointestinal (GI) cancer receiving curative treatment in Sheffield, UK. This service evaluation assessed the feasibility, engagement, and impact of a multimodal intervention, combining exercise, dietetic, and psychological support, delivered across four phases: prehabilitation (pre-treatment), maintenance rehabilitation (during treatment), restorative rehabilitation (up to 12 weeks post-treatment), and supportive rehabilitation (12 to 24 weeks post-treatment). Methods Between March 2022 and May 2024, 847 patients were referred; 685 enrolled (80.9%), and 649 consented to evaluation (mean age 68). Outcomes included six-minute walk test (6MWT), sit-to-stand (30s/60s), handgrip strength, EQ-5D-5L index and visual analogue scale (VAS), FACIT-Fatigue, PHQ-9, and GAD-7. Wilcoxon signed-rank tests were used to assess change scores across each service phase. Results Ninety-three percent completed prehabilitation, and 62% completed the full programme (median duration 44 weeks). After prehabilitation, improvements were observed for 6MWT (+27m, p<0.001), 30s sit-to-stand (+2 reps, p<0.01), EQ-5D VAS (+7.5 points, p<0.01), fatigue (+2.5 points, p<0.01), and depression (−1 point, p<0.01). Following rehabilitation, 6MWT improved by +20m above baseline, EQ-5D VAS increased +7.5 to +10 points, and PHQ-9 and GAD-7 scores reduced by ≈2 points (all p<0.01). Recovery trajectories differed by sex and cancer type, with males and individuals with upper GI cancer experiencing greater post-treatment decline and less complete recovery. Conclusion Active Together demonstrated high engagement and clinically meaningful improvements in cardiorespiratory fitness and quality of life. While the absence of a control group limits conclusions about effectiveness, the findings suggest that multimodal prehabilitation and rehabilitation in routine cancer care is feasible, supports functional recovery, and improves wellbeing.

The Active Together service was originally designed by Sheffield Hallam University with funding from Macmillan Cancer Support. The service is delivered as an NHS programme funded by Yorkshire Cancer Research (YCR), with an embedded service evaluation overseen by Sheffield Hallam University, which is also funded by YCR.

https://journals.humankinetics.com/view/journals/jpah/21/10/article-p1080.xml

The Active Together service was originally designed by Sheffield Hallam University with funding from Macmillan Cancer Support. The service is delivered as an NHS programme funded by Yorkshire Cancer Research (YCR), with an embedded service evaluation overseen by Sheffield Hallam University, which is also funded by YCR.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

As this service evaluation used routinely collected clinical data and there was no change in patient care, formal ethical approval was not required per local governance policies. Data were pseudonymised prior to analysis to ensure patient confidentiality. This service evaluation was approved by the Sheffield Teaching Hospitals NHS Foundation Trust Clinical Effectiveness Unit (Reference: 11115-May 19, 2022).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors