Is it possible to prepare your body before beginning bladder cancer treatment?  Emerging data points to yes. A growing body of research suggests that prehabilitation, targeted support before treatment, can help bladder cancer patients feel stronger, more prepared, and better equipped to recover, especially when facing intensive therapies like surgery.

Simply put, prehabilitation means building strength and resilience ahead of time, so you’re better equipped to handle treatment and recover afterward. 

What is prehabilitation?

Prehabilitation introduces elements of rehabilitation prior to cancer treatment, including surgery, chemotherapy, or radiation. Cancer treatments can take a toll on the body, affecting strength, energy, nutrition, and overall function. Prehabilitation works to counteract those effects early.

Instead of waiting until after treatment to focus on recovery, prehabilitation helps patients:

• Improve physical fitness
• Support nutrition and immune health
• Address lifestyle factors like smoking or alcohol use
• Build habits that support healing and long-term well-being

Research across many cancer types, including bladder, shows that patients who take part in prehabilitation often have better physical function, feel more prepared for treatment, and may recover faster.

Prehabilitation for bladder cancer

For many bladder cancer patients, particularly those undergoing radical cystectomy (removal of the bladder), treatment can be physically demanding, with high rates of complications and a long recovery period.

A recent review compiled several studies involving over 1,000 bladder cancer patients to see whether prehabilitation could improve physical function, patient experience, and recovery after treatment.

Below are their key findings:

• Exercise and multimodal programs were most effective at improving physical function, helping patients feel stronger and more capable before and after surgery.
  
• Education programs improved patient-reported outcomes, meaning patients felt more informed, confident, and prepared.
  
• Smoking and alcohol cessation support helped patients achieve abstinence, which was linked to fewer post-surgery complications.
  
• While nutrition-only programs didn’t show significant improvements on their own, combining nutrition with exercise or other interventions may be more beneficial.

Despite these benefits, prehabilitation is still underused, especially for patients with non–muscle-invasive bladder cancer (NMIBC) or those receiving non-surgical treatments like intravesical therapy or radiation. Experts see this as a major opportunity to improve care.

What should a bladder cancer prehabilitation program include?

While every plan should be tailored to the individual, effective prehabilitation programs often include:

• Physical activity: A mix of aerobic exercise (like walking) and resistance or strength training, adapted to your fitness level.
  
• Nutrition support: Screening for malnutrition, adequate protein intake, and sometimes specialized immune-supporting nutrition.
  
• Lifestyle support: Counseling and, when needed, medication support to help with smoking or alcohol cessation.

Dr. Elizabeth Plimack from Fox Chase Cancer Center recommends a healthy lifestyle for all patients diagnosed with bladder cancer. She says, “Being active, as best your body can, is the best medicine. If you tend to be sedentary, but your body’s able to walk and get outside, do so.” 

While there’s no specific “cancer diet,” Dr. Plimack suggests eating an overall healthy diet. “Just eat foods your grandma would recognize, grown from the earth, and try to limit processed foods,” she emphasizes.

These steps help improve physical strength and empower patients to take an active role in their care, even before treatment starts.

Prehabilitation as part of standard bladder cancer care

While more research is still needed to understand how prehabilitation may affect long-term cancer outcomes, experts agree on one thing: it helps patients feel stronger, more prepared, and more in control.

Prehabilitation can be a powerful starting point, setting the tone not just for treatment, but for recovery and survivorship. If you’re facing bladder cancer treatment, asking your care team about prehabilitation may be one of the most important early steps you can take.

To learn more from Dr. Plimack, read the recap on bladder cancer staging and treatment options.