What to expect

Send your diagnosis and stage, current and planned treatment with dates, recent blood counts, imaging where there are bone metastases, surgical history, and your main difficulties. A physician replies within 48 hours with what is realistic and when to come.

If the timing is wrong — mid-cycle, counts too low, surgery imminent — the reply will say so and propose a better window.

Assessment of fitness, strength, balance, neuropathy, shoulder and scar mobility where relevant, nutritional status, and fatigue measured with a scale rather than described. Exercise intensity is set from testing.

Expect the first sessions to feel too easy. Starting where you think you should be is the most common way a cancer block goes wrong in week two.

Aerobic and resistance training at prescribed intensity, balance work for neuropathy, shoulder and scar work after surgery, aquatic sessions, and breathing work. Two to four hours a day, shorter than other programmes because fatigue governs.

A bad week is planned for rather than treated as failure. What matters is the trend, and the fatigue score is re-measured rather than guessed.

Re-measurement against day one, including the fatigue score, and a home programme built for your energy on an average day rather than a good one.

A discharge document goes to your oncology team with what was done and what was measured.