--- title: "For Clinicians: Prostate Cancer Exercise Rehabilitation Referral" url: /for-clinicians primary_question: "How do I refer a man with prostate cancer for supervised specialist exercise rehabilitation?" sources: - "NICE NG131, Prostate cancer: diagnosis and management, recommendation 1.4.19 (2019). https://www.nice.org.uk/guidance/ng131" - "ACSM international multidisciplinary roundtable: Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise Guidelines for Cancer Survivors: Consensus Statement. Med Sci Sports Exerc. 2019;51(11):2375-2390. doi:10.1249/MSS.0000000000002116" --- # For Clinicians: a specialist exercise rehabilitation referral for men with prostate cancer This page is for GPs, oncologists and cancer nurse specialists. It explains how to refer a man with prostate cancer for one-to-one supervised specialist exercise rehabilitation, and what he receives after you refer him. Piotr Kardas works alongside your patient's care team, never in place of it. Piotr delivers specialist exercise rehabilitation for men with prostate cancer, at a world-leading NHS cancer centre, as a clinical exercise physiologist. ## Does NICE recommend exercise for prostate cancer? Yes. NICE guideline NG131 recommends that men starting or having androgen deprivation therapy are offered supervised resistance and aerobic exercise, at least twice a week for twelve weeks, to reduce fatigue and improve quality of life. That is a recommendation to offer, the guideline's strongest wording (NICE NG131, 2019, recommendation 1.4.19). Quotation: "Offer people who are starting or having androgen deprivation therapy supervised resistance and aerobic exercise at least twice a week for 12 weeks to reduce fatigue and improve quality of life." (NICE NG131, Prostate cancer: diagnosis and management, recommendation 1.4.19, 2019. https://www.nice.org.uk/guidance/ng131) The recommendation names resistance and aerobic exercise together, in that order, as co-equal parts of the prescription, and sets a clear dose: supervised, at least twice weekly, for twelve weeks. That frequency works out to a minimum of 24 supervised sessions across the twelve weeks. The 24-session figure is arithmetic derived from the guideline's dose, not a number NICE itself prints. NICE NG131 applies in England and Wales. ## What does the evidence show? For men on androgen deprivation therapy, supervised exercise has been shown to reduce fatigue and improve quality of life (NICE NG131, 2019). An American College of Sports Medicine international roundtable reached the same conclusion for cancer-related fatigue and quality of life (ACSM roundtable: Campbell KL et al., Med Sci Sports Exerc. 2019;51(11):2375-2390). HealthySwitch.Me makes no bone, cardiovascular or survival claim; those claims are cut from all copy, including this page. ## Which men can you refer? HealthySwitch.Me may consider referrals for men with prostate cancer at any treatment stage, subject to an individual assessment of suitability; most often men who are starting or receiving androgen deprivation therapy. Each referral needs the man's oncologist or consultant to be aware, and supportive of him beginning supervised exercise. Referral criteria: - Men with a prostate cancer diagnosis, at any treatment stage. - Particularly suited to men starting or on androgen deprivation therapy. - The referring or treating team is aware, and supportive of him beginning supervised exercise. - The man can take part in supervised sessions online or in his own home. Piotr assesses the suitability of each referral individually. ## Is it safe to refer a patient on ADT to exercise? Supervised, individually designed exercise is central to how HealthySwitch.Me manages safety. Every man begins with an assessment, and his programme is built around his stage, symptoms and treatment. Advanced or metastatic disease, including bone involvement, is handled conservatively and individually, and Piotr defers to the treating team on any limits; in these cases HealthySwitch.Me makes no bone-strengthening or fracture-prevention claim. How safety is handled: - Individual assessment before any programme begins. - Supervision throughout, with the load and method adapted to the man. - Conservative, individualised handling of advanced or metastatic disease. - Escalation back to you where new or unstable symptoms appear. Contraindications and limits are assessed for each man individually, guided by his own care team. ## Will you report back to me? With his consent, Piotr emails you a short summary after the initial assessment, then progress updates you can file alongside his records. You refer a man, and you stay informed about his exercise rehabilitation without chasing for it. ## What will your patient receive? The man you refer starts with a paid 15-minute online video consultation. If he decides to go on, Piotr suggests what suits him and sends a secure payment link: single online appointments of 55 minutes, home visits in London or Surrey, an exercise plan, or an exercise toolbox. There are no packages and no subscription, and how often he sees Piotr is agreed with him at the consultation. Delivery is online by video call anywhere in the UK, or as a home visit in London or Surrey, arranged with Piotr and priced individually. Each programme is built around progressive resistance and aerobic work, in line with NG131. Piotr draws on adapted methods, including Tai Chi, Qigong, Pilates and progressive resistance training, as tools within the programme rather than as standalone products. Sessions are delivered by Piotr Kardas, a Prostate Cancer Exercise Specialist, Registered Clinical Exercise Physiologist. Piotr delivers specialist exercise rehabilitation for men with prostate cancer, at a world-leading NHS cancer centre, as a clinical exercise physiologist. ## How do you refer a patient? Refer by email to contact@healthyswitch.me, keeping identifiable health details out of a first email. Or give the man you refer your usual post-appointment letter, setting out his diagnosis, your approach and your recommendation of professionally guided exercise rehabilitation. That letter is enough, and he can share it with Piotr at or before his consultation. He can also book the 15-minute consultation himself and name you as his referrer. ## Contact Refer a man with prostate cancer, or ask a question about the service, and Piotr will respond personally. Email: contact@healthyswitch.me. Or give the man you refer your usual post-appointment letter to share with Piotr. --- Every man is advised to have his oncologist's or consultant's agreement before starting any exercise programme. HealthySwitch.Me delivers specialist exercise rehabilitation alongside a man's cancer care, not in place of it.