February 28, 2026 · Andrew Wilson · 2 min read
The Prehab Window: Why the Weeks Between Diagnosis and Surgery Matter More Than You Think
The 2–6 weeks between a cancer diagnosis and surgery is one of the most powerful opportunities in medicine. Most of it is being wasted.
A window that almost no one uses
For most patients diagnosed with a solid tumor, there is a window — 2 to 6 weeks, sometimes longer — between the day they hear the words "you have cancer" and the day they are wheeled into surgery. That window is spent waiting. Scans. Consults. Insurance approvals. Fear.
It does not have to be.
What prehabilitation actually does
Prehabilitation — supervised, progressive exercise delivered during the pre-surgical window — has been studied in hundreds of trials across colorectal, lung, prostate, breast, and abdominal cancers. The consistent finding: patients who prehab have ~32% fewer 30-day readmissions than those who do not. 15 They have shorter hospital stays. They return to baseline function weeks earlier. Some evidence suggests lower rates of post-operative complications, though the mechanisms are still being characterized.
The cost of an avoided 30-day readmission is $15,000–$30,000. 15 A prehab program, delivered by a certified Cancer Exercise Specialist over 4–6 weeks, costs a fraction of that. For most institutions running a breast, lung, or colorectal program, prehab is one of the highest-ROI investments available.
Why hospitals have not adopted it
The barrier is not evidence. The barrier is infrastructure.
Prehab requires a triage protocol that identifies eligible patients at the point of diagnosis. It requires a referral pathway embedded in the EHR. It requires a clinical workforce — Cancer Exercise Specialists — that most hospitals do not have on staff. And it requires a billing pathway, which for many prehab modalities does not yet exist as a clean CPT code. 20
Each of those is solvable. Each one is what memios builds.
The NAPBC standard has already changed
The 2024 NAPBC breast center accreditation standards now require documented exercise recommendations for every breast cancer patient under oncology care. 18 That is a regulatory forcing function. Centers that fail to document will fail accreditation. Centers that document but do not deliver will be reviewed in upcoming updates.
The standards are moving toward delivery. The field is moving with them. The centers that pilot prehab in 2026 will be ahead of the accreditation wave — not chasing it.
A 90-day ask
If you run a breast, lung, or colorectal program and you are reading this: open a 90-day prehab pilot. Pick one surgical pathway. Instrument the readmission rate, the LOS, and the documented 6-week functional outcome. Measure it.
We will stake our platform on those numbers moving in the right direction.
References
- 15Stout NL, Brown JC, Schwartz AL, et al. An exercise oncology clinical pathway: screening and referral for personalized interventions. Cancer. 2020;126:2750–2758.Prehabilitation reducing surgical complications, LOS, and readmissions; 30-day readmission reduction data.
- 18National Accreditation Program for Breast Centers (NAPBC). Optimal Resources for Breast Care 2024 Standards. American College of Surgeons 2025.Requirement that exercise recommendations be documented in the medical record for breast cancer patients under oncology care — effective 2024.
- 20Kennedy MA, Potiaumpai M, Maitin-Shepard M, et al. Looking back: a review of policy implications for exercise oncology. J Natl Cancer Inst Monogr. 2023:140–148.Policy review: comparison with Diabetes Prevention Program, peripheral artery disease supervised exercise; payer coverage pathway analysis.