Prehabiltation Prepares Cancer Patients for Surgery

A four-week prehabilitation program is sufficient to modify exercise behaviors and improve preoperative functional walking capacity in surgical colorectal cancer patients, according to a new study.

Researchers at McGill University (Montreal, Canada), the University of Toronto (Canada), and other institutions conducted a study to assess if a four-week prehabilitation program that includes exercise, nutritional supplementation, and counseling on relaxation techniques is sufficient to modify exercise behaviors and improve functional capacity of elderly patients scheduled for colorectal cancer surgery. During the study, 57 patients were assigned to prehabilitation and 59 were assigned to a matched control group.

The Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire was used to measure physical activity levels, while the six-minute walk test (6MWT) was used for assessment of functional walking capacity. Measurements were collected at baseline and at the time of surgery. After four weeks, 70% of the patients in the prehabilitation group had doubled the number of hours they spent exercising, and as a result had increased the distance they were able to walk in six minutes by a significant 24 meters.

This was in marked contrast to the patients in the control group, who tended to exercise less over the four-week period between diagnosis and surgery. Patients in the prehabilitation group also significantly increased the amount of moderate and vigorous intensity physical activities that they performed at the time of surgery, with a greater proportion meeting current physical activity guidelines, as compared to the control group. The study was published in the January 2017 issue of Supportive Care in Cancer.

“Surgery places tremendous physical stress on the body in a very short period of time. So over the past 10 years, some doctors and kinesiologists have started getting their patients ready for surgery in the same way that you would prepare an athlete for an event, through individually tailored exercise programs that challenge the body and allow adaptations to occur before their operations,” said senior author kinesiologist Celena Scheede-Bergdahl, of McGill University. “And we're seeing that people have a better recovery as a result.”

According to the latest figures from the World Health Organization (WHO; Geneva, Switzerland), colorectal cancer is now the third most common cancer in women around the globe and the second most common cancer in men. The recovery process from this major abdominal surgery is often slow and difficult, partly because of the poor state of physical fitness that many patients have going into the operation; typically, six months after surgery only one in five patients have regained their previous level of physical activity. Prehabilitation could help many colorectal cancer patients recover faster.

Related Links:
McGill University
University of Toronto
World Health Organization