open access
Vol 72, No 5 (2022)
Review paper
Published online: 2022-07-06
Get Citation
Prehabilitation as an extra approach to usual care for cancer patients
1
, 2
, 2
Affiliations- Department of Oncology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
- Department of Psychology and Sociology of Health and Public Health, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
open access
Vol 72, No 5 (2022)
Review article
Published online: 2022-07-06
Abstract
Prehabilitation seems to be an important issue in oncology. The main purpose of prehabilitation is to improve a patient’s physical and psychological condition at the beginning of and during cancer treatment. Prehabilitation also reduces the risk of potential complications, average length of stay at hospital, stress and risk of depression, and improves quality of life. Prehabilitation activities should be individualized. Multimodal prehabilitation is more recommended and it can include a spectrum of interventions like: general conditioning exercise, targeted exercise, nutritional interventions, psychological interventions, smoking cessation and education. There is a lack of clinical trials concerning prehabilitation. Therefore new studies are still needed to standardize protocols for different types of cancer and clinical situations, and to estimate the efficacy of prehabilitation programs.
Abstract
Prehabilitation seems to be an important issue in oncology. The main purpose of prehabilitation is to improve a patient’s physical and psychological condition at the beginning of and during cancer treatment. Prehabilitation also reduces the risk of potential complications, average length of stay at hospital, stress and risk of depression, and improves quality of life. Prehabilitation activities should be individualized. Multimodal prehabilitation is more recommended and it can include a spectrum of interventions like: general conditioning exercise, targeted exercise, nutritional interventions, psychological interventions, smoking cessation and education. There is a lack of clinical trials concerning prehabilitation. Therefore new studies are still needed to standardize protocols for different types of cancer and clinical situations, and to estimate the efficacy of prehabilitation programs.
Get Citation
Keywords
prehabilitation; cancer; exercise; psychological interventions
About this articleTitle
Prehabilitation as an extra approach to usual care for cancer patients
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
294-302
Published online
2022-07-06
Page views
3795
Article views/downloads
567
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2022;72(5):294-302.
Keywords
prehabilitation
cancer
exercise
psychological interventions
Authors
Monika Rucińska
Karolina Osowiecka
References (105)- Gillis C, Carli F. Promoting Perioperative Metabolic and Nutritional Care. Anesthesiology. 2015; 123(6): 1455–1472.
- Singh F, Newton RU, Galvão DA, et al. A systematic review of pre-surgical exercise intervention studies with cancer patients. Surg Oncol. 2013; 22(2): 92–104.
- Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2015; 15: 77.
- Paterson C, Jensen BT, Jensen JB, et al. Unmet informational and supportive care needs of patients with muscle invasive bladder cancer: A systematic review of the evidence. Eur J Oncol Nurs. 2018; 35: 92–101.
- Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997; 78(5): 606–617.
- https://erassociety.org/guidelines/.
- Silver JK. Cancer prehabilitation and its role in improving health outcomes and reducing health care costs. Semin Oncol Nurs. 2015; 31(1): 13–30.
- Stene GB, Helbostad JL, Balstad TR, et al. Effect of physical exercise on muscle mass and strength in cancer patients during treatment--a systematic review. Crit Rev Oncol Hematol. 2013; 88(3): 573–593.
- Chan SP, Ip KY, Irwin MG. Peri-operative optimisation of elderly and frail patients: a narrative review. Anaesthesia. 2019; 74 Suppl 1: 80–89.
- Karlsson E, Egenvall M, Farahnak P, et al. Better preoperative physical performance reduces the odds of complication severity and discharge to care facility after abdominal cancer resection in people over the age of 70 - A prospective cohort study. Eur J Surg Oncol. 2018; 44(11): 1760–1767.
- Albrecht TA, Taylor AG. Physical activity in patients with advanced-stage cancer: a systematic review of the literature. Clin J Oncol Nurs. 2012; 16(3): 293–300.
- Trépanier M, Minnella EM, Paradis T, et al. Improved Disease-free Survival After Prehabilitation for Colorectal Cancer Surgery. Ann Surg. 2019; 270(3): 493–501.
- van Rooijen S, Carli F, Dalton S, et al. Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation. BMC Cancer. 2019; 19(1): 98.
- Rao MR, Raghuram N, Nagendra HR, et al. Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial. Complement Ther Med. 2009; 17(1): 1–8.
- Garssen B, Boomsma MF, Meezenbroek Ed, et al. Stress management training for breast cancer surgery patients. Psychooncology. 2013; 22(3): 572–580.
- Christensen JF, Simonsen C, Hojman P. Exercise Training in Cancer Control and Treatment. Compr Physiol. 2018; 9(1): 165–205.
- Dronkers JJ, Chorus AMJ, van Meeteren NLU, et al. The association of pre-operative physical fitness and physical activity with outcome after scheduled major abdominal surgery. Anaesthesia. 2013; 68(1): 67–73.
- Lukez A, Baima J. The Role and Scope of Prehabilitation in Cancer Care. Semin Oncol Nurs. 2020; 36(1): 150976.
- Carli F, Awasthi R, Gillis C, et al. Optimizing a frail elderly patient for radical cystectomy with a prehabilitation program. Can Urol Assoc J. 2014; 8(11-12): E884–E887.
- Jensen BT, Dalbagni G, Jensen J, et al. MP38-14 IMPLEMENTING A MULTIMODAL PREHABILITATION PROGRAM IN A HIGH-VOLUME BLADDER CANCER CENTER. J Urol. 2016; 195(4S).
- McCarthy M. Popular measure in California ballot targets drug prices. BMJ. 2016: i5830.
- Leedham B, Ganz PA. Psychosocial concerns and quality of life in breast cancer survivors. Cancer Invest. 1999; 17(5): 342–348.
- Giles C, Cummins S. Prehabilitation before cancer treatment. BMJ. 2019; 366: l5120.
- Cavalheri V, Granger CL. Exercise training as part of lung cancer therapy. Respirology. 2020; 25 Suppl 2: 80–87.
- Meneses-Echávez JF, Loaiza-Betancur AF, Díaz-López V, et al. Prehabilitation programs for cancer patients: a systematic review of randomized controlled trials (protocol). Syst Rev. 2020; 9(1): 34.
- Bongers BC, Dejong CHC, den Dulk M. Enhanced recovery after surgery programmes in older patients undergoing hepatopancreatobiliary surgery: what benefits might prehabilitation have? Eur J Surg Oncol. 2021; 47(3 Pt A): 551–559.
- van Noort HHJ, Heinen M, van Asseldonk M, et al. On the behalf of the Basic Care Revisited (BCR) Research group. Using intervention mapping to develop an outpatient nursing nutritional intervention to improve nutritional status in undernourished patients planned for surgery. BMC Health Serv Res. 2020; 20(1): 152.
- Gillis C, Fenton TR, Sajobi TT, et al. Trimodal prehabilitation for colorectal surgery attenuates post-surgical losses in lean body mass: A pooled analysis of randomized controlled trials. Clin Nutr. 2019; 38(3): 1053–1060.
- Luther A, Gabriel J, Watson RP, et al. The Impact of Total Body Prehabilitation on Post-Operative Outcomes After Major Abdominal Surgery: A Systematic Review. World J Surg. 2018; 42(9): 2781–2791.
- Rimer J, Dwan K, Lawlor DA, et al. Exercise for depression. Cochrane Database Syst Rev. 2012(7): CD004366.
- Buffart LM, Galvão DA, Brug J, et al. Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev. 2014; 40(2): 327–340.
- Nilsson H, Angerås U, Bock D, et al. Is preoperative physical activity related to post-surgery recovery? A cohort study of patients with breast cancer. BMJ Open. 2016; 6(1): e007997.
- Wennman-Larsen A, Alexanderson K, Olsson M, et al. Sickness absence in relation to breast and arm symptoms shortly after breast cancer surgery. Breast. 2013; 22(5): 767–772.
- Lee L, Schwartzman K, Carli F, et al. The association of the distance walked in 6 min with pre-operative peak oxygen consumption and complications 1 month after colorectal resection. Anaesthesia. 2013; 68(8): 811–816.
- Cavalheri V, Granger C. Preoperative exercise training for patients with non-small cell lung cancer. Cochrane Database Syst Rev. 2017; 6: CD012020.
- Morano MT, Araújo AS, Nascimento FB, et al. Preoperative pulmonary rehabilitation versus chest physical therapy in patients undergoing lung cancer resection: a pilot randomized controlled trial. Arch Phys Med Rehabil. 2013; 94(1): 53–58.
- Moran J, Guinan E, McCormick P, et al. The ability of prehabilitation to influence postoperative outcome after intra-abdominal operation: A systematic review and meta-analysis. Surgery. 2016; 160(5): 1189–1201.
- Kim DoJ, Mayo NE, Carli F, et al. Responsive measures to prehabilitation in patients undergoing bowel resection surgery. Tohoku J Exp Med. 2009; 217(2): 109–115.
- Zylstra J, Whyte GP, Beckmann K, et al. Exercise prehabilitation during neoadjuvant chemotherapy may enhance tumour regression in oesophageal cancer: results from a prospective non-randomised trial. Br J Sports Med. 2022; 56(7): 402–409.
- Metcalfe RS, Babraj JA, Fawkner SG, et al. Towards the minimal amount of exercise for improving metabolic health: beneficial effects of reduced-exertion high-intensity interval training. Eur J Appl Physiol. 2012; 112(7): 2767–2775.
- Palma S, Hasenoehrl T, Jordakieva G, et al. High-intensity interval training in the prehabilitation of cancer patients-a systematic review and meta-analysis. Support Care Cancer. 2021; 29(4): 1781–1794.
- Drigny J, Gremeaux V, Dupuy O, et al. Effect of interval training on cognitive functioning and cerebral oxygenation in obese patients: a pilot study. J Rehabil Med. 2014; 46(10): 1050–1054.
- Brunelli A, Salati M, Refai M, et al. Development of a patient-centered aggregate score to predict survival after lung resection for non-small cell lung cancer. J Thorac Cardiovasc Surg. 2013; 146(2): 385–90.e1.
- Barberan-Garcia A, Ubre M, Pascual-Argente N, et al. Post-discharge impact and cost-consequence analysis of prehabilitation in high-risk patients undergoing major abdominal surgery: secondary results from a randomised controlled trial. Br J Anaesth. 2019; 123(4): 450–456.
- Lau CSM, Chamberlain RS. Prehabilitation Programs Improve Exercise Capacity Before and After Surgery in Gastrointestinal Cancer Surgery Patients: A Meta-Analysis. J Gastrointest Surg. 2020; 24(12): 2829–2837.
- Carli F, Bousquet-Dion G, Awasthi R, et al. Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial. JAMA Surg. 2020; 155(3): 233–242.
- Zhang Y, Tan S, Wang J, et al. Nutrition and exercise prehabilitation in elderly patients undergoing cancer surgery. Asia Pac J Clin Nutr. 2021; 30(3): 349–357.
- Weimann A, Braga M, Carli F, et al. ESPEN practical guideline: Clinical nutrition in surgery. Clin Nutr. 2021; 40(7): 4745–4761.
- Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clinical Nutrition. 2021; 40(5): 2898–2913.
- Minnella EM, Awasthi R, Bousquet-Dion G, et al. Multimodal Prehabilitation to Enhance Functional Capacity Following Radical Cystectomy: A Randomized Controlled Trial. Eur Urol Focus. 2021; 7(1): 132–138.
- Gillis C, Buhler K, Bresee L, et al. Effects of Nutritional Prehabilitation, With and Without Exercise, on Outcomes of Patients Who Undergo Colorectal Surgery: A Systematic Review and Meta-analysis. Gastroenterology. 2018; 155(2): 391–410.e4.
- Osland E, Yunus RM, Khan S, et al. Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis. JPEN J Parenter Enteral Nutr. 2011; 35(4): 473–487.
- Kabata P, Jastrzębski T, Kąkol M, et al. Preoperative nutritional support in cancer patients with no clinical signs of malnutrition--prospective randomized controlled trial. Support Care Cancer. 2015; 23(2): 365–370.
- Mavros MN, Athanasiou S, Gkegkes ID, et al. Do psychological variables affect early surgical recovery? PLoS One. 2011; 6(5): e20306.
- Ho PM, Masoudi FA, Spertus JA, et al. Depression predicts mortality following cardiac valve surgery. Ann Thorac Surg. 2005; 79(4): 1255–1259.
- Pirl WF, Fann JR, Greer JA, et al. Recommendations for the implementation of distress screening programs in cancer centers: report from the American Psychosocial Oncology Society (APOS), Association of Oncology Social Work (AOSW), and Oncology Nursing Society (ONS) joint task force. Cancer. 2014; 120(19): 2946–2954.
- Tsimopoulou I, Pasquali S, Howard R, et al. Psychological Prehabilitation Before Cancer Surgery: A Systematic Review. Ann Surg Oncol. 2015; 22(13): 4117–4123.
- Laurino Neto RM, Herbella FAM. Effects of psychological problems on surgical outcomes. Rev Assoc Med Bras (1992). 2019; 65(5): 586–588.
- Gravani S, Matiatou M, Nikolaidis PT, et al. Anxiety and Depression Affect Early Postoperative Pain Dimensions after Bariatric Surgery. J Clin Med. 2020; 10(1).
- Chou YJ, Kuo HJ, Shun SC. Cancer Prehabilitation Programs and Their Effects on Quality of Life. Oncol Nurs Forum. 2018; 45(6): 726–736.
- Schnoll RA, Martinez E, Langer C, et al. Predictors of smoking cessation among cancer patients enrolled in a smoking cessation program. Acta Oncol. 2011; 50(5): 678–684.
- Thomsen T, Villebro N, Møller AM, et al. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2010(7): CD002294.
- Sørensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012; 255(6): 1069–1079.
- Smith SG, Sestak I, Forster A, et al. Factors affecting uptake and adherence to breast cancer chemoprevention: a systematic review and meta-analysis. Ann Oncol. 2016; 27(4): 575–590.
- Sørensen LT, Hørby J, Friis E, et al. Smoking as a risk factor for wound healing and infection in breast cancer surgery. Eur J Surg Oncol. 2002; 28(8): 815–820.
- Goodwin SJ, McCarthy CM, Pusic AL, et al. Complications in smokers after postmastectomy tissue expander/implant breast reconstruction. Ann Plast Surg. 2005; 55(1): 16–19; discussion 19.
- Chang DW, Reece GP, Wang B, et al. Effect of smoking on complications in patients undergoing free TRAM flap breast reconstruction. Plast Reconstr Surg. 2000; 105(7): 2374–2380.
- Syrowatka A, Motulsky A, Kurteva S, et al. Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Res Treat. 2017; 165(2): 229–245.
- Gillis C, Li C, Lee L, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014; 121(5): 937–947.
- Minnella EM, Bousquet-Dion G, Awasthi R, et al. Multimodal prehabilitation improves functional capacity before and after colorectal surgery for cancer: a five-year research experience. Acta Oncol. 2017; 56(2): 295–300.
- Dimeo F, Schwartz S, Fietz T, et al. Effects of endurance training on the physical performance of patients with hematological malignancies during chemotherapy. Support Care Cancer. 2003; 11(10): 623–628.
- Carli F, Bousquet-Dion G, Awasthi R, et al. Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial. JAMA Surg. 2020; 155(3): 233–242.
- Minnella EM, Liberman AS, Charlebois P, et al. The impact of improved functional capacity before surgery on postoperative complications: a study in colorectal cancer. Acta Oncol. 2019; 58(5): 573–578.
- Brown JC, Zemel BS, Troxel AB, et al. Dose-response effects of aerobic exercise on body composition among colon cancer survivors: a randomised controlled trial. Br J Cancer. 2017; 117(11): 1614–1620.
- Parekh AR, Feng MI, Kirages D, et al. The role of pelvic floor exercises on post-prostatectomy incontinence. J Urol. 2003; 170(1): 130–133.
- Tienforti D, Sacco E, Marangi F, et al. Efficacy of an assisted low-intensity programme of perioperative pelvic floor muscle training in improving the recovery of continence after radical prostatectomy: a randomized controlled trial. BJU Int. 2012; 110(7): 1004–1010.
- Centemero A, Rigatti L, Giraudo D, et al. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: a randomised controlled study. Eur Urol. 2010; 57(6): 1039–1043.
- Burgio KL, Goode PS, Urban DA, et al. Preoperative biofeedback assisted behavioral training to decrease post-prostatectomy incontinence: a randomized, controlled trial. J Urol. 2006; 175(1): 196–201; discussion 201.
- Au D, Matthew AG, Lopez P, et al. Prehabilitation and acute postoperative physical activity in patients undergoing radical prostatectomy: a secondary analysis from an RCT. Sports Med Open. 2019; 5(1): 18.
- Yang A, Sokolof J, Gulati A. The effect of preoperative exercise on upper extremity recovery following breast cancer surgery: a systematic review. Int J Rehabil Res. 2018; 41(3): 189–196.
- Brahmbhatt P, Sabiston CM, Lopez C, et al. Feasibility of Prehabilitation Prior to Breast Cancer Surgery: A Mixed-Methods Study. Front Oncol. 2020; 10: 571091.
- Santa Mina D, Brahmbhatt P, Lopez C, et al. The Case for Prehabilitation Prior to Breast Cancer Treatment. PM R. 2017; 9(9S2): S305–S316.
- Garssen B, Boomsma MF, Meezenbroek Ed, et al. Stress management training for breast cancer surgery patients. Psychooncology. 2013; 22(3): 572–580.
- Kirkham AA, Shave RE, Bland KA, et al. Protective effects of acute exercise prior to doxorubicin on cardiac function of breast cancer patients: A proof-of-concept RCT. Int J Cardiol. 2017; 245: 263–270.
- Campbell KL, Winters-Stone KM, Wiskemann J, et al. American College of Sports Medicine. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010; 42(7): 1409–1426.
- Baima J, Reynolds SG, Edmiston K, et al. Teaching of Independent Exercises for Prehabilitation in Breast Cancer. J Cancer Educ. 2017; 32(2): 252–256.
- Arends J, Bodoky G, Bozzetti F, et al. DGEM (German Society for Nutritional Medicine), ESPEN (European Society for Parenteral and Enteral Nutrition). ESPEN Guidelines on Enteral Nutrition: Non-surgical oncology. Clin Nutr. 2006; 25(2): 245–259.
- Liu Z, Qiu T, Pei L, et al. Two-Week Multimodal Prehabilitation Program Improves Perioperative Functional Capability in Patients Undergoing Thoracoscopic Lobectomy for Lung Cancer: A Randomized Controlled Trial. Anesth Analg. 2020; 131(3): 840–849.
- Lai Y, Su J, Yang M, et al. [Impact and Effect of Preoperative Short-term Pulmonary Rehabilitation Training on Lung Cancer Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease: A Randomized Trial]. Zhongguo Fei Ai Za Zhi. 2016; 19(11): 746–753.
- Stefanelli F, Meoli I, Cobuccio R, et al. High-intensity training and cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease and non-small-cell lung cancer undergoing lobectomy. Eur J Cardiothorac Surg. 2013; 44(4): e260–e265.
- Coats V, Maltais F, Simard S, et al. Feasibility and effectiveness of a home-based exercise training program before lung resection surgery. Can Respir J. 2013; 20(2): e10–e16.
- Peddle CJ, Jones LW, Eves ND, et al. Effects of presurgical exercise training on quality of life in patients undergoing lung resection for suspected malignancy: a pilot study. Cancer Nurs. 2009; 32(2): 158–165.
- Morano MT, Mesquita R, Da Silva GP, et al. Comparison of the effects of pulmonary rehabilitation with chest physical therapy on the levels of fibrinogen and albumin in patients with lung cancer awaiting lung resection: a randomized clinical trial. BMC Pulm Med. 2014; 14: 121.
- Huang J, Lai Y, Zhou X, et al. Short-term high-intensity rehabilitation in radically treated lung cancer: a three-armed randomized controlled trial. J Thorac Dis. 2017; 9(7): 1919–1929.
- Rosero ID, Ramírez-Vélez R, Lucia A, et al. Systematic Review and Meta-Analysis of Randomized, Controlled Trials on Preoperative Physical Exercise Interventions in Patients with Non-Small-Cell Lung Cancer. Cancers (Basel). 2019; 11(7).
- Sebio Garcia R, Yáñez Brage MI, Giménez Moolhuyzen E, et al. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2016; 23(3): 486–497.
- Pouwels S, Fiddelaers J, Teijink JAW, et al. Preoperative exercise therapy in lung surgery patients: A systematic review. Respir Med. 2015; 109(12): 1495–1504.
- Cavalheri V, Granger C. Preoperative exercise training for patients with non-small cell lung cancer. Cochrane Database Syst Rev. 2017; 6: CD012020.
- Peddle-McIntyre CJ, Singh F, Thomas R, et al. Exercise training for advanced lung cancer. Cochrane Database Syst Rev. 2019; 2: CD012685.
- Quist M, Adamsen L, Rørth M, et al. The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy. Integr Cancer Ther. 2015; 14(4): 341–349.
- Minnella EM, Awasthi R, Loiselle SE, et al. Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery: A Randomized Clinical Trial. JAMA Surg. 2018; 153(12): 1081–1089.
- Loewen I, Jeffery CC, Rieger J, et al. Prehabilitation in head and neck cancer patients: a literature review. J Otolaryngol Head Neck Surg. 2021; 50(1): 2.
- Jensen BT, Petersen AK, Jensen JB, et al. Efficacy of a multiprofessional rehabilitation programme in radical cystectomy pathways: a prospective randomized controlled trial. Scand J Urol. 2015; 49(2): 133–141.
- Nahon I, Paterson C, Sayner A. The Impact of Exercise and Nutrition as Part of a Person-Centered Approach to Prehabilitation in Patients with Bladder Cancer. Semin Oncol Nurs. 2020; 36(5): 151072.
- Treanor C, Kyaw T, Donnelly M. An international review and meta-analysis of prehabilitation compared to usual care for cancer patients. J Cancer Surviv. 2018; 12(1): 64–73.