Surgical Prehabilitation in Patients with Cancer : State-of-the-Science and Recommendations for Future Research from a Panel of Subject Matter Experts - 19/12/17

Doi : 10.1016/j.pmr.2016.09.002

Francesco Carli, MD, MPhil ^a,^{^{1
Contributed equally to the publication of this article.},}^⁎ , Julie K. Silver, MD ^b,^{^{1
Contributed equally to the publication of this article.}}, Liane S. Feldman, MD ^c, Andrea McKee, MD ^d, Sean Gilman, MD ^e, Chelsia Gillis, MSc, RD ^a, Celena Scheede-Bergdahl, PhD ^f, Ann Gamsa, PhD ^a, Nicole Stout, DPT, CLT-LANA ^g, Bradford Hirsch, MD ^h
^a Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada
^b Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
^c Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada
^d Department of Radiation Oncology, Lahey Hospital and Medical Center, Burlington, MA, USA
^e Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
^f Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
^g Rehabilitation Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD, USA
^h Flatiron Health, New York, NY, USA

^∗Corresponding author. Department of Anesthesia, Montreal General Hospital, McGill University Health Centre, 1950 Cedar Avenue, Room D10.144, Montreal, Quebec H3G 1A4, Canada.Department of AnesthesiaMontreal General HospitalMcGill University Health Centre1950 Cedar AvenueRoom D10.144MontrealQuebecH3G 1A4Canada

Résumé

This review by a 10-member panel of experts in surgical prehabilitation addresses processes that may improve oncologic care. Surgical prehabilitation is the process on the continuum of care that occurs between the time of cancer diagnosis and the beginning of surgical treatment. The panel focused on the current state-of-the-science and recommended future research that would help to identify the elements that enhance preoperative physical, nutritional, and psychological health in anticipation of surgery, mitigate the burden of disease, facilitate the return of patient health status to baseline values, decrease postoperative morbidity, and reduce health care costs.

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Keywords : Cancer, Surgery, Exercise, Nutrition, Prehabilitation, Anxiety, Outcome

Plan

Key points

Introduction

The role of exercise in surgical prehabilitation

Exercise in the Cancer Trajectory

Prescribing Exercise in the Prehabilitation Period

The role of nutrition in surgical prehabilitation

Malnutrition and Nutritional Risk

Nutritional Care Goals

Optimal Nutrition Care: A Combination of Oral Nutrition Supplements and Dietary Counseling

Integrating Nutrition with Exercise

The role of psychological stress reduction in surgical prehabilitation

Emotional Stress and Its Impact on Perioperative Outcome

Preoperative Strategies to Attenuate Anxiety

The role of smoking cessation in surgical prehabilitation

Prehabilitation as part of an enhanced recovery strategy to attenuate surgical stress and improve recovery

Specific examples of surgical prehabilitation

Surgical Prehabilitation for Lung Cancer

Surgical Prehabilitation for Colorectal Cancer

Surgical Prehabilitation for Breast Cancer

Summary

Research recommendations

	This work was supported by the Peri-Operative Program, a Nonprofit Charitable Foundation, Montreal, Quebec, Canada.
	Disclosure: The opinions expressed in this publication are not an official policy or position of the National Institutes of Health, the Department of Health and Human Services, or the U.S. Government.

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Vol 28 - N° 1

P. 49-64 - février 2017 Retour au numéro

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Palliative Care and Physiatry in the Oncology Care Spectrum : An Opportunity for Distinct and Collaborative Approaches
Vishwa S. Raj, Julie K. Silver, Terrence M. Pugh, Jack B. Fu

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Surgical Prehabilitation in Patients with Cancer : State-of-the-Science and Recommendations for Future Research from a Panel of Subject Matter Experts - 19/12/17

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