Cancer prehab may not be as common as preparation programs for joint replacement, but maybe it should be. For anyone having surgery, whether it’s replacement of a knee joint or removal of a cancerous tumor, some type of rehabilitation, or rehab, is an expected part of the recovery process. But pre-habilitation programs before treatment also are helping improve outcomes for all kinds of cancer patients, according to research published in the Journal of Cancer Survivorship.
Cancer prehab is an emerging field, that, as its name implies, takes place before surgery or other treatment begins. Pre-habilitation programs aim to help patients build endurance, cardiovascular health, and strength to prepare their bodies for the stress of surgery, radiation, and chemotherapy.
A growing number of oncologists now are recommending a program of pre-habilitation for patients before they begin cancer treatment. Cancer prehab may involve exercises or counseling to promote healthy eating habits. But it’s more than that. In a comprehensive pre-habilitation program, patients undergo a physical and psychological assessment to determine if there are any conditions or diseases in addition to cancer that might affect cancer treatment or recovery.
According to one study, there is a good chance a cancer patient does have other health challenges. That study, done in 2015, found that between 65 percent and 90 percent of cancer patients had at least one health condition in addition to their cancer diagnosis. For some patients, those additional health concerns can complicate treatment, or even limit their treatment options.
“Recognizing those conditions and, when possible, treating them before cancer treatment begins makes sense, and may help improve cancer treatment outcomes,” says Rocky Mountain Cancer Centers oncologist Dr. Jenny Fox.
Multiple benefits of cancer prehab
Even for those patients who are otherwise healthy, cancer prehabilitation can help them prepare for and recover from cancer treatment. Studies have found that benefits may include:
- Better physical outcomes
- Better psychological outcomes
- Fewer complications
- Less need for patients to be re-admitted to the hospital
- Patients are better able to tolerate cancer treatment
- Patients are able to resume work or other regular activities
In one research study, 77 people with colorectal cancer who were awaiting surgery were divided into two groups. One group participated in an exercise, relaxation, and nutritional counseling program in the four weeks before surgery. The other half participated in the same program in the eight weeks after surgery.
Eight weeks after surgery, 84 percent of the patients who had the cancer prehab program had recovered well enough to perform as well on a walking test as they had before surgery. Of those who completed the program after surgery, only 62 percent had recovered to their pre-surgery levels.
Other examples of cancer prehab include:
- A woman about to undergo a mastectomy and breast reconstruction may benefit from pretreatment support from an oncology mental health professional, who can offer guidance on skills to decrease stress and anxiety. At the same time, a physical therapist may help with upper-body strengthening and range-of-motion exercises that could help reduce pain and immobility after surgery.
- A patient who smokes might receive counseling to help break the habit. Research shows that people who smoke at the time of surgery tend to have more complications.
- A patient who has head or neck cancer may receive swallowing therapy before surgery, to strengthen muscles around the jaw. That can help speed recovery and prevent unwanted weight loss.
“As evidence showing the benefits of cancer prehab grows, the practice is likely to become more accepted, and widespread,” Dr. Fox says.