Nav: Home

Four weeks to prepare cancer patients for surgery

December 01, 2016

Just four weeks of prehabilitation may be enough to help some cancer patients get in shape for surgery. That's according to a recent study of close to 120 colorectal cancer patients in Montreal. This potentially means that, barring unforeseen circumstances that stem from the surgery itself, their recovery is likely to be speedier too, according to earlier research from the same McGill-led team.

"We don't have a one size-fits-all prescription for how much exercise people need leading up to cancer surgery," says Celena Scheede-Bergdahl, a kinesiologist who teaches at McGill University and is one of the authors of the study on the 4-week prehabilitation program. "But we hope that by including a kinesiologist on the team along with oncologists and other specialized medical personnel, and by moving towards prehabilitation rather than rehabilitation, we can help patients recover more quickly so that they can get back to the daily activities they enjoy."

The success of prehabilitation is important news for those over sixty years of age who make up the majority of colorectal cancer patients. According to the latest figures from the World Health Organization, colorectal cancer is now the third most common cancer in women around the globe and the second most common cancer in men.

Although mortality from the disease is decreasing around the world, the recovery process from this kind of 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.

That's where the growing trend towards prehabilitation - preparing patients for an operation rather than simply helping them to recover afterwards - comes in.

Pre-surgery patients - like athletes in training

Scheede-Bergdahl started working with elderly cancer patients 4 years ago and understands the challenges facing patients when they are asked to change their exercise behaviours immediately after receiving a cancer diagnosis.

"When you get a cancer diagnosis, you're likely to feel stressed out and not be thinking about exercise much. But becoming more physically active could make all the difference. Surgery places tremendous physical stress on the body in a very short period of time. So, over the past ten 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. And we're seeing that people have a better recovery as a result."

A changing prescription for post-operative health

To test the four-week prehabilitation program that they had developed, which combines exercise, relaxation techniques and whey protein supplements, the researchers randomly assigned 116 colorectal cancer patients to either a control group or a prehabilitation group. After four weeks of prehabilitation, 70 percent 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 6 minutes by close to 24 metres on average (a change of 20 metres is considered clinically significant). This was in marked contrast to the patients in the control group who tended to exercise less over the 4 week period between diagnosis and surgery. As a result the distance that they were able to walk in 6 minutes diminished significantly. (Those in the control group were offered a similar rehabilitation program once the surgery had taken place.)

"In the past, physicians would often advise their patients to rest in bed prior to surgery in order to build up their strength. This is actually likely to cause more complications, since it means that patients lose muscle mass and are more tired and slower to recover after an operation. This means that it takes them longer to be ready for chemotherapy or radiation," says Scheede-Bergdahl.

Growing global interest in prehabilitation for cancer patients

The concept of preparing the patients for surgery through prehabilitation programs has been gaining interest from those who work with cancer patients. Franco Carli, the McGill anesthesiologist who initiated prehabilitation at the MUHC, has been meeting with health care professionals from across the globe. "It is an exciting time for prehabilitation. Bringing together specialists from various backgrounds gives us the opportunity to best prepare cancer patients to meet the challenges of their upcoming surgery, recovery period and subsequent treatment."
-end-


McGill University

Related Colorectal Cancer Articles:

Colorectal cancer partner-in-crime identified
A protein that helps colorectal cancer cells spread to other parts of the body could be an effective treatment target.
Cancer cell reversion may offer a new approach to colorectal cancer treatment
A novel approach to reverse the progression of healthy cells to malignant ones may offer a more effective way to eradicate colorectal cancer cells with far fewer side effects, according to a KAIST research team based in South Korea.
A novel pathway to target colorectal cancer
Survival rates for patients with late-stage colorectal cancer are dismal, and new therapeutic strategies are needed to improve outcomes.
Colorectal cancer rates in Canada
The incidence of colorectal cancer among younger adults increased in recent years in this analysis of data from Canadian national cancer registries that included about 688,000 new colorectal cancers diagnosed over more than 40 years.
Cancer drugs promote stem cell properties of colorectal cancer
Scientists from the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) and the Mannheim University Medical Center have now discovered that a certain group of cancer drugs (MEK Inhibitors) activates the cancer-promoting Wnt signalling pathway in colorectal cancer cells.
Aspirin before at-home colorectal cancer screening test didn't significantly improve ability to detect cancer precursors
Some observational studies have suggested that taking aspirin before undergoing colorectal cancer screening with a fecal immunochemical test for blood in stool might improve the ability of the test to detect cancer precursors.
Gene involved in colorectal cancer also causes breast cancer
Rare mutations in the NTHL1 gene, previously associated with colorectal cancer, also cause breast cancer and other types of cancer.
Bug that causes stomach cancer could play a role in colorectal cancer
A bacterium known for causing stomach cancer might also increase the risk of certain colorectal cancers, particularly among African Americans, according to a study led by Duke Cancer Institute researchers.
'Chromosomal catastrophes' in colorectal cancer
'Chromosomal catastrophes' have been found to occur along the evolutionary timeline of colorectal cancer development, according to new research led by Queen Mary University of London.
Colorectal cancer: Tipping the scales
Tumors of the colon are among the most prevalent cancers.
More Colorectal Cancer News and Colorectal Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Uncharted
There's so much we've yet to explore–from outer space to the deep ocean to our own brains. This hour, Manoush goes on a journey through those uncharted places, led by TED Science Curator David Biello.
Now Playing: Science for the People

#555 Coronavirus
It's everywhere, and it felt disingenuous for us here at Science for the People to avoid it, so here is our episode on Coronavirus. It's ok to give this one a skip if this isn't what you want to listen to right now. Check out the links below for other great podcasts mentioned in the intro. Host Rachelle Saunders gets us up to date on what the Coronavirus is, how it spreads, and what we know and don't know with Dr Jason Kindrachuk, Assistant Professor in the Department of Medical Microbiology and infectious diseases at the University of Manitoba. And...
Now Playing: Radiolab

Dispatch 1: Numbers
In a recent Radiolab group huddle, with coronavirus unraveling around us, the team found themselves grappling with all the numbers connected to COVID-19. Our new found 6 foot bubbles of personal space. Three percent mortality rate (or 1, or 2, or 4). 7,000 cases (now, much much more). So in the wake of that meeting, we reflect on the onslaught of numbers - what they reveal, and what they hide.  Support Radiolab today at Radiolab.org/donate.