A tertiary cancer centre experience of prehabilitation for surgical ovarian cancer patients receiving neoadjuvant chemotherapy: The royal Mile - Marsden integrated lifestyle and exercise programm

Shovel, Louisa; Dunne, John F.; Whibley, Jessica; Fernandes, Ancilla W.; Kasivisvanathan, Ramanathan

doi:10.1016/j.clnesp.2019.03.117

Cited by 3 publications

(10 citation statements)

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“…We were already aware that there are no published trials for prehabilitation within gynaecological cancer (47), however our review provides a summary of several ongoing randomised controlled trials for which protocols have been published. Pilot observational studies suggest that prehabilitation is bene cial for this group, however, sample sizes of gynaecological cancer patients have been small and results are mostly limited to published abstracts (32)(33)(34)37). Our ndings reveal several barriers and facilitators which need to be taken into account in future prehabilitation interventions for this group.…”

Section: Discussionmentioning

confidence: 81%

“…The 24 articles included nine registered protocols for randomised controlled trials of prehabilitation interventions (23)(24)(25)(26)(27)(28)(29)(30)(31), six observational studies (of which four were abstracts only) (32)(33)(34)(35)(36)(37), three mixed-methods studies (38)(39)(40), two qualitative studies (41,42), two cross-sectional surveys (43,44), one costeffectiveness analysis (45) and one review (46) (Table 2). 'Last chance to live normally'.…”

Section: Resultsmentioning

confidence: 99%

“…Other countries of origin were UK (n = 3), Denmark (n = 3), France (n = 3), India (n = 2), Spain (n = 2), Brazil (n = 1), Prague (n = 1), China (n = 1), The Netherlands (n = 1). UK data were limited to three abstracts describing pilot interventions (32)(33)(34), two of which related to ovarian cancer patients (32,33), whilst the remaining abstract included only one gynaecological cancer patient in the study population (34).…”

Section: Limitationsmentioning

confidence: 99%

“…(42). Interestingly, there are several interventions which take advantage of three to six cycles of neo-adjuvant chemotherapy as a period for prehabilitation prior to surgery (27,30,32,33).…”

Section: The Prioritisation Of Prehabilitation By Patientsmentioning

confidence: 99%

“…(25,27,30,32,34,38). This has been a particular feature of the Marsden Mile programme, whereby initial results found a lack of attendance to facility-based exercise programme (32), which led to the development of an entirely remote programme (33). The reasons why patients did not attend the facility-based sessions were mainly due to being too unwell, which has been highlighted in several other qualitative studies (40)(41)(42).…”

Section: The Accessibility Of Prehabilitation To Patientsmentioning

confidence: 99%

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Considerations for multimodal prehabilitation in women with gynaecological cancers: A realist scoping review

Saggu

Barlow

Butler

et al. 2022

Preprint

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Background: There is increasing recognition that prehabilitation is important as a means of preparing patients physically and psychologically for cancer treatment, however, little is understood about the role of prehabilitation for gynaecological cancer patients. Review question: This scoping review was conducted to collate the research evidence on multimodal prehabilitation in gynaecological cancers and the related barriers and facilitators to delivery and engagement that should be considered when designing a prehabilitation model for this group of women. Methods: Seven medical databases and four grey literature repositories were searched from database inception to September 2021. All articles, except for opinion papers and social media posts, surrounding multimodal prehabilitation in gynaecological cancers were included in the final review. All qualitative papers including gynaecological cancer patients were included, irrespective of whether the intervention of interest was unimodal or multimodal. A realist framework of context, mechanism and outcome was used to assist interpretation of findings. Results: In total, 24 studies were included in the final review. The studies included the following tumour groups: ovarian only (n=12), endometrial only (n=1), mixed ovarian, endometrial, vulvar (n=5) and non-specific gynaecological tumours (n=6). There was considerable variation across studies in terms of screening, delivery of prehabilitation and measured outcomes. Key mechanisms and contexts underpinning engagement with prehabilitation can be summarised by 5 overarching themes: 1) The role of healthcare professionals and organisations 2) Acceptability of prehabilitation 3) Patient motivation 4) Prioritisation of prehabilitation 5) Accessibility of prehabilitation. Implications for practice: A standardised and well evidenced prehabilitation programme for women with gynaecological cancer does not yet exist. Healthcare organisations and researchers should take into account the enablers and barriers to effective engagement by healthcare professionals and by patients, when designing and evaluating prehabilitation for gynaecological cancer patients.

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Section: Discussionmentioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: The Prioritisation Of Prehabilitation By Patientsmentioning

confidence: 99%

Section: The Accessibility Of Prehabilitation To Patientsmentioning

confidence: 99%

See 3 more Smart Citations

Considerations for multimodal prehabilitation in women with gynaecological cancers: A realist scoping review

Saggu

Barlow

Butler

et al. 2022

Preprint

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Multimodal prehabilitation improves functional capacity in patients with advanced ovarian cancer undergoing cytoreductive surgery

Sebio-Garcia,

Celada-Castro,

Arguis

et al. 2024

Int J Gynecol Cancer

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ObjectivePrehabilitation, defined as the preparatory intervention to increase patient preparedness in the lead-up to surgery, has shown a decrease in post-operative complications in various types of surgery. However, there is limited evidence in advanced ovarian cancer surgery. This study aimed to evaluate the benefits of multimodal prehabilitation in advanced ovarian cancer patients in terms of improving physical functioning, body composition, and psychological well-being during the pre-operative period.MethodsThis single-center, ambispective study included patients with advanced ovarian cancer eligible for primary or interval cytoreductive surgery. Participants attended a multimodal prehabilitation program comprising medical optimization, supervised exercise training, nutritional counseling and supplementation, and psychological support. Functional capacity, nutritional status, and psychological well-being were assessed before the start of the program and before surgery.Results62 patients were referred for the multimodal prehabilitation program from July 2019 to May 2023. Median adherence to the training program reached 75% (IQR 58–87%). 35 patients (59%) were evaluated pre-operatively. Patients attended a median of 8 (IQR 6–12) supervised exercise training sessions with no differences between those who underwent primary or interval cytoreductive surgery (p=0.80). A significant improvement was observed in functional capacity according to the 6 min walk test (mean 33.1 m, 95% CI 10.5 to 55.5) as well as in the 30 s sit-to-stand test (+3.3 repetitions, 95% CI 1.8 to 4.8), with both being above the minimal clinically important difference of 14 m and two repetitions, respectively. Patients also reported a significant decrease in depression, anxiety, and total scores of the Hospital Anxiety and Depression Scale.ConclusionsMultimodal prehabilitation in patients with advanced ovarian cancer undergoing cytoreductive surgery improves pre-operative physical functioning and decreases emotional distress. Further controlled studies with a larger sample size are warranted to corroborate improvement in functional capacity, body composition, and psychological well-being through prehabilitation programs.

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Considerations for multimodal prehabilitation in women with gynaecological cancers: a scoping review using realist principles

et al. 2022

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Background There is increasing recognition that prehabilitation is important as a means of preparing patients physically and psychologically for cancer treatment. However, little is understood about the role and optimal nature of prehabilitation for gynaecological cancer patients, who usually face extensive and life-changing surgery in addition to other treatments that impact significantly on physiological and psychosexual wellbeing. Review question This scoping review was conducted to collate the research evidence on multimodal prehabilitation in gynaecological cancers and the related barriers and facilitators to engagement and delivery that should be considered when designing a prehabilitation intervention for this group of women. Methods Seven medical databases and four grey literature repositories were searched from database inception to September 2021. All articles, reporting on multimodal prehabilitation in gynaecological cancers were included in the final review, whether qualitative, quantitative or mixed-methods. Qualitative studies on unimodal interventions were also included, as these were thought to be more likely to include information about barriers and facilitators which could also be relevant to multimodal interventions. A realist framework of context, mechanism and outcome was used to assist interpretation of findings. Results In total, 24 studies were included in the final review. The studies included the following tumour groups: ovarian only (n = 12), endometrial only (n = 1), mixed ovarian, endometrial, vulvar (n = 5) and non-specific gynaecological tumours (n = 6). There was considerable variation across studies in terms of screening for prehabilitation, delivery of prehabilitation and outcome measures. Key mechanisms and contexts influencing engagement with prehabilitation can be summarised as: (1) The role of healthcare professionals and organisations (2) Patients’ perceptions of acceptability (3) Factors influencing patient motivation (4) Prehabilitation as a priority (5) Access to prehabilitation. Implications for practice A standardised and well evidenced prehabilitation programme for women with gynaecological cancer does not yet exist. Healthcare organisations and researchers should take into account the enablers and barriers to effective engagement by healthcare professionals and by patients, when designing and evaluating prehabilitation for gynaecological cancer patients.

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A tertiary cancer centre experience of prehabilitation for surgical ovarian cancer patients receiving neoadjuvant chemotherapy: The royal Mile - Marsden integrated lifestyle and exercise programm

Cited by 3 publications

References 0 publications

Considerations for multimodal prehabilitation in women with gynaecological cancers: A realist scoping review

Considerations for multimodal prehabilitation in women with gynaecological cancers: A realist scoping review

Multimodal prehabilitation improves functional capacity in patients with advanced ovarian cancer undergoing cytoreductive surgery

Considerations for multimodal prehabilitation in women with gynaecological cancers: a scoping review using realist principles

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