What matters to you? An investigation of patients’ perspectives on and acceptability of prehabilitation in major cancer surgery

Abstract

Prehabilitation refers to the process of making patients fit for surgery with the aim of enabling them to withstand treatment-related stress (Topp et al., 2002). The last decade prehabilitation interventions in patients with cancer have attracted attention, owing to a growing body of evidence indicating beneficial effects on postoperative outcomes (Scheede-Bergdahl et al., 2019). However, in particular, prehabilitation in cancer care represents a challenge, as newly diagnosed cancer patients are going through a stressful and life-changing period of time prior to surgery that often entails feelings such as shock, fear, anger, confusion and powerlessness

Incidence, treatment, and survival trends in older versus younger women with epithelial ovarian cancer from 2005 to 2018: A nationwide Danish study

“…Our results show that patients are getting older at diagnosis, highlighting the need to explore these approaches further. Additionally, studies support that this patient population is positive towards supported and supervised prehabilitation [40].…”

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

“…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'.…”

“…For a cohort of women in Denmark, prehabilitation was considered acceptable if it tted in with their everyday lives and allowed them to carry out other tasks which helped them 'prepare' for surgery, such as meal preparation, laundry, gardening (39,40). Following the recommendations provided, women were ready to accept prehabilitation as being bene cial for health and wellbeing, but spending time with loved ones, funeral planning and nances were considered equally as important by some.…”

“…Only one study commented on the acceptability of nutritional recommendations, in which patients felt that nutritional optimisation extended beyond the recommendations of a 'high protein' diet and should be more inclusive to fruits and vegetables (39). Studies reporting baseline characteristics of participants found high rates of sarcopenia and malnutrition (32,36,37) and it is therefore unsurprising that nutritional components of prehabilitation are focussed around increasing protein intake (23,38,46).…”

“…Motivation is a key mechanism in uencing the engagement of patients with prehabilitation. Qualitative studies have revealed that patients believe that prehabilitation is bene cial to their health and wellbeing, treatment-related outcomes and cancer-related outcomes (39,39,41,42), and as such, these beliefs are motivating. Patients who participated in a UK based multimodal prehabilitation programme reported being more motivated to make long term lifestyle changes, as did their families (34).…”