Cancer patients presenting for surgery are deconditioned due to lifestyle choice, pre-existing comorbidities, their cancer and associated neoadjuvant chemoradiation therapies (n-CRT). This impaired functional capacity associates with increased complications after surgery – with increased critical care requirements and a five-fold increase in healthcare expenditure. Deconditioned patients suffer a greater rate of postoperative complications and n-CRT is an important contributor to this deconditioning, which is potentially reversible or has the capacity to be ameliorated. Studies have shown that preoperative optimisation (prehabilitation) therapies such as nutritional support and exercise prescription improves functional capacity within cancer patients and reported to reduce postoperative complications and hospital length-of-stay after cardiac and abdominal surgery. However, no identified research has tested an Enhanced Structured Preoperative Optimisation Program (ESPOP) that combines nutrition, exercise prescription and haematinic optimisation and studied its impact on perioperative patient morbidity, mortality, quality of life and health resource utilisation. This feasibility study will assess the practical components and viability of a proposed “prehabilitation program” and generate preliminary data to platform a larger (appropriately powered) study to demonstrate efficacy and economic impact.
The trimodal prehabilitation program (ESPOP) that we have developed requires participants to undergo pre-anesthesia assessment prior to taking part in the study. Those who meet inclusion criteria will be provided with the ESPOP strategy. Nutritional intervention counselling and exercise prescription will be guided by the specialist oncology dietitian and exercise physiologist, with participants provided individualised information at specified time-points prior to surgical resection. The aim of our study will be to develop, pilot and evaluate the feasibility of a multidisciplinary (trimodal) ESPOP strategy to improve recovery from functional deconditioning that occurs from lifestyle choice, from cancer and during n-CRT in patients awaiting major colorectal surgery.
Peter MacCallum Cancer Centre
Peter MacCallum Cancer Foundation
Mr Andrew Murnane
Mr Andrew Murnane
Principle Investigator - Exercise Physiologist
Email: [email protected]ac.org