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Exercise and Nutrition Prehabilitation Influence Esophagogastric Cancer Outcome

A randomized clinical trial shows just how important having a supervised physical and dietary plan can improve cancer treatment and outcome McGill University Health Centre in Montreal, Quebec, conducted a study intended “to determine the extent in which a multimodal prehabilitation regimen optimizes functional recovery in patients suffering from esophageal cancer and the incidence of [...]

A randomized clinical trial shows just how important having a supervised physical and dietary plan can improve cancer treatment and outcome

McGill University Health Centre in Montreal, Quebec, conducted a study intended “to determine the extent in which a multimodal prehabilitation regimen optimizes functional recovery in patients suffering from esophageal cancer and the incidence of postoperative pulmonary complications” and also “understand further which measures of immediate surgical recovery are sensitive to prehabilitation interventions, and predict change in later outcome measures”.

Prehabilitation is defined asphysical and/or lifestyle preparation designed to improve recovery time following surgery”. It helps with surgical stress response and inactivity due to the procedure. This can also reduce the amount of rehab needed after surgery. Postoperative complications are a very worrying sign, especially for long-term prognosis.

51 participants were divided into two groups, 26 for prehabilitation and a control group of 25. The selection criteria was pretty wide, be over 18, be referred electively for resection of a malignant esophageal lesion, not have cardiac or renal problems, anemia, obesity or be in stages 4-5 according to the American Society of Anesthesiologists (ASA) health status.

The program offered nutrition counseling and exercise routines for a period of 4 weeks before surgery and 8 weeks after surgery. 20 minutes of exercise, three times a week were recommended, alternating between aerobic and resistance training.

A 6 minute-walk distance was the test, done once before and then after surgery. Compared to the control group, the prehabilitation group had improved functional capacity on both times, of up to 20%.

The article concluded that “prehabilitation improves perioperative functional capacity in esophagogastric surgery. Keeping patients from physical and nutritional status decline could have a significant effect on the cancer care continuum”.

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