Haven’t heard of “prehabilitation”? Neither had we, until a colleague’s mom worked hard to get fit before her knee replacement surgery years ago and then again before her hysterectomy due to uterine cancer a few years later. In both cases, her speedy recovery was a testament to the hard physical and psychological work she had put in before surgery.
Prehabilitation not just for Orthopedics, now for Cancer too
According to a Medscape article, “For patients newly diagnosed with cancer, getting in better physical and mental shape before starting treatment can improve outcomes and reduce complications, according to a new study. The practice of prehabilitation is common in orthopedic surgery, where patients who are set to undergo knee or hip replacement or other procedures are encouraged to get in the best shape possible beforehand, so that they will be better able to withstand the rigors of surgery and optimize postoperative recovery. The first review of prehabilitation in cancer patients examines studies that used aerobic exercise to improve strength and stamina. The results, which appear in the August issue of American Journal of Physical Medicine & Rehabilitation, show that prehabilitation improves not just physical outcomes, but also psychologic outcomes. It also decreases hospital readmissions and reduces cancer-related healthcare costs.”
Ideal Cancer Prehabilitation Timing
“The time between a diagnosis of cancer and the beginning of therapy is an ideal teaching moment, and can be successfully used to help patients cope with their anxiety and worries about their future, coauthor Julie K. Silver, MD, from the Department of Physical Medicine and Rehabilitation at Harvard Medical School in Boston, told Medscape Medical News. ‘There is a window of time when newly diagnosed patients are thinking about their upcoming treatment and want to do things to help themselves. I saw this first-hand in my cancer rehabilitation practice, and saw that patients could benefit from interventions before their treatment started,’ Dr. Silver explained…She added that the ideal prehabilitation regimen is multimodal. ‘There is more than one assessment and/or intervention that is offered. One of the things that should be considered for every newly diagnosed cancer patient is a prehabilitation intervention designed to decrease anxiety about the upcoming treatment. This would involve helping the patient learn progressive muscle relaxation techniques or meditation,’ Dr. Silver said. Prehabilitation could also include things like financial counseling, which could help decrease anxiety, she noted.”
“Too often, patients get referred to rehabilitation after their treatment, or worse, when their disease has spread and they are severely disabled. ‘The best thing is to help patients before things get that bad, and these programs are available now at more and more hospitals. Even if you just give patients an exercise program so they can get in better shape, they will feel more in control. Unfortunately, cancer patients have so many things done to them; the one thing prehab can really offer these patients is [a sense of] control,’ Dr. Mayer said.”