Prehabilitation as Novel Paradigm Shift in Cancer Care

Abstract

Objectives: Prehabilitation aims to optimize patients' preoperative risk factors while waiting for surgery. The preoperative period is a salient time to modify health behaviors with the aim to mitigate the stress of surgery and facilitate the recovery process.

Data sources: This is a narrative review of scientific evidence and published reports on aspects of prehabilitation for patients with cancer.

Conclusion: While the prehabilitation team identifies the health issues ahead of the surgical date, patients become engaged in improving their health. This demands a shift in how the perioperative care is organized, taking into consideration the active role of the patient and the multidisciplinary team approach.

Implications for nursing practice: While the patient with cancer is at the center of the perioperative care, the prehabilitation multidisciplinary team, which includes the perioperative physician, the physiotherapist/kinesiologist/exercise physiologist, the dietician, the psychologist, and the specialist nurse, works together with the surgeon and the oncologist to screen, assess, and plan a personalized intervention. In this context, the specialist nurse can collaborate with the team in identifying those patients at risk who might benefit from the prehabilitation program (eg, frail, older, malnourished, smoker, with many comorbidities) . The specialist nurse will be able to coordinate the time of visits, liaise with the caregivers, identify barriers, and participate in decision-making activities.