Post-Operative Care of the Cancer Patient: Emphasis on Functional Recovery, Rapid Rescue, and Survivorship

Abstract

A cancer diagnosis and its subsequent treatments are life-changing events, impacting the patient and their family. Treatment options available for cancer care are developing at pace, with more patients now able to achieve a cancer cure. This is achieved through the development of novel cancer treatments, surgery, and modern imaging, but also as a result of better understanding treatment/surgical trauma, rescue after complications, perioperative care, and innovative interventions like pre-habilitation, enhanced recovery, and enhanced post-operative care. With more patients living with and beyond cancer, the role of survivorship and quality of life after cancer treatment is gaining importance. The impact cancer treatments can have on patients vary, and the "scars" treatments leave are not always visible. To adequately support patients through their cancer journeys, we need to look past the short-term interactions they have with medical professionals and encourage them to consider their lives after cancer, which often is not a reflection of life before a cancer diagnosis.

Keywords: enhanced recovery; failure to rescue; functional recovery; perioperative medicine; survivorship.

Figure 1

The evolving role of perioperative medicine. The evolving field looks to optimise patients pre-operatively to reduce the stress response of operations while attention to fluid management and post-operative care reduces post-operative complications and reduces post-operative stay. This involves members of the wider MDT, and there is a need to audit the data to continue improvements in this area.

Figure 2

Failure to rescue. Failure to rescue (FTR) is failure or delay in recognising and responding to a hospitalised patient experiencing complications from a disease process or medical intervention. This situation leads to unnecessary mortalities. There are 3 key areas in recognising this situation and possibly reversing the situation. Early warning systems, good communication frameworks, and specialised teams have all been introduced to help reduce these mortalities.