An international review and meta-analysis of prehabilitation compared to usual care for cancer patients
Open accessAbstract
PURPOSE: The purpose of the study is to systematically review and synthesise randomised controlled trials investigating the effectiveness of prehabilitation compared to usual care for newly diagnosed, adult-onset cancer patients. METHODS: MEDLINE, EMBASE, PsycINFO, CINAHL and SSCI were searched up to April 2017. Studies were included if disease-related, treatment-related, patient-reported and health service utilisation outcomes were assessed. Two reviewers independently reviewed and appraised the risk of bias of each study. RESULTS: Eighteen studies were included. Interventions comprised one or more of the following components: psychological support, education and exercise. Meta-analyses found that pelvic floor muscle training (PFMT) significantly increased odds of continence at 3 months (OR = 3.29, 95% CI = 1.57-6.91), but did not significantly reduce daily pad use at 6 months post-surgery Mean Difference (MD)= ( = - 0.96, 95% CI = - 2.04-0.12) for prostate cancer patients. Although quality of life improved due to PFMT, functional ability or distress did not. Further meta-analyses indicated that pre-surgical exercise significantly reduced length of hospital stay (MD = - 4.18, 95% CI = - 5.43-- 2.93) and significantly lowered odds of post-surgery complications (OR = 0.25, 95% CI = 0.10-0.66) for lung cancer patients. Psychology-based prehabilitation significantly improved mood, physical well-being and immune function for prostate cancer patients and improved fatigue and psychological outcomes and a trend for better quality of life among breast cancer patients. Risk of bias was high for most studies. CONCLUSIONS: Prehabilitation appears to benefit cancer patients. Rigorous trials are needed to investigate the effectiveness of prehabilitation among other cancer sites and other related effects. The cost-effectiveness of prehabilitation remains unanswered. IMPLICATIONS FOR CANCER SURVIVORS: Providing interventions earlier in the care pathway may lead to better outcomes for patients during survivorship.
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Several published trials, including prehabilitation trials, have reported benefits of perioperative physical activity on surgical outcomes.
“The concept of perioperative physical activity is not new, and several published trials, including prehabilitation, reported benefits on surgical outcomes [14].”
From Pilot study of a telehealth perioperative physical activity intervention for older adults with cancer and their caregivers (2020) · cites this paper as [14]
The observed outcome patterns are consistent with published trials that show an immediate decline after surgery followed by gradual improvements.
“However, the outcome patterns are consistent with published trials, where an immediate decline after surgery followed by gradual improvements are observed [14, 34].”
From Pilot study of a telehealth perioperative physical activity intervention for older adults with cancer and their caregivers (2020) · cites this paper as [14]
Perioperative physical activity grounded in a self-management framework has the potential to reduce postoperative complications, limit functional decline, and improve well-being for patients and caregivers.
“Thus, participation in perioperative physical activity that are based on the self-management framework has the potential to reduce postoperative complications, minimize functional decline, and improve well-being for both patients and caregivers [14].”
From Pilot study of a telehealth perioperative physical activity intervention for older adults with cancer and their caregivers (2020) · cites this paper as [14]
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- Authors
- Treanor, C., Kyaw, T., & Donnelly, M.
- Affiliations
- Queen's University Belfast (GB)
- Corresponding author
- Treanor, C.
- ORCID
- Treanor, C.
- Venue
- Journal of Cancer Survivorship
- Published
- 2017-09-12
- Volume
- 12
- Issue
- 1
- Pages
- 64-73
- ISSN
- 1932-2259 (ISSN-L)
- 1932-2267
- OpenAlex
- W2754730491
- Cited by
- 146
- References
- 47
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 26 · 2023: 16 · 2022: 18 · 2021: 23 · 2020: 26 · 2019: 7 · 2018: 6
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Cancer Survivorship (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion, cc-by)
- Funders
- Queen's University of Belfast
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- prehabilitation, cancer patients, prostate cancer, breast cancer, lung cancer, pelvic floor muscle training, continence, psychological support, quality of life, fatigue, postoperative complications, length of hospital stay, cancer survivorship
- MeSH terms
- Female, Humans, Male, Neoplasms, Quality of Life, Survivors
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