Cancer Patients Have A Better Chance To Bounce Back With Prehabilitation

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Many cancer patients have shown they they can recover quickly from intensive cancer treatments if they do rehabilitation before going into a cancer treatment. This is commonly associated with orthopedic operations and cardiac procedure. However, researchers have a reason to believe that this can also help in case of cancer treatments.

Although the research is still in the early stage about impacts of prehabilitation, there is already some encouraging findings. People who are physically and psychologically fit have a better chance of sustaining minimum damage from invasive surgery or radiation.

“It’s really the philosophy of rehab, rebranded,” says Dr. Samman Shahpar, a physiatrist at the Rehabilitation Institute of Chicago.

The main component of cancer prehab is often a structured exercise program to improve patients’ endurance, strength or cardiorespiratory health. The clinician establishes baseline measurements, such as determining how far a patient can walk on a treadmill in six minutes, and may set a goal for improvement. He also evaluates and addresses existing physical impairments, such as limited shoulder mobility that could be problematic for a breast cancer patient who will need to hold her shoulder in a particular position for radiation. Depending on the program, patients may also receive psychological and nutritional counseling or other services.

Some early research suggests prehab may improve people’s ability to tolerate cancer treatment and return to normal physical functioning more quickly. In one randomized controlled trial of 77 people with colorectal cancer who were awaiting surgery, two groups of patients participated in an exercise, relaxation and nutritional counseling program. Half went through the program in the four weeks prior to surgery and half in the eight weeks after it.

Eight weeks after their surgery, 84 percent of prehab patients’ performance on a six-minute walking test had recovered to or over their baseline measurements compared with 62 percent of rehab patients, according to the study, published lastprehab helps cancer patients

“Prehab could be a relatively cheap way to get people ready for cancer treatment and surgery, both of them stressors,” says Dr. Francesco Carli, a professor of anesthesiology at McGill University in Montreal who co-authored the study.

More research is needed to determine the effect of prehab on cancer patients’ outcomes. “There are some physiatrists who don’t believe in prehab,” says Catherine Alfano, vice president of survivorship at the American Cancer Society. “They feel like the science isn’t there yet.”

Insurance plans typically cover rehabilitation services such as physical therapy and occupational therapy. But patients can face problems with coverage such as preauthorization requirements and limits on visits. There may be even more coverage obstacles with prehab.

“What we need is a system that systemically screens people for problems with physical and mental health that is then coordinated with their oncology care,” Alfano says.

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