‘Prehab’ before surgery speeds up patient recovery, review suggests

Christopher Wanczycki, a 65-year-old Ottawa resident, loved to ski and work up a sweat outdoors before his advanced cancer diagnosis. However, in May 2021, he received the devastating news that he had a five centimetre diameter tumour in his rectum. Despite the aggressive radiation and chemotherapy treatments to shrink the tumour, his oncologist recommended surgery as the next step in his treatment plan.

Wanczycki decided to enroll in a clinical trial at Ottawa Hospital that focused on prehabilitation, or prehab, to help him prepare for the upcoming surgery. The prehab program included exercise, enhanced nutrition, psychological support, and cognitive training aimed at helping patients recover more quickly. Wanczycki saw prehab as a motivating factor to push him through his treatments and surgery.

A recent systematic review published in the medical journal BMJ supports Wanczycki’s experience. The review, led by Dr. Daniel McIsaac from Ottawa Hospital, found that prehab programs could reduce complications and hospital stays after surgery, as well as improve patients’ quality of life. McIsaac likened prehab to training for a half marathon, stating that preparing the body before surgery can lead to better outcomes.

The review analyzed data from 15,000 patients undergoing planned surgeries and found a 40 to 50 percent relative reduction in complications for those who participated in prehab. Additionally, there was a one-day reduction in hospital stays and improvements in patients’ physical independence and overall quality of life.

Wanczycki’s three-month prehab program included weekly check-in calls with a research assistant who guided him through exercises and stretches to do at home. Despite losing weight and experiencing discomfort from chemotherapy, Wanczycki found motivation in the program and was able to resume cross-country skiing just five weeks after his surgery.

Researchers believe that tailoring prehab programs to specific patient needs, such as focusing on leg strength for knee replacement patients or improving nutrition for frail older patients, could further enhance outcomes. Wanczycki’s successful recovery and return to outdoor activities serve as a testament to the benefits of prehab in helping patients bounce back after surgery.

As Wanczycki continues to enjoy the outdoors and pursue his passion for skiing, he encourages others facing cancer surgery to consider participating in prehab programs to optimize their recovery. His story is a testament to the power of exercise, nutrition, and psychological support in helping patients overcome the challenges of cancer treatment and surgery.