MOST PEOPLE ARE FAMILIAR with physical rehabilitation, or rehab, which helps people recover physical function after an injury or surgery. But many cancer specialists encourage patients to consider “prehab,” a program that optimizes physical and mental health before surgery, chemotherapy or radiation to prepare them for the rigors of treatment.
Prehabilitation typically includes physical activities such as walking and weight training but can also address nutrition, mental health and even smoking cessation in the weeks before cancer treatment, says An Ngo-Huang, a physical medicine and rehabilitative physician at the University of Texas MD Anderson Cancer Center in Houston. Prehab goals, which may include boosting cardiovascular fitness, building muscle mass or improving nutrient intake through diet, can be tailored to the patient’s individual needs. “They could have more complications or worse outcomes if they’ve been diagnosed with low muscle mass and malnutrition,” Ngo-Huang says. “Prehab could be a potential intervention for that.”
Increase your daily movement with aerobic activities you enjoy.
People with cancer who wish to incorporate more movement into their routines before treatment don’t have to relive the fitness feats of their teen years, says thoracic cervical oncologist David Finley of Dartmouth Cancer Center in Lebanon, New Hampshire. “I tell patients, ‘Try to get up every 10 minutes and walk for two minutes, and also do 30 minutes of some kind of aerobic activity each day,’” he says. Brisk walking, dancing and stair climbing are all great options.
Some research suggests moderate exercise before cancer surgery can help reduce inflammation. Excessive inflammation may increase the risk of surgical complications, says David Finley, a thoracic cervical oncologist at Dartmouth Cancer Center in Lebanon, New Hampshire. Regular exercise also gives patients “the stamina and strength to recover afterward and get back at or above their level of fitness before surgery,” he says.
David Finley, a thoracic cervical oncologist at Dartmouth Cancer Center in Lebanon, New Hampshire, says people with cancer do not need to regularly travel to a cancer center to participate in a prehab program. Patients can receive initial instruction from a cancer exercise specialist and then complete the program at home. Wearing a fitness watch is one way to stay on track during home workouts.
An Australian study published December 2023 in the Journal of Cancer Research and Clinical Oncology divided 41 men with localized prostate cancer into two groups. One group completed aerobic and resistance exercise three times a week in the six weeks before having their prostates removed, while the other group did the identical program after surgery. Researchers found that the prehab group had improved muscle strength and physical function by the time of surgery. Although the rehab group saw similar improvements by 12 weeks post-surgery, the prehab group entered the recovery period in a fitter state and with less fatigue compared with those who exercised afterward.
Because prehab is a relatively new concept in cancer care, Ngo-Huang encourages patients to ask their medical team if the hospital offers a prehabilitation program or to ask for referrals in their community through organizations such as the YMCA.
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