Can exercise prior to oesophageal cancer surgery improve outcomes?

 

Expert speakers outlined the benefits of exercise before surgery for oesophageal cancer during a recent lecture at the Flinders Centre for Innovation in Cancer.

Known as “prehab”, exercising ahead of cancer surgery is thought to improve patient outcomes and quality of life, and reduce the risk of surgical complications. Clinicians say prehab is equally as beneficial as traditional post-operative rehabilitation, and combining the two is ideal.

Studies have shown the crucial role exercise plays in recovering from cancer and potentially reducing the risk of it coming back. Exercise is known to be protective against oesophageal cancer, along with a plethora of other conditions, such as stroke, depression, multiple sclerosis and Parkinson’s disease.

According to physiotherapist Mr Ernest Lourens, any kind of pre-surgery physical activity will have a positive effect – whether it’s dancing, running, swimming or weight lifting – with a combination of cardio and resistance training thought to be best. Mr Lourens says there is no set limit on how much exercise is needed, and patients should do as much as they can.

Dr Tim Bright, head of the Oesophago-Gastric Surgical Unit at Flinders Medical Centre, says individuals are faced with a host of challenges after receiving a diagnosis of oesophago-gastric cancer. Treatment typically involves pre-surgery chemotherapy and radiation, several weeks in hospital and a lengthy recovery period. Along with pain relief and pre-op counselling, getting up and moving as soon as possible after surgery is vital in the recuperation process. Gentle post-op exercise, such as walking, helps to boost lung function and mitigate loss of muscle strength.

Dr Bright says rehab is known to improve patient outcomes, and that prehab could provide added benefits, but studies are needed to test feasibility and efficacy.

Patients are currently being recruited for a research study to do just this, says Mr Lourens. Running until 2019, the feasibility study will follow 30 patients before, during and after treatment. Participants will be monitored over 12 weeks, with six weeks of prehab and six weeks of rehab, plus home-based exercises.

While this research is focused on outcomes of oesophageal cancer, it is thought the effects of pre-op exercise could also be beneficial for patients undergoing surgery for many other types of cancer.

Many thanks to Julie Marker – member of our Consumer Advisory Panel – for providing details from the lecture she attended and Katherine Harrison – a recent GI Cancer Institute volunteer – for writing this article.