Cancer treatment can be a significant challenge for the body. Whether it’s surgery, radiation, chemotherapy, or another form of cancer therapy, the body undergoes significant stress while the treatment strives to eradicate and/or control the disease. Like any challenge we face, preparation can be a key component to a successful outcome. Preparing for necessary cancer treatments includes preparing physically with exercise. This concept is known as pre-habilitation; that is, engaging in pre-treatment conditioning in an effort to optimize treatment recovery. Pre-treatment is often an opportune time to invest in post-treatment outcomes because the body is functionally capable of engaging in routine activity.

Pre-habilitation is growing in popularity as a complementary therapeutic approach due to an expanding volume of research describing its benefits. While the literature on pre-habilitation for people diagnosed with cancer is currently limited to those undergoing surgery, the principles would generally apply to other forms of treatment; however, research in these non-surgical therapies is greatly needed. To date, research has shown benefit for pre-habilitation for patients undergoing surgery for colorectal, prostate, and lung surgery, as well as in a mixed-population of patients that were undergoing surgeries for pancreatic, liver, colon, rectum, bone and esophageal cancers. While the specific benefits vary across cancer sites; the research indicates that post-operative length of stay, functional capacity and physical fitness, risk of surgical complications, and overall quality of life can be improved for surgical patients that engage in pre-habilitation.

So what does pre-habilitation consist of? The idea is not to make drastic changes in your exercise routine after you schedule your treatment, but rather, to continue or start engaging in moderate physical activity that raises your overall fitness prior to treatment to create a buffer against the anticipated fitness declines associated with treatment. This may include basic aerobic exercises like walking or cycling, as well as resistance training exercises like weight lifting. A total-body workout will better prepare you to sustain the loss of fitness associated with post-treatment inactivity. For certain surgeries, a localized exercise approach may assist with regional side effects. For example, research has shown that pelvic floor muscle exercises (often referred to as Kegel exercises) prior to radical prostatectomy for prostate cancer can improve post-operative urinary incontinence.

Pre-habilitation has conventionally consisted of physical exercise, but stress management and a healthy diet are also critical components of a comprehensive pre-habilitation program. If you have other health conditions or cancer-related effects that could limit your ability to exercise, it is best that you consult with your physician before starting a pre-habilitation program. Furthermore, if you are new to exercise, a qualified exercise professional with an understanding of cancer and associated treatments is recommended to ensure a safe and optimal pre-habilitation program.

Daniel Santa Mina, CEP, PhD