New Research Supports “Prehabilitation” as a Powerful Tool in Modern Cancer Care
For decades, many patients preparing for surgery were told to rest, conserve energy, and simply wait for the operation date. But an important new study published in the Journal of the American College of Surgeons suggests a very different approach may lead to better outcomes:
Get stronger before surgery.
The study examined “prehabilitation” programs — structured exercise and nutrition interventions performed before surgery — and found they can significantly reduce complications and shorten recovery time after major operations.
For cancer patients, this research may be especially important.
Many individuals facing cancer surgery already struggle with fatigue, muscle loss (sarcopenia), poor nutrition, weight changes, decreased physical activity, and emotional stress from chemotherapy, radiation, or the cancer itself. These factors can weaken the body’s ability to recover after surgery.
This new analysis suggests that targeted exercise and nutritional preparation before surgery may help patients enter the operating room stronger, healthier, and better prepared for recovery.
What Did the Study Show?
Researchers analyzed 23 randomized controlled trials involving more than 2,100 patients undergoing orthopedic, cardiac, gastrointestinal, abdominal, vascular, and spine surgeries.
The results were impressive:
- Patients participating in exercise or nutrition-based prehabilitation had fewer postoperative complications.
- Hospital stays were shorter.
- Exercise programs improved quality of life measures.
- Nutrition-focused programs were especially effective at reducing length of hospitalization.
The benefits were seen across multiple types of surgery, suggesting that prehabilitation may become an increasingly important part of future surgical care.
Why This Matters So Much for Cancer Patients
Cancer and cancer treatments can significantly weaken the body before surgery ever begins.
Chemotherapy, radiation therapy, inactivity, chronic inflammation, and poor nutrition may contribute to:
- Sarcopenia (loss of muscle mass)
- Reduced cardiovascular fitness
- Fatigue
- Frailty
- Poor wound healing
- Increased infection risk
- Longer recovery times
This study reinforces a growing concept within exercise oncology:
Physical fitness and nutritional health are not “extras” in cancer care — they may directly influence clinical outcomes.
The authors note that surgery itself increases inflammation, oxidative stress, and muscle breakdown. Exercise and nutritional optimization may help counter many of these physiologic stresses.
Exercise Before Surgery: More Than “Getting in Shape”
The exercise programs studied included:
- Resistance training
- Aerobic exercise
- Walking programs
- High-intensity interval training
- Balance training
- Stretching and posture exercises
Importantly, these were not elite athletic programs. Many interventions involved manageable activities performed several times per week for only a few weeks before surgery.
Exercise-based prehabilitation was particularly effective at reducing postoperative complications.
For cancer patients, maintaining or rebuilding muscle mass and endurance before surgery may become one of the most important steps in recovery preparation.
Nutrition Also Plays a Major Role
The study also showed that nutrition-centered prehabilitation significantly shortened hospital stays.
Many nutritional programs focused on:
- Increased protein intake
- Immune-enhancing nutritional supplements
- High-quality calorie intake
- Nutritional optimization before surgery
This is highly relevant in cancer care because malnutrition is often underrecognized in oncology patients.
Cancer-related weight loss and poor body composition may negatively affect recovery, immune function, wound healing, and treatment tolerance. Improving nutrition before surgery may help patients recover faster and return to treatment sooner.
The Future: Personalized Prehabilitation in Cancer Care
One of the most exciting aspects of this study is the movement toward personalized prehabilitation.
Not every patient needs the same program.
Some patients may require:
- Strength training
- Aerobic conditioning
- Protein supplementation
- Body composition monitoring
- Psychological support
- Virtual coaching or telehealth programs
The authors also discuss emerging technology-assisted prehabilitation programs that may allow patients to participate from home through virtual platforms and digital coaching.
This could dramatically expand access for cancer patients across the world.
The CancerFitness.org Call-to-Action
Cancer surgery preparation should not begin the night before surgery.
It should begin weeks earlier with intentional efforts to improve:
- Physical fitness
- Muscle strength
- Nutritional status
- Functional reserve
- Emotional readiness
Exercise oncology and prehabilitation are moving closer to becoming essential components of comprehensive cancer care.
Cancer patients should speak with their healthcare team about:
- Exercise programs before surgery
- Nutritional evaluation
- Body composition assessment
- Sarcopenia screening
- Physical therapy or supervised rehabilitation programs
Healthcare systems should increasingly view prehabilitation not as an optional wellness program — but as a potentially critical component of improving surgical outcomes and survivorship.
The goal is simple:
Help patients enter surgery stronger so they can recover stronger.
Reference: Exercise-Based and Nutrition-Based Prehabilitation Programs in Surgery: A Systematic Review and Meta-Analysis. Catherine T Cascavita, MD, MLS, Anne E Hall, BS, Kaavian Shariati, MEng, BS1, Jose M Chevalier, BS1, Alexander A Argame, BSN, RN, et al.
Journal of the American College of Surgeons Publish Ahead of Print
DOI: 10.1097/XCS.0000000000001891
