EDISCIENCES

ABSTRACT

Cancer prehabilitation defined by Silver and Baima (2013) as “a process on the cancer continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment”, includes physical and psychological assessments, targeted interventions with objective outcome measures, and is also most commonly described as the process of enhancing a patient’s ability to cope after surgery.1,2 Prehabilitation was thought to benefit geriatric patients more in some studies.3 However, it is found that the high risk surgical patient is found to be not only older, but one who has multiple comorbidities and is frail.4 Furthermore, it is increasingly recognized that sarcopenia and frailty exists in many chronic diseases including diabetes,5 heart diseases,6 renal disease7and pulmonary disease,8 and is not confined to the elderly. Although prehabilitation is commonly applied to cancer patients, such as in colorectal cancer,9,10 breast cancer,11 urologic cancers,12 it could also be considered in a broader context, for example in chronic kidney disease. Prehabilitation in Singapore currently is diagnosis-based, and includes primarily surgical patients with the involvement of surgeons and/or anesthetists. Prehabilitation may benefit not only pre-surgical patients but also patients who are awaiting other systemic or localized anti-tumor treatments. This paper will focus on and review the various condition groups that can benefit from cancer prehabilitation and discuss how a prehabilitation framework was set up in our acute hospital.