How 'Prehabilitation' Can Benefit Cancer Patients

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Cancer treatment can be debilitating, but there may be ways patients can better prepare themselves for the challenges to come.

The benefits of exercise in helping cancer patients deal with fatigue, mood swings, and other issues experienced during and after treatment are well documented. Now physician-scientists at Dana-Farber and elsewhere are investigating whether a new field known as cancer prehabilitation (or cancer prehab) — preparing physically and mentally before surgery, chemotherapy, and other treatment — can also be advantageous.

Jennifer Ligibel, MD, MPH, director of the Leonard P. Zakim for Integrative Therapies and a medical oncologist in Dana-Farber's Susan F. Smith Center for Women's Cancers, led a recent randomized study testing whether women with newly diagnosed breast cancer requiring surgery can benefit from pre-operative cancer prehab. Forty-eight patients at Dana-Farber and Yale University were given either an exercise intervention or mind-body intervention in the weeks before surgery; an examination of their tumor tissue determined that a supervised pre-operative aerobic and strength-training exercise program led to changes in genes expressed by tumor cells, showing for the first time that exercise could have a direct effect on breast cancer in patients (although the size of the cancer itself did not decrease).

"As one of the first investigations of its kind, this gives us some early insight into the mechanisms through which exercise may effect breast cancer," says Ligibel of the study, co-led by Melinda Irwin, MD, of Yale, and presented at the 2016 San Antonio Breast Cancer Symposium. "We hope it leads to further exploration and understanding of the biologic underpinnings of this relationship."

While Ligibel and others continue exploring the potential benefits of cancer prehab, Zakim Center exercise physiologist Nancy Campbell, MS, offers these tips for newly diagnosed oncology patients:

  • Consult with your providers before you start any exercise or other prehab program.
  • Walk, walk, walk — an easy aerobic exercise that anybody can do.
  • Strengthen your muscles through core training, which may make it easier to recover after surgery or other treatment.
  • Make sure you're eating and sleeping well.
  • Look into Zakim Center exercise classes and other resources.