Prehabilitation for surgical oncology patients: empowering patient volition

Prehabilitation is the improvement of patient health in anticipation of a physiological stressor, such as major surgery. Prehabilitation optimizes health by taking a proactive approach to promoting exercise, nutrition, and lifestyle modifications. Engaging patients in the pre-operative phase provides an opportunity to positively impact their recovery and return to functional baseline by reducing post-operative deconditioning. At the Odette Cancer Centre at Sunnybrook Health Sciences Centre in Toronto, Canada, the Interprofessional Multidisciplinary Prehabilitation Assessment Consultation Team (IMPACT—Surgical Oncology) was developed. The program was initiated in January 2015 and assesses approximately 3–5 patients/week (with a total of over 250 patients so far). This program offers patients individualized pre-operative assessments, including medical optimization, functional, and nutritional assessments, as well as counseling for mood-related issues, smoking/alcohol cessation, and preparing for surgery (such as ensuring adequate home supports/functional equipment prior to surgery). By providing holistic, person-centered, individualized pre-operative optimization strategies, patients and families feel empowered, motivated, and in control of their own health.