Prehabilitation Program for Elderly Patients with Stage III-IV Epithelial Ovarian, Fallopian Tube, Primary Peritoneal Carcinoma, Pancreatic Cancer, Muscle Invasive Bladder Cancer, and Esophageal Cancer Undergoing Neoadjuvant Chemotherapy
This phase I/II trial examines whether a daily exercise and nutrition program designed to prepare for surgery is usable and helps with physical function and recovery after surgery for patients with stage III-IV epithelial ovarian, fallopian tube, and primary peritoneal cancer (EOC), pancreatic cancer, muscle invasive bladder cancer, and esophageal cancer undergoing chemotherapy before surgery (neoadjuvant). Frailty and malnutrition are highly common in elderly patients with advanced cancer. Prehabilitation is the multidisciplinary process of enhancing functional capacity prior to surgery by including structured exercise, nutritional support and psychological (mental and emotional) test into preoperative care. Prehabilitation decreases the surgical stress response and increases the preparedness of patients to undergo the planned surgery. Structured exercises to strengthen inspiratory (breathing) muscles, limb, back and abdominal muscles can improve overall physiologic capacity and strength. In addition, nutritional supplementation with prehabilitation has been shown to decrease hospital stay by 2 days in patients undergoing colorectal surgery and lower hospital charges. A prehabilitation program may improve preparing patients for surgery and surgical recovery in the future as well as improving overall quality of life or prolong survival for elderly patients with cancer undergoing neoadjuvant chemotherapy.