Every cancer operation carries risks. But these can be minimized with targeted precautions. Proper diet and exercise before the procedure can help prevent complications in stressed patients.
Cancer surgery in cancer patients carries risks. But going to surgery with a heavy load increases the risk of complications and a worse outcome of the procedure. Patients lose blood during a surgical procedure. If a patient goes to the operating room with anemia and continues to lose blood during the procedure, the likelihood of needing a blood transfusion increases. This weakens the immune system and increases the risk of the cancer returning. Also, patients with anemia have a harder time getting back on their feet after the operation. The same is true of malnutrition, which is widespread among older people. Their protein deficiency is significant, which impairs wound healing.
The technical term is pre-enabling
For a long time, an increased risk of surgery for older and pre-existing cancer patients was considered a fate. And most of the efforts to get patients back on their feet have focused on post-procedure measures. They sent her to rehabilitation, for example. However, it was not on the agenda to prepare the patient for the operation in a time-consuming manner. But recently, doctors have pursued just such an approach, called prehabilitation. The term describes the targeted precaution before surgery. This may include an exercise program or a change in diet in the weeks leading up to the surgery. The goal is to reduce the side effects of surgery and allow the patient to recover more quickly.
Chemotherapy can start earlier
But is it also possible that a patient will be ready for the operation for weeks? After all, time is running out when it comes to cancer – a tumor can continue to grow and metastasize. “It was believed that when a tumor was discovered, one had to operate as quickly as possible,” says Natascha Nüssler, chief physician of general and visceral surgery at the Munich clinic in Neuperlach. “Today, however, we know that we can easily delay a four-week operation in the case of colon cancer, for example, without worsening the prognosis.” This discovery has opened a window of time in which physicians can optimize the patient’s health status. “If a patient is in poor condition before the operation, it takes forever to recover from the operation and be able to start the next chemotherapy,” says Nüssler. On the other hand, if you prepare the patient in the two or three weeks before the operation, he will recover faster and receive chemotherapy sooner. “So the alleged waste of time is more than made up for in the end.”
Beware of malnutrition
Soul instead of saving
At the Munich clinic in Neuperlach, where Natascha Nüssler works, every cancer patient is screened for risk factors such as malnutrition using a questionnaire. If malnutrition is likely, Nüssler turns to a nutritionist. She advises the patient what to eat. Patients should also quit smoking and exercise. In the case of frail patients, it is sometimes enough to encourage them to climb stairs if they live in a building with an elevator. Or patients should go for a walk two or three times a week to get out of breath. “Patients often think they need to relax, so you usually have to encourage them.”
The length of stay is shortened
So far there have not been many studies on the effectiveness of prehabilitation in cancer interventions. But the first studies are optimistic. For example, in a Swedish study, the complication rate was lower in patients with prehab than in patients who received only usual care. “What we know so far: Pre-habilitation reduces the length of hospital stay,” says Natascha Nüssler. And the treatment of anemia reduces the risk of a blood transfusion and improves the outcome of an operation.
The Munich clinic offers pre-habilitation, although health insurance companies have not yet reimbursed the costs. Natascha Nüssler: “We do this because we assume that the costs will pay off, on the one hand for our patients, on the other hand because we will probably save on costs after the operation.”
Here’s how you can recover quickly
risk factors
Malnutrition and anemia are associated with an increased risk of prolonged hospital stays and wound infections in patients undergoing cancer surgery. They are also associated with increased overall mortality and reduced quality of life.
Preparation
Many people who have to undergo an operation have multiple diseases and are sometimes in poor general condition. Prehabilitation is intended to make the patient ready for an operation. This is intended to reduce the risk of complications and ensure that patients recover as quickly as possible after the operation. The measures include nutritional therapy, but also exercise, sport and physiotherapy.
