title: Psychological Prehabilitation Before Cancer Surgery: A Systematic Review.
abstract: BACKGROUND
  Cancer patients experience anxiety and depression after diagnosis and during treatment. A wide range of psychological interventions have been proposed to alleviate distress, but the evidence about the perioperative effectiveness of such interventions is not clear. This systematic review examined the effect of preoperative psychological interventions or prehabilitation on the postoperative outcomes of patients undergoing surgery for cancer.
  
  
  METHODS
  A systematic review of the published data was performed using Embase, Medline, and PsycInfo for the period from 1946 to February 2014. A total of 951 publications (case series, single case reports, and reviews) were found. Only seven of these studies included patients undergoing an operation for cancer and a preoperative psychological intervention.
  
  
  RESULTS
  Six of the seven studies were randomized controlled trials. Four were conducted with patients who had breast cancer (n = 356). The other studies included patients with gynecologic cancer (n = 30), colorectal cancer (n = 60), and prostate cancer (n = 159). Assessment of the studies showed four to be of good quality, two to be of moderate quality, and one to be of poor quality. Interventions did not affect traditional surgical outcomes (e.g., length of hospital stay, complications, analgesia use, or mortality) but positively affected patients' immunologic function. However, psychological interventions appeared to have an impact on patients' reported outcome measures including psychological outcomes, quality of life, and somatic symptoms.
  
  
  CONCLUSIONS
  Available data suggested that preoperative psychological prehabilitation may have a role for cancer patients undergoing surgery. Further evidence is needed to evaluate its role.
authors: School of Psychology, University of Birmingham, Birmingham, UK.
authors: Ioanna
authors: I
authors: Tsimopoulou
authors: Midlands Abdominal and Retroperitoneal Sarcoma Unit, The Queen Elizabeth Hospital Birmingham, Birmingham, UK. pasqualisandro@hotmail.com.
authors: Sandro
authors: S
authors: Pasquali
authors: School of Psychology, University of Birmingham, Birmingham, UK.
authors: Ruth
authors: R
authors: Howard
authors: Midlands Abdominal and Retroperitoneal Sarcoma Unit, The Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors: Anant
authors: A
authors: Desai
authors: Midlands Abdominal and Retroperitoneal Sarcoma Unit, The Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors: David
authors: D
authors: Gourevitch
authors: Psychology Service, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors: Inigo
authors: I
authors: Tolosa
authors: Academic Department of Surgery, University of Birmingham, Birmingham, UK. ravinder.vohra@uhb.nhs.uk.
authors: Ravinder
authors: R
authors: Vohra
mesh_terms: D006801:Humans; D009369:Neoplasms / Q000523:psychology* / Q000601:surgery; D011300:Preoperative Care / Q000523:psychology*; D011613:Psychotherapy; D013315:Stress, Psychological / Q000534:rehabilitation*