title: Promoting a culture of prehabilitation for the surgical cancer patient.
abstract: BACKGROUND
  Traditional rehabilitative approaches to perioperative cancer care have focused on the postoperative period to facilitate the return to presurgical baseline conditions. However, there is some realization that the preoperative period can be a very effective time for intervention as the patients are more amenable to target their physiological condition to prepare to overcome the metabolic cost of the surgical stress.
  
  
  METHODS
  We undertook a narrative review of the current literature on surgical prehabilitation and discussed the current evidence of preoperative interventions before cancer surgery in order to increase physiological reserve before surgery and accelerate postoperative recovery.
  
  
  RESULTS
  Published data indicate the positive impact of prehabilitation on postoperative functional capacity and return to daily activities. However, the current evidence on the impact on short- and long-term clinical outcome is limited, and more research needs to be conducted.
  
  
  CONCLUSIONS
  Preliminary findings indicate that a group of interventions such as exercise, nutrition and anxiety reduction in the preoperative period can complement the enhanced recovery program and facilitate the return to baseline activities of daily living. It is not clear at this stage whether the preoperative increase in functional capacity mitigates the burden of postoperative morbidities and subsequent cancer therapies. Therefore, more research is warranted.
authors.affiliation: a Department of Anesthesia , McGill University , Montreal , QC , Canada.
authors.forename: Francesco
authors.initials: F
authors.lastname: Carli
authors.affiliation: b Cumming School of Medicine , University of Calgary , AB , Canada.
authors.forename: Chelsia
authors.initials: C
authors.lastname: Gillis
authors.affiliation: c Department of Kinesiology and Physical Education, McGill Research, Centre for Physical Activity & Health , McGill University , Montreal , QC , Canada.
authors.forename: Celena
authors.initials: C
authors.lastname: Scheede-Bergdahl
mesh_terms: D000203:Activities of Daily Living; D015444:Exercise; D006801:Humans; D009369:Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery*; D009752:Nutritional Status; D011300:Preoperative Care; D020127:Recovery of Function