Exercise before cancer surgery: a pilot trial encouraging for participation, not efficacy

Supervised preparation compared with usual care

Researchers at a single center recruited patients with breast, prostate or colorectal cancer who were scheduled for surgery. They randomly assigned them to a prehabilitation program or usual care.

Prehabilitation consisted of supervised aerobic training two to three days per week before surgery. The available abstract specifies neither session intensity nor the total duration of the program.

The primary objective was to assess feasibility and safety: recruitment, session attendance, program adherence, withdrawals and adverse events. Cardiorespiratory fitness, quality of life and fatigue were exploratory outcomes. Complications and length of hospital stay were also recorded during the 30 days after surgery.

Good session attendance, but limited recruitment

Of 47 potentially eligible patients approached and assessed, 23 were recruited and randomized. Twenty completed follow-up assessments: 11 in the prehabilitation group and nine in the usual-care group.

Participants attended an average of 5.25 sessions. Among those who started prehabilitation, attendance reached 91.3% and program adherence 82.6%. These results describe sustained participation among those who engaged, without demonstrating that the program would be as accessible to a broader population.

Five adverse events were recorded in the prehabilitation group: three episodes of fatigue and two instances of muscle pain in the limbs. All were grade 1. No serious adverse events were observed, but such a small sample cannot rule out rare risks.

Clinical efficacy remains to be established

The analyses found no statistically significant between-group differences in changes in cardiorespiratory fitness, quality of life or fatigue. This does not demonstrate an absence of effect: the estimates were too imprecise to draw a conclusion.

The abstract provides no numerical results allowing comparison of complications or length of hospital stay. It therefore does not support a claim that this preparation improves postoperative outcomes.

The trial's contribution is primarily practical: it documents participation in and tolerability of a supervised program at one center. However, low recruitment and the inclusion of several different cancers limit the conclusions, including those about feasibility.

What we can take away

This pilot trial supports further evaluation of supervised prehabilitation before cancer surgery. It does not yet demonstrate a clinical benefit or provide a protocol to follow on your own.