The Potential of Prehabilitation in Radical Cystectomy Pathways: Where Are We Now?

Bente Thoft Jensen*, Susanne Vahr Lauridsen, Celena Scheede-Bergdahl

*Corresponding author for this work
6 Citations (Scopus)

Abstract

Objective: The growing recognition of prehabilitation has caused an emerging paradigm shift in surgical cancer care and an integrated component of the cancer care continuum. This narrative review aims to update and inform the urological community of the potential of prehabilitation before radical cystectomy. Data Sources: A nonsystematic narrative review was performed through a database search in PubMed, and CINAHL using the following search terms: enhanced recovery after surgery (ERAS); Frailty; Prehabilitation and/or Rehabilitation; Physical Activity and/or exercises; Nutrition; Nutritional Care; Smoking cessation; Alcohol cessation; Prevention; Supportive Care; and combined with Radical Cystectomy. Conclusion: A multimodal and multi-professional approach during the preoperative period may offer an opportunity to preserve or enhance physiological integrity and optimize surgical recovery. Studies indicate a positive effect of prehabilitation on postoperative functional capacity and earlier return to daily activities and health related quality of life. Meaningful outcomes that reflect recovery from a patient's perspective and clinical outcome measures, as well as validating metrics, are necessary to establish whether prehabilitation diminish the risk of developing long-term disability in high-risk patients. Implications for Nursing Practice: Uro-oncology nurses are at the forefront in every ERAS program and vital in screening patients ahead of surgery for common risk factors, current impairments, and limitations that can compromise baseline functional capacity. The growing movement to standardize clinical implementation of prehabilitation, indicate there is a clear need for further investigation, optimization of a multimodal approach and an open discussion between health care providers from different areas of expertise who might best support and promote these initiatives.

Original languageEnglish
Article number151107
JournalSeminars in Oncology Nursing
Volume37
Issue number1
ISSN0749-2081
DOIs
Publication statusPublished - Feb 2021

Keywords

  • Bladder Cancer
  • Enhanced Recovery
  • Prehabilitation
  • Radical Cystectomy
  • Rehabilitation
  • Cystectomy
  • Humans
  • Postoperative Period
  • Quality of Life
  • Preoperative Exercise
  • Preoperative Care

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