Challenges of a prehabilitation program for oesophageal cancer patients in the Australian setting

Patients with oesophageal cancer (OC) considered for surgery typically undergo neoadjuvant therapy (NAT) before oesophagectomy. While NAT improves cancer survival compared to surgery alone, these regimens can negatively impact patient fitness and subsequent surgical outcomes. Prehabilitation is a preoperative process that aims to improve the functional capacity of patients with exercise, nutrition and psychological interventions, helping patients endure surgical stress and improve postoperative outcomes. Studies internationally of prehabilitation in oesophageal cancer patients have yielded positive results. This has encouraged the implementation of prehabilitation programs in Australian hospitals, including on our unit.

This article discusses the challenges that may impact the implementation of a prehabilitation program for OC patients in Australia. The data provided below was obtained from a feasibility study conducted at Flinders Medical Centre, South Australia, to measure the impact of prehabilitation on the recovery of patients undergoing oesophagectomy. The study was approved by the Southern Adelaide Clinical Human Research Ethics Committee.