Prehabilitation for cancer surgery: perspectives of Australian patients, families, and health professionals

Purpose: Multimodal prehabilitation prior to major surgery is becoming an expected component of comprehensive, quality cancer care. Participation and adherence remain low, and few health services offer it as usual care. Our aim was to explore stakeholder perspectives, enablers, and barriers to participation in a multimodal prehabilitation programme before cancer surgery. 

Methods: An exploratory cross-sectional survey was conducted from July to October 2022 with questions about perspectives towards prehabilitation, and barriers and enablers to participation. Participants who had surgery (i.e. tumour resection) as part of their cancer treatment, their family members, and health professionals at a South Australian tertiary hospital were recruited. Descriptive statistics were used to analyse the data. 

Results: Patients (n = 80), their family members (n = 33), and health professionals (n = 37) held positive perceptions towards prehabilitation. Key enablers were the recommendations for multimodal prehabilitation from their surgeon and oncologist (patients n = 46, 58%; family members n = 20, 61%) and the belief it may improve recovery after surgery (n = 41, 51% patients; n = 17, 52% family members). Travel, lack of awareness of benefits, and symptoms were identified as barriers. 

Conclusions: Prehabilitation was perceived positively, however, access and logistical barriers need to be addressed. Awareness of the benefits of prehabilitation, recommendations from medical staff, and flexible programme delivery are key recommendations. 

Implications for cancer survivors: To engage patients undergoing surgery for cancer, there are tangible enablers that should be harnessed and barriers that need to be overcome to increase the uptake of multimodal prehabilitation. Clear and consistent information, and access to such programmes, should be seen as a priority.