Surgical Prehabilitation of Cancer Patients Undergoing Colorectal Resection. Modalities to Mitigate the Level of Anxiety and Depression Prior to Surgery.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Colorectal Cancer
- Sponsor
- McGill University Health Centre/Research Institute of the McGill University Health Centre
- Enrollment
- 20
- Primary Endpoint
- Functional capacity: Six-minute walk test (Enright, 2003)
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
Psychological distress is common among adults newly diagnosed with cancer and those awaiting cancer treatment(s). Although preoperative psychological distress has been shown to be associated with poorer physical health and adverse treatments among colorectal cancer survivors, few psychological interventions have been developed to reduce distress, and improve physical health in the preoperative period. Moreover, whether a preoperative psychological intervention, delivered in addition to a multimodal Prehabilitation program can improve psychological and physical health remains unknown. Therefore, the purpose of this pilot cohort study was to examine the impact of a structured psychological intervention, given in addition to standard Prehabilitation, on preoperative psychological health and functional capacity in colorectal cancer patients awaiting surgery.
Detailed Description
All participants will receive a multimodal prehabilitation program preoperatively for 4 weeks, composed of three elements: aerobic and strength training exercise program, nutritional counselling and psychological support. The exercise program will be three times per week and include a combination of home-based (twice per week) and supervised (once per week) sessions. Participants' nutritional status and dietary intake will be assessed by a registered dietician/nutritionist, and a whey protein supplement (Immunocal) will be prescribed to achieve a daily intake of 1.5 g protein/kg. Psychological support will consist of a 90-minute interview/session at baseline and weekly in-person follow-ups before surgery aimed at reducing psychological distress and improving adherence to the exercise program and nutritional recommendations. Perioperative care will follow the McGill Surgical Recovery Pathway, also called Enhanced Recovery Program, which is an evidence-based care plan set up by the Surgical Recovery (SuRe) multidisciplinary committee of the McGill University Health Centre.
Investigators
Franco Carli
MD
McGill University Health Centre/Research Institute of the McGill University Health Centre
Eligibility Criteria
Inclusion Criteria
- •Currently aged 18 years or older
- •Diagnosed with non-metastatic, colorectal cancer
- •Awaiting resection of malignant colorectal lesions
- •Able to provide informed consent in English or in French
Exclusion Criteria
- •Have health condition(s) interfering with ability to safely perform exercise at home or to complete testing procedures (e.g., non-ambulatory, dementia, severe end-organ disease, morbid obesity, cardiac abnormalities)
Outcomes
Primary Outcomes
Functional capacity: Six-minute walk test (Enright, 2003)
Time Frame: Baseline (week 0), post-intervention (week 4)
Change in participants' performance on the six-minute walk test (6MWT) across baseline (week 0), and post-intervention (week 4). The 6MWT measures the distance an individual can walk, in metres, in a 6-minute period. Greater distance walked during the 6MWT indicates greater functional capacity.
Secondary Outcomes
- Nutritional status: body weight loss, serum albumin, hand grip strength, body mass index, lean body mass and percentage of body fat(Baseline (week 0), post-intervention (week 4))
- Postoperative complications: Clavien Classification (Dindo, Demartines & Clavien, 2004)(8-weeks post-surgery (week 12))
- Depressive and anxiety symptoms: The Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983)(Baseline (week 0), post-intervention (week 4))
- Health related quality of life: RAND 36-item Short Form Health Survey (SF-36; Ware & Sherbourne, 1992)(Baseline (week 0), post-intervention (week 4))
- Physical activity: Community Health Activities Model Program for Seniors (CHAMPS; Stewart et al., 2001)(Baseline (week 0), post-intervention (week 4))
- Lower body strength: Sit-to-Stand test (Bohannon, 1995)(Baseline (week 0), post-intervention (week 4))