Prehabilitation – physical preparation prior to (cancer) surgery – involving physical training, nutritional support, and psychological care can enhance recovery in older cancer patients after surgery. This thesis of Sharon Hendriks demonstrates that older adults are at risk of reduced intestinal function during physical activity followed by a large post-exercise meal, which may impair nutrient absorption at that moment. Additionally, older cancer patients may be at risk of a reduced intestinal function during the cancer surgery itself as well. For nutritional interventions in prehabilitation strategies to be effective, it is important to identify which patients are unable or less able to absorb essential nutrients due to impaired intestinal function. Given the observed reduction in intestinal function when a meal follows immediately after exercise, a more effective nutritional strategy may be to distribute essential nutrient intake more evenly throughout the day.
For older patients, physical functioning and maintaining independence are important outcomes after surgery. This thesis shows that a substantial proportion of older cancer patients do not return to their preoperative daily step count even three months after surgery. No clear predictors were found for whether or not patients would regain their preoperative activity levels. Future research should aim to identify which older cancer patients are at risk of reduced physical function and loss of independence postoperatively, and whether physical activity levels prior to surgery play a role. Based on these findings, these patients may be particularly suitable candidates for prehabilitation, potentially accelerating recovery of physical functioning.
Sharon Hendriks is part of MoHAD.
