Anyone facing major surgery likely knows that rehabilitation may be necessary after the procedure – physical therapy to strengthen muscles and regain mobility, for example. But what about “prehabilitation?"
The concept of prehabilitation is gaining traction in health care. In essence, prehabilitation means using the concepts of rehabilitation before a patient undergoes surgery.
At the University of Oklahoma Health Sciences Center in Oklahoma City, a team of health professionals and researchers has launched a new trial to compare different prehabilitation approaches for patients about to undergo surgery for pancreatic cancer. Pancreatic cancer is an especially difficult disease, with survival rates under 7 percent.
The best chance for survival involves surgery to remove the tumor; however, pancreatic cancer patients often become weak and deconditioned before surgery, making the procedure riskier. By helping patients with their physical activity and nutrition in the weeks leading up to surgery, researchers hope to improve their ability to handle the stress of the operation and to recover their physical function more quickly afterward.
“We are very excited about this research project and its potential for helping patients with pancreatic cancer to be able to tolerate treatments like surgery and chemotherapy to extend their lives without sacrificing quality of life,” said physical therapist Elizabeth Hile, PhD, who is director of the Cancer Rehabilitation Clinic and Research Program at the Stephenson Cancer Center.
“Studies have shown that exercise and nutrition regimens improve outcomes for patients with other types of cancers, but we don’t know as much about the value of prehabilitation for pancreatic cancer patients, or the best approach to take based on the individual and the cancer.”
Hile and her team work with patients enrolled in the trial for two weeks before their surgeries. A physical therapist provides an individualized exercise program, and registered dietitians establish a nutrition plan for each patient. Registered dietitian Leah Hoffman, PhD, leads the nutrition component of the intervention.
After the surgery is over, the team will follow patients for six months, tracking their surgical complications, length of hospitalization, quality of life and other outcomes. The goal of the trial is to compare approaches to prehabilitation for patients undergoing Whipple surgery for pancreatic cancer with Russell Postier, MD, chief surgical investigator for the trial and chairman of the Department of Surgery for the OU College of Medicine. Such research trials are important because they provide the evidence needed to establish programs such as prehabilitation as a regular part of patient care.
Both Hile and Hoffman are faculty members in the OU College of Allied Health. Because the OU Health Sciences Center features seven colleges on the same campus, collaboration among health disciplines is not only feasible, but it is an increasingly important part of both research and patient care. Physical therapists and dietitians work with surgeons and physicians from the OU College of Medicine, with nurses from the OU College of Nursing and others – all in the name of improving patient care. This project also features a component related to laboratory science – Min Li, PhD, a researcher with the OU College of Medicine, is examining the effects of prehabilitation on pancreatic cancer biomarkersfrom blood and tumor tissues.
“Interprofessional collaboration in research will play a major role in the future of patient care,” said James Tomasek, PhD, vice president for research at the OU Health Sciences Center. “Working together as a team, researchers from various disciplines can make significant headway toward new discoveries.”
To support the prehabilitation trial over the next year, Hile received a $75,000 grant from the Presbyterian Health Foundation. This Oklahoma City-based organization is dedicated to supporting projects like the prehabilitation trial because they stand to make a difference in the quality of life for patients.
“We are proud to support the work of Dr. Hile and her team in seeking new answers for patients facing surgery for pancreatic cancer,” said Tom R. Gray III, president of the Presbyterian Health Foundation. “Our mission is to invest in research projects that have the potential to improve patients’ lives, and prehabilitation is a promising and exciting new concept in patient care.”