The Feasibility and Efficacy of Prehabilitation for Prostate Cancer Surgery

Abstract

Physical activity and fitness are predictors of post-operative prostate cancer recovery; however the capacity to improve pre-operative fitness in this population has yet to be demonstrated in a randomized controlled trial. This study examined the feasibility and efficacy of conducting a pre-operative total-body exercise program, also known as prehabilitation, for men undergoing radical prostatectomy. Participants were prescribed home-based, moderate-intensity exercise, and/or pelvic floor muscle strengthening exercise. To estimate intervention efficacy, fitness and psychosocial outcomes were measured at baseline and ∼1 week pre-operatively. From February 2014 to September 2015, 113 eligible patients were approached; 50 consented (recruitment rate = 44.2%) and were randomized to a comprehensive prehabilitation intervention or control group. Participants were mostly Caucasian and had a mean age of 61.1 years. Twelve participants withdrew pre-operatively (attrition rate = 24%). Statistically significant between-group differences were observed in body fat, waist circumference and emotional well-being in favor of the prehabilitation intervention. To our knowledge, this is the first study to assess feasibility and efficacy of a total-body exercise program in the home-based setting prior to radical prostatectomy.