Our Summary

The paper discusses a new approach called prehabilitation for treating patients with colorectal cancer. Prehabilitation is a process that prepares patients before their surgery. It aims to reduce post-surgery complications, speed up patient recovery, and improve the overall quality of life.

The paper introduces the FIT model, a framework for implementing prehabilitation. The FIT model has three parts: “facts” (identifying which patients need prehabilitation and what it should include), “integration” (using data from questionnaires to understand the motivation of patients and doctors), and “tools” (deciding how to measure the results).

The authors argue that this method could help create more effective prehabilitation programs that are centered on the patient’s needs. They also suggest that any team wanting to start prehabilitation could use the FIT model as a guide.

FAQs

  1. What is prehabilitation and what is its goal in treating colorectal cancer patients?
  2. What is the FIT model and how does it help in implementing prehabilitation?
  3. How can the FIT model create more effective prehabilitation programs centered on the patient’s needs?

Doctor’s Tip

One helpful tip a doctor might tell a patient about colorectal surgery is to follow any prehabilitation program recommended by their healthcare team. Prehabilitation can help improve surgical outcomes, reduce complications, and shorten recovery time. It is important for patients to actively participate in their prehabilitation program to ensure the best possible results from their surgery.

Suitable For

Patients who are typically recommended colorectal surgery may include those with colorectal cancer, inflammatory bowel disease, diverticular disease, colorectal polyps, or other conditions affecting the colon and rectum. These patients may have symptoms such as rectal bleeding, changes in bowel habits, abdominal pain, or other concerning symptoms that warrant further evaluation and potentially surgical intervention.

In the context of prehabilitation, patients who are scheduled for colorectal surgery may benefit from this approach to help optimize their physical and emotional health before the procedure. Prehabilitation may be especially beneficial for patients who are older, have multiple medical comorbidities, are at a higher risk for post-surgical complications, or have a lower baseline fitness level.

Ultimately, the decision to recommend colorectal surgery and to implement prehabilitation will depend on the individual patient’s medical history, current health status, and the recommendations of their healthcare team. The FIT model introduced in the paper may help guide healthcare teams in identifying which patients could benefit from prehabilitation and how to tailor the program to meet their specific needs.

Timeline

Before colorectal surgery:

  1. Patient is diagnosed with colorectal cancer.
  2. Patient undergoes initial consultations and tests to determine the best treatment plan.
  3. Patient is recommended for prehabilitation to prepare for surgery.
  4. Patient meets with healthcare team to discuss prehabilitation program and goals.
  5. Patient undergoes physical therapy, nutritional counseling, and other interventions to optimize health before surgery.

After colorectal surgery:

  1. Patient undergoes surgery to remove the cancerous tissue.
  2. Patient is monitored in the hospital for post-operative complications.
  3. Patient begins rehabilitation program to regain strength and function.
  4. Patient follows up with healthcare team for ongoing care and support.
  5. Patient continues with follow-up appointments and monitoring to ensure long-term success and well-being.

What to Ask Your Doctor

  1. What specific prehabilitation activities or programs do you recommend for me before my colorectal surgery?
  2. How will prehabilitation benefit me in terms of reducing complications, speeding up recovery, and improving my quality of life after surgery?
  3. What criteria do you use to determine if a patient would benefit from prehabilitation before colorectal surgery?
  4. How will the FIT model be implemented in my prehabilitation plan?
  5. What tools or assessments will be used to measure the effectiveness of the prehabilitation program for me?
  6. How will my progress in prehabilitation be monitored and adjusted if necessary?
  7. How does prehabilitation fit into the overall treatment plan for my colorectal cancer?
  8. Are there any specific lifestyle changes or recommendations I should follow during the prehabilitation period?
  9. What support or resources will be available to me during the prehabilitation process?
  10. How can I best prepare myself mentally and emotionally for the surgery through prehabilitation?

Reference

Authors: Bruns ERJ, van Rooijen SJ, Argillander TE, van der Zaag ES, van Grevenstein WMU, van Duijvendijk P, Buskens CJ, Bemelman WA, van Munster BC, Slooter GD, van den Heuvel B. Journal: Am J Phys Med Rehabil. 2019 Mar;98(3):231-238. doi: 10.1097/PHM.0000000000001025. PMID: 30153125