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Viewpoint
June 25, 2020

Exercise Prehabilitation—Supporting Recovery From Major Head and Neck Cancer Surgery

Author Affiliations
  • 1Ohlson Research Initiative, Cumming School of Medicine, Arnie Charbonneau Research Institute, University of Calgary, Calgary, Alberta, Canada
  • 2Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 3Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  • 4Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
JAMA Otolaryngol Head Neck Surg. Published online June 25, 2020. doi:10.1001/jamaoto.2020.1346

Head and neck cancer (HNC) is the seventh most common type of cancer worldwide.1 Surgery involving resection and free flap reconstruction is a mainstay of HNC treatment. Multimodal care pathways using Enhanced Recovery After Surgery (ERAS) guidelines have transformed perioperative care in HNC,2 and the overall goal of ERAS is to achieve early functional recovery for patients undergoing major surgery. ERAS is a set of evidence-based recommendations that span preoperative, intraoperative, and postoperative care. A key component of preoperative care is prehabilitation, or optimizing a patient’s condition before surgery. In HNC, prehabilitation has focused on optimizing nutritional status and includes a comprehensive assessment and nutritional interventions for individuals who are malnourished.2 A frequently overlooked but equally important component of preparing a patient for surgery is exercise. Considering the overwhelming evidence for the benefits of exercise as adjunct care in cancer,3 the purpose of this Viewpoint is to highlight the potential role of exercise prehabilitation in patients scheduled to undergo major surgery for HNC.

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