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PM R. 2017 Sep;9(9S2):S305-S316. doi: 10.1016/j.pmrj.2017.08.402.

The Case for Prehabilitation Prior to Breast Cancer Treatment.

Author information

1
Faculty of Kinesiology and Physical Education, The University of Toronto, 55 Harbord St, Toronto, ON, M5S 2W6, Canada; Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON, Canada(∗). Electronic address: daniel.santamina@utoronto.ca.
2
Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON, Canada(†).
3
Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON, Canada(‡).
4
University of Massachusetts Medical School, Worcester, MA(§).
5
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada(‖).
6
Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada(¶).
7
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA; Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Boston, MA(#).

Abstract

Cancer rehabilitation in breast cancer survivors is well established, and there are many studies that focus on interventions to treat impairments as well as therapeutic exercise. However, very little is known about the role of prehabilitation for people with breast cancer. In this narrative review, we describe contemporary clinical management of breast cancer and associated treatment-related morbidity and mortality considerations. Knowing the common short- and long-term sequelae, as well as less frequent but serious sequelae, informs our rationale for multimodal breast cancer prehabilitation. We suggest 5 core components that may help to mitigate short- and long-term sequelae that align with consensus opinion of prehabilitation experts: total body exercise; locoregional exercise pertinent to treatment-related deficits; nutritional optimization; stress reduction/psychosocial support; and smoking cessation. In each of these categories, we review the literature and discuss how they may affect outcomes for women with breast cancer.

PMID:
28942905
DOI:
10.1016/j.pmrj.2017.08.402
[Indexed for MEDLINE]

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