CGH cancer patients can get home exercise, care plan before surgery

Newly diagnosed cancer patients awaiting surgery can now do their pre-operation prehabilitation at home, thanks to a new programme by Changi General Hospital (CGH).

Prehabilitation is a process of care initiated before a patient receives cancer treatment or surgery, to facilitate the return to health following treatment.

After consultation with the surgeon, patients undergo frailty, functional and mental wellness tests performed by a prehabilitation coordinator, who then draws up a personalised plan that includes exercise prescriptions as well as advice on nutrition and mental wellness.

CGH offers a one-stop solution to reduce the number of patient visits for pre-operation assessment and, subsequently, to allow patients to do their prehabilitation at home.

This eliminates the need for multiple visits to the hospital.

Under the new framework, most patients will need only two appointments - one for the first consultation and the other before treatment starts.

Dr Tay San San, chief of CGH's department of rehabilitation medicine, said: "Prehabilitation reduces the risk of post-operative complications, re-admissions and dying, and also improves the recovery of their daily function and fitness.

"In patients who need chemotherapy after their surgery, we have increased their ability to tolerate the side effects."

At the start, as a pilot study in January 2020, 59 patients were enrolled in the programme over 18 months. As at the middle of last month, close to 200 patients have undergone CGH's home-based prehabilitation.

One such patient was 64-year-old Goh Tong Nang, who was diagnosed with stage one colorectal cancer in March last year and underwent surgery in April.

"When I was diagnosed with cancer, I was worried and scared.

"I used to run 5km several times a week and I did not think I'd be doing it after my surgery," said the retiree who used to work in the manufacturing industry.

During his first cancer prehabilitation appointment, Mr Goh went through physical assessments.

He was also taught exercises by a rehabilitation specialist, who also advised him to include more protein in his diet and shared anxiety reduction strategies.

Dr Tay said: "Despite the pandemic, our cancer patients have been able to undergo cancer prehabilitation in the safety and comfort of their homes with minimal disruption due to the home-based model of this programme."

Dr Navin Kuthiah, a medical consultant at Woodlands Health who specialises in perioperative medicine - the care of patients before and after surgery - said there were pros and cons to home-based prehabilitation.

"Non-compliance is a challenge because patients might not adhere to the advice as they are unsupervised," he said.

"While centre-based prehab provides a more conducive environment with the necessary equipment, patients who are assessed to be fit for home-based prehab help to reduce costs and the strain on medical resources."