The objective of this study is to determine the feasibility (main aim) and effectiveness (secondary aim) of a prehabilitation program in patients with head and neck cancer or liver cancer. Participating patients will participate in a 3-to-6 week rehabilitation program consisting of training and nutritional, smoking cessation and psychosocial counselling.
In patients diagnosed with head and neck cancer (HNC) or liver cancer, (major) surgery is the standard of care. Nevertheless, surgery may result in complications that have a substantial impact on the physical and psychological state of the patient. Detrimental postoperative outcomes are influenced by unhealthy lifestyle behaviors such as a sedentary lifestyle, smoking and malnutrition. Prehabilitation programs focusing on these lifestyle aspects have been suggested as a promising intervention to improve pre- and postoperative outcomes. Therefore, the obective of this study is to determine the feasibility (main aim) and effectiveness (secondary aim) of a prehabilitation program in patients with HNC or liver cancer This study concerns a prospective cohort study in 60 patients with HNC or liver cancer that participate in a 3 to 6-week pilot prehabilitation program consisting of training and nutritional, smoking cessation and psychosocial counselling. Data on feasibility (program satisfaction, program compliance and percentage of patients willing to participate in the prehabilitation program) and effectiveness (e.g. complications, health status, compliance to healthy lifestyle) is collected at three time points (pre- and post the prehabilitation program and 30 days post-surgery).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
60
The prehabilitation program consists of 4 components: 1. Fitness training led by a physiotherapist. The patients will receive personalized training schedules to perform at home. The training sessions focus on improving aerobic fitness (biking or walking) and muscle strength (specific exercises for the different patient groups) and respiratory exercises aimed to relax. 2. Nutritional counseling led by a dietician. All patients will be offered an intake with a dietician (60 min) to discuss current eating habits and give personalized advices. Based on indication, patients will receive follow-up consults. 3. Smoking cessation counseling led by a trained social worker. For patients that are currently smoking, a social worker will offer counseling sessions to coach the patient in the process of smoking cessation. 4. Psychosocial counseling led by a psychologist. All patients will be offered counselling by a psychologist.
ErasmusMC
Rotterdam, South Holland, Netherlands
RECRUITINGProgram satisfaction
Self-designed questionnaire score (score between 1-10, higher score means higher satisfaction)
Time frame: At completion of the prehabilitation program (3-6 weeks after baseline)
Program compliance
Number of sessions that patient participates in the fitness training, the counselling on nutrition, smoking cessation and psychosocial sessions will be registered.
Time frame: At completion of the prehabilitation program (3-6 weeks after baseline)
Percentage of patients willing to participate in prehabilitation program
It will be registered which patient are willing and not willing to participate
Time frame: At completion of the prehabilitation program (3-6 weeks after baseline)
Frailty
Groningen Frailty Score questionnaire score: score of 0-15, a GFI score of four or greater is considered the cut-off point for frailty
Time frame: Outcomes will be collected twice: at baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Functional capacity
6-minute walk test: meters walked in 6 minutes time
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Physical activity level
ActiGraph GTx3+ accelerometer: average time per day (min) spend in moderate-to-vigorous activity, light physical activity and sedentary behaviour
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
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Hand grip strength
Hand dynamometer (kg)
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Quadriceps strength
Biodex dynamometer (Peak torque to body weight extension + Work fatigue)
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Nutritional status
Short Nutritional Assessment Questionnaire (SNAQ) score (range 4-20, lower score means higher risk of malnutrition)
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Body composition
Weight scale (kg)
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Health status
EuroQol-5D (EQ5D) questionnaire score (0-1, the maximum score of 1 indicates the best health state)
Time frame: At baseline, at completion of the prehabilitation program (3-6 weeks after baseline), 30 days post surgery
Anxiety and Depression
Hospital Anxiety and Depression Scale questionnaire score (0-21, higher scores denotes risk of anxiety or depression
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Self-efficacy
General Self Efficacy Scale questionnaire score (10-40, with a higher score indicating more self-efficacy
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Self-reported smoking behaviour
Self-designed questionnaire (smoking yes/no)
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Smoking behaviour
carbon monoxide breath analyser (CO ppm + % COhb)
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Alcohol consumptiom
Five shot questionnaire score (0-7, a higher score indicates possible alcohol misuse)
Time frame: At baseline and at completion of the prehabilitation program (3-6 weeks after baseline)
Length of hospital stay
Registrered in patient file (length in days)
Time frame: 30 days post surgery
Complications Clavien Dindo grade ≥3 in first 30 days
Registrered in patient file (number of complications and clavien dindo grade)
Time frame: 30 days post surgery
Readmission rate in first 30 days
Number and reason for readmissions in first 30 days
Time frame: 30 days post surgery
Age
Age in years
Time frame: Baseline
Sex
Female/male/other
Time frame: Baseline
Medical diagnosis
Medical diagnosis for surgery
Time frame: Baseline
Educational level
Single-item question (high, middle, low educated)
Time frame: Baseline
Marital status
Single-item question (Partnered/ unpartnered)
Time frame: Baseline
Work status
Single-item question (employed/unemployed)
Time frame: Baseline