Remote multimodal prehabilitation in the presence of cachexia and resectable gastric cancer: a clinical case

Abstract

Background. The high frequency of cachexia and sarcopenia (skeletal muscle depletion) in patients with cancer led to the development of prehabilitation concept. Multimodal prehabilitation includes physical training, nutritional and psychological support before anticancer treatment. Aim. To present the results of treatment of a patient with cachexia who underwent a multimodal prehabilitation program before surgery for gastric cancer. Materials and methods. A 74-year-old woman with early stage cancer of the gastric antrum had lost 28% of total body weight in the previous 6 months because of a dysphoric disorder. The patient underwent a multimodal prehabilitation for 2 weeks prior to surgery, which included nutritional (600 ml siping per day) and psychological support as well as a supervised remote physical exercise program based on nordic walking. Results. The patient increased functional walking capacity from low to medium, grip strength and gait speed. The postoperative period went uneventfully and the patient was discharged home 8 days after surgery. Conclusion. Multimodal remote prehabilitation is a potentially beneficial option in cachectic patients with gastric cancer who need surgery.

Keywords

• prehabilitation
• gastric cancer
• cachexia
• sarcopenia