Multidisciplinary rehabilitation program following abdomino-pelvic cancer surgery

Dr Helena Frawley1,2, Project team3

1Cabrini Health, Malvern, Australia, 2La Trobe University, Bundoora, Australia, 3on behalf of Cabrini and The University of Melbourne abdomino-pelvic oncology rehabilitation research project team, Malvern; Parkville, Australia

Aim: the aim of this project was to evaluate the feasibility of implementing an oncology rehabilitation program for patients who had undergone surgery for abdomino-pelvic cancer.

Method: This was a prospective study with an intervention and a quasi-control arm. Eligibility included surgical ± adjunctive therapy for Stage I-III colorectal, gynaecological or prostate cancer. Participants were referred from surgeons. Feasibility measures included rates of referral, recruitment, retention, adherence and adverse events. We provided an 8-week, bi-weekly education and exercise program, delivered by a physiotherapist, exercise physiologist, psychologist and dietitian. The quasi-control arm completed postal questionnaires only. Clinical outcome measures were collected at baseline (time 1), post-intervention (time 2) and 6 months (time 3).

Results: 637 patients were eligible to participate; consent rates were 13% to the program and 16% to the questionnaire groups. Cancer stream participants in the program include prostate (65%), colorectal (18%) and gynaecology (16%). To date, 86% have attended all 16 exercise sessions; adherence to return of exercise diaries is 75%; satisfaction with the program is 98%; time 2 retention rate is 78%. Participants have requested more detailed focus on pelvic floor health and pelvic floor muscle exercises. There have been 6 serious adverse events, unrelated to the program. All results will be available by March 2017.

Significance of the findings to allied health: recruitment to our program was considerably lower than expected and recruitment varied substantially between streams. A future clinical service will require supplementary recruitment strategies and could offer alternative exercise options. Once participants joined the program, attendance and adherence were very good, satisfaction was high and valuable insights for providing a clinical service have been gained. Our findings indicate such a service is feasible in a private health setting.