Supervised aerobic prehabilitation before breast, colorectal or prostate cancer surgery

MS-N311 · Exercise and rehabilitation · Prehabilitation · Surgery · Human evidence · Appraised 12 November 2026

Is short-course supervised aerobic exercise feasible and safe while people with breast, colorectal or prostate cancer wait for surgery?

Evidence at a glance

Evidence label: Small pilot randomized trial; feasible among participants, but recruitment and effectiveness remained uncertain
Benefit: Attendance and session adherence were high, but fitness, quality of life and fatigue did not improve significantly versus usual care.
Certainty: Low. The single-center heterogeneous pilot enrolled 23 people and was not powered for clinical effectiveness.
Risk: Five grade 1 events occurred with prehabilitation—three fatigue and two extremity muscle-pain events; no serious event was reported.

What was studied

Design: A regional Australian center randomized 23 surgical patients 1:1 to supervised aerobic training two to three days weekly before surgery or usual care. Twenty completed presurgery and postsurgery assessments.

Outcomes: Recruitment, attendance, adherence, completeness, attrition and adverse events were primary feasibility/safety measures. Fitness, health-related quality of life, fatigue, 30-day complications and length of stay were exploratory.

What the evidence found

Attendance was 91.3%, adherence 82.6%, assessment completeness 85.7% and attrition 13%. Participants attended a mean 5.25 sessions (SD 2.16). Only 23 of 47 screened people were randomized, limiting recruitment feasibility.

No significant group-by-time effects were seen for cardiorespiratory fitness, quality of life or fatigue. Estimates for clinical outcomes were imprecise.

Five grade 1 events—fatigue (three) and muscular pain in an extremity (two)—were recorded in the prehabilitation group; no serious adverse event was observed.

How to interpret it

The study shows that a brief supervised program can be delivered to some people awaiting surgery, but it does not prove better surgical outcomes. Mixed cancer sites, few sessions and a small sample limit generalizability.

Prehabilitation is supportive care. This trial did not test tumor response, recurrence or survival.

Practical safety context

Exercise selection should reflect the operation, anemia, cardiopulmonary disease, bone metastases, ostomies, neuropathy and baseline activity. New chest pain, syncope, fever, acute infection or worsening treatment symptoms warrant clinical review.

Surgery should not be delayed to complete an exercise program unless the treating team explicitly recommends that timing.

Questions for the care team

How much time is available before surgery without delaying cancer treatment?
Would aerobic exercise alone address my needs, or should strength, breathing, nutrition or pelvic-floor work be added?
What symptoms should stop a session and prompt contact with the surgical team?

Funding and conflicts

The authors declared no competing interests. Funding details were not reported in the PubMed record and were not independently verified.

Sources

Last literature search: 12 November 2026. Record appraisal: 12 November 2026. The PubMed record and full-text report were available for appraisal. This page is educational and does not replace individualized medical advice. These supportive-care outcomes do not establish tumor shrinkage, delayed recurrence or longer survival.