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MS-N175 · Exercise and rehabilitation · older adults awaiting prostate, bladder or kidney-cancer surgery

Evidence at a glance

  • Question: Can four weeks of supervised high-intensity interval training improve fitness before major urologic-cancer surgery?
  • Finding: Yes for cardiopulmonary fitness in a small trial; postoperative complications and cancer outcomes were not established.
  • Evidence label: Positive small randomized fitness evidence
  • Benefit: Anaerobic-threshold oxygen uptake improved by 2.26 mL/kg/min.
  • Certainty: Low-to-moderate for fitness; very low for surgical or oncologic outcomes.
  • Risk: No reportable adverse safety event in the supervised selected sample; two people reported self-limited discomfort.
  • Cancer-control boundary: Improved fitness is not evidence of fewer complications, better tumor control or longer survival.

What was studied

Adults older than 65 awaiting major urologic surgery, predominantly men with prostate cancer.

  • Design and comparator: Parallel randomized controlled trial; fully supervised cycle-ergometer HIIT versus standard care.
  • Participants: 40 randomized (21 control, 19 HIIT); 34 completed both assessments. Mean age 72; 39 of 40 were men.
  • Intervention: At least 10 sessions within about four weeks: five one-minute cycling intervals at 100–115% of peak baseline workload with unloaded recovery, medically supervised.
  • Primary outcome and follow-up: Change in oxygen uptake at anaerobic threshold before surgery.

What the study found

HIIT improved anaerobic-threshold oxygen uptake by 2.26 mL/kg/min (95% CI 1.25–3.26) and peak oxygen uptake by 2.16 mL/kg/min (95% CI 0.24–4.08). Adherence was 84%. No significant quality-of-life change was found.

Negative or uncertain findings: The study was not powered for postoperative complications, hospital stay or survival and was overwhelmingly male and prostate-cancer focused.

Limits and applicability

Small, single-center sample with medically supervised equipment and screening; this regimen should not be copied unsupervised. Fitness surrogates cannot substitute for clinical surgical outcomes.

Funding and conflicts: UK Medical Research Council, Department of Health and Dunhill Medical Trust grants were reported; no commercial funder was identified.

Safety context

HIIT may be inappropriate with unstable cardiac disease, uncontrolled blood pressure, symptomatic anemia, acute infection, unsafe bone lesions or poor balance. Surgical teams should approve timing and intensity.

Questions for the care team

  • Is cardiopulmonary exercise testing or monitored rehabilitation available?
  • Could moderate training achieve the goal with less risk?
  • Will surgery timing allow recovery after the last intense session?

Primary sources

Last literature search: 29 October 2026. Record appraisal: 29 October 2026. This page is educational and does not replace individualized medical advice. Exercise prescriptions should be adapted to diagnosis, treatment, surgical restrictions, blood counts, cardiopulmonary status, neuropathy, fall risk and bone-metastasis location. Symptom or fitness improvement is not proof of tumor response, recurrence prevention or longer survival unless those outcomes were directly tested.