Journal of Modern OncologyJournal of Modern Oncology1815-14341815-1442LLC Obyedinennaya Redaktsiya11389710.26442/18151434.2022.4.201986Research ArticleRemote multimodal prehabilitation in the presence of cachexia and resectable gastric cancer: a clinical caseLyadovVladimir K.<p>D. Sci. (Med.)</p>vlyadov@gmail.comhttps://orcid.org/0000-0002-7281-3591BoldyrevaTatyana S.dikovatatyanasergeevna@gmail.comhttps://orcid.org/0000-0003-4174-6637AchkasovEvgeny E.<p>D. Sci. (Med.), Prof.</p>2215.g23@rambler.ruhttps://orcid.org/0000-0001-9964-5199GorshkovAlexander Yu.<p>Cand. Sci. (Med.)</p>Aygorshkov@gmail.comhttps://orcid.org/0000-0002-1423-214XChashchinMikhail G.<p>Res. Officer</p>dr.chaschin@gmail.comhttps://orcid.org/0000-0001-6292-3837ProtsenkoElena V.<p>Clinical Psychologist</p>elena-procenco@mail.ruStarodubovaValentina V.<p>D. Sci. (Med.), Assoc. Prof.</p>vlyadov@gmail.comGalkinVsevolod N.<p>D. Sci. (Med.), Prof.</p>vlyadov@gmail.comRussian Medical Academy of Continuous Professional EducationNovokuznetsk State Institute for Postgraduate Medical Education – branch of the Russian Medical Academy of Continuous Professional EducationCity Clinical Oncology Hospital №1Sechenov First Moscow State Medical University (Sechenov University)National Medical Research Center for Therapy and Preventive MedicineFederal Research Center of Nutrition, Biotechnology and Food Safety1512202224446446718112022Copyright © 2022, Consilium Medicum2022<p><strong>Background</strong>. 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.</p>
<p><strong>Aim</strong>. To present the results of treatment of a patient with cachexia who underwent a multimodal prehabilitation program before surgery for gastric cancer.</p>
<p><strong>Materials and methods</strong>. 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.</p>
<p><strong>Results</strong>. 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.</p>
<p><strong>Conclusion</strong>. Multimodal remote prehabilitation is a potentially beneficial option in cachectic patients with gastric cancer who need surgery.</p>prehabilitationgastric cancercachexiasarcopeniaпреабилитациярак желудкакахексиясаркопения[Sadeghi M, Keshavarz-Fathi M, Baracos V, et al. Cancer cachexia:diagnosis, assessment and treatment. Crit Rev Oncol Hematol. 2018;127:91-104. DOI:10.1016/j.critrevonc.2018.05.006][Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489-95. DOI:10.1016/S1470-2045(10)70218-7][Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. DOI:10.1093/ageing/afy169][Bowen TS, Schuler G, Adams V. Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training. J Cachexia Sarcopenia Muscle. 2015;6:197-207. DOI:10.1002/jcsm.12043][Minnella EM, Carli F. Prehabilitation and functional recovery for colorectal cancer patients. Eur J Surg Oncol. 2018;44(7):919-26.][Рак желудка. Клинические рекомендации. Современная Онкология. 2021;23(4):541-71. [Gastric cancer: Russian clinical guidelines. Journal of Modern Oncology. 2021;23(4):541-71 (in Russian)]. DOI:10.26442/18151434.2021.4.201239][Prado CM, Lieffers JR, McCargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9(7):629-35. DOI:10.1016/S1470-2045(08)70153-0][Martin L, Birdsell L, Macdonald N, et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol. 2013;31(12):1539-47. DOI:10.1200/JCO.2012.45.2722][Daniels SL, Lee MJ, George J, et al. Prehabilitation in elective abdominal cancer surgery in older patients: systematic review and meta-analysis. BJS Open. 2020;4(6):1022-41. DOI:10.1002/bjs5.50347][Pasquer A, Renaud F, Hec F, et al. Is Centralization Needed for Esophageal and Gastric Cancer Patients With Low Operative Risk?: A Nationwide Study. Ann Surg. 2016;264(5):823-30. DOI:10.1097/SLA.0000000000001768]