Enhanced Surgical Recovery and Cancer

Abstract

Cancer is emerging globally and remains the second common cause of mortality. It is estimated that up to 50% of inpatient admissions worldwide are for a diagnosis of cancer. With increasing cancer prevalence over time, it is expected that patients requiring surgical intervention under anesthesia shall also increase. Despite significant immunological advances in cancer care, surgery will continue to be a mainstay strategy for reducing tumor burden, particularly for solid tumors. Frequently, chemo-radiation therapies are administered before the surgical resection as neoadjuvant therapy or after the surgical resection as adjuvant therapies to provide optimal surgical resection and increase overall cancer-free survival. The routine presurgical evaluation and optimization remain an important parameter for better patient care. These relate to evaluating and optimizing the anatomic, physiological paraneoplastic, and treatment-related effects of cancer on different organ function. Anesthesia providers should therefore be cognizant of immediate, and long-term systemic effects of cancer therapies (organ toxicities), and the effects of chemo-radiation on nutrition, fatigue, anemia, and physical deconditioning all of which could influence the recovery profile after major surgery.