Protein for the Pre-Surgical Cancer Patient: a Narrative Review

Purpose of ReviewPrehabilitation prepares patients to withstand the rigors of surgery; however, there is little consensus on nutritional prehabilitative support for surgical patients. In this narrative review, we offer our perspectives on the role of protein in surgical prehabilitation.Recent FindingsWhile the exact dietary protein requirements of pre-surgical patients are unknown, protein is an important piece of any nutritional care plan. Body protein, in particular skeletal muscle, is catabolized to support surgery-related systemic responses such as inflammation and wound healing. Older adults and patients with cancer, who may be sarcopenic, undernourished, or cachectic, often experience perturbations in protein metabolism that deplete skeletal muscle tissue prior to surgery. Reduced body protein combined with surgery-induced stress can result in a concomitant loss of physiologic function.SummaryMulti-modal prehabilitation that includes nutrition and exercise can augment patients’ body protein reserve before surgery and mitigate losses post-surgery to improve functional outcomes.