Lifestyle perceptions following multimodal prehabilitation in patients undergoing cancer surgery: a qualitative study

BACKGROUND: Lifestyle behaviors play a pivotal role across all stages of cancer. Multimodal prehabilitation, incorporating exercise, nutrition, and psychological support before treatment, has demonstrated improvements for short-term postoperative outcomes. Yet, its potential to catalyze sustainable lifestyle change after surgery remains unexplored. Understanding how patients perceive lifestyle changes after the perioperative phase is key to fully realizing prehabilitation benefits and leveraging the teachable moment at diagnosis. OBJECTIVE: To gain a deeper understanding of patients' perceptions of lifestyle after undergoing surgery following a multimodal prehabilitation program. METHODS: This phenomenological qualitative study was performed in a university hospital between December 2022 and September 2023. Sixteen patients who have undergone abdominal cancer surgery following Fit4Surgery participation were interviewed using semi-structured interviews and thematic analysis. All interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. RESULTS: The analysis identified five key themes that illustrate how patients with abdominal cancer perceive lifestyle following major surgery: (1) multimodal prehabilitation as a catalyst for lifestyle change, (2) challenges in maintaining a healthy lifestyle post-surgery, (3) the role of motivation and support in sustaining lifestyle change, (4) meaning of health and well-being, and (5) unequal access and personal context influence lifestyle choices. CONCLUSION: Multimodal prehabilitation provides a foundation for lifestyle change, but without ongoing support and realistic timelines, sustained healthy behavior adoption remains challenging, especially for less active patients. Future programs should move beyond clinical endpoints to prioritize long-term behavior change by leveraging motivation, external support, habit formation, and addressing barriers like fatigue and insufficient medical guidance.