Researchers studied whether exercise and nutrition support could help patients with esophageal cancer maintain their muscle strength before and after surgery. Thirty-six patients participated in a 3-week exercise and nutrition program before surgery, then continued for 4 weeks after. While patients gained muscle before surgery, they still lost some muscle afterward—but those who kept eating well and staying active lost less muscle than others. The program was safe with no serious problems, and patients’ physical abilities improved overall. This research suggests that combining exercise with good nutrition may help cancer surgery patients recover better.

The Quick Take

  • What they studied: Can exercise and nutrition support help patients with esophageal cancer keep their muscle strength before and after surgery?
  • Who participated: 36 patients with esophageal cancer who were scheduled for surgery at two hospitals. All patients completed the study program.
  • Key finding: Patients gained about 5% muscle before surgery, but lost about 10% overall by one month after surgery. However, patients who maintained good eating and exercise habits after surgery lost significantly less muscle (8.3% loss) compared to those who couldn’t maintain these habits (15.4% loss).
  • What it means for you: If you or a loved one faces esophageal cancer surgery, combining exercise with proper nutrition—especially after surgery—may help preserve muscle strength and speed recovery. However, this is early research, and more studies are needed to confirm these benefits.

The Research Details

This was a prospective interventional study, meaning researchers followed patients forward in time while they received a specific treatment program. Patients with esophageal cancer scheduled for surgery participated in an exercise and nutrition program for 3 weeks before their operation and 4 weeks after. Researchers measured muscle mass using CT scans (a type of detailed imaging) and tested physical function at three time points: when starting the program, just before surgery, and one month after surgery.

The study was designed to see if this combined approach was safe and whether it could prevent the typical muscle loss that happens after major surgery. Researchers compared their results to previous research that predicted a 7.5% muscle loss after surgery.

Major surgery like esophagectomy (removing part of the esophagus) causes significant muscle loss, which can slow recovery and weaken patients. Understanding whether exercise and nutrition support can reduce this muscle loss is important because maintaining muscle strength helps patients recover faster, regain independence, and improve their quality of life after cancer treatment.

This study had good completion rates (94.4% of patients finished the program) and reported no serious safety problems, which is important for cancer patients. The study was relatively small with 36 patients, so results should be viewed as promising but not definitive. The research was published in a peer-reviewed nutrition journal, indicating it met scientific standards. However, this was a single-arm study without a comparison group, which limits how much we can conclude about the program’s effectiveness.

What the Results Show

The study found that patients gained muscle during the 3-week pre-surgery exercise and nutrition program, increasing muscle mass by about 4.9%. This was a positive sign that the program could build strength before the major operation.

However, by one month after surgery, patients had lost about 10% of their muscle mass overall—more than the 7.5% loss that researchers had predicted based on previous studies. This means that while the pre-surgery program helped, the surgery itself caused more muscle loss than expected.

The most encouraging finding was that patients who maintained good eating habits and stayed physically active after surgery lost significantly less muscle. Those who kept up with nutrition and activity lost only 8.3% of their muscle, while those who couldn’t maintain these habits lost 15.4%—nearly twice as much. This 7% difference is substantial and suggests that post-surgery behavior matters greatly.

Beyond muscle mass, researchers measured physical function (how well patients could move and perform daily activities). Physical function was significantly better one month after surgery compared to when patients started the program, even though muscle mass had decreased. This suggests that the combination of pre-surgery conditioning and post-surgery rehabilitation helped patients regain their ability to move and function, which is crucial for quality of life.

This research builds on previous studies showing that major surgery causes muscle loss in cancer patients. The finding that pre-surgery exercise and nutrition can increase muscle before surgery aligns with other research. However, the fact that muscle loss after surgery was greater than predicted suggests that the pre-surgery gains weren’t enough to fully protect against post-surgery muscle breakdown. The strong relationship between maintaining post-surgery nutrition and activity levels and reduced muscle loss is consistent with general surgical recovery research.

The study had several limitations worth noting. First, there was no comparison group of patients who didn’t receive the exercise and nutrition program, making it harder to know exactly how much the program helped. Second, the study was relatively small with only 36 patients, so results may not apply to all patients with esophageal cancer. Third, researchers only followed patients for one month after surgery, so we don’t know what happens to muscle mass and function over longer periods. Finally, the study didn’t track whether patients’ improved physical function lasted beyond the one-month measurement point.

The Bottom Line

Based on this research, patients with esophageal cancer scheduled for surgery should consider participating in exercise and nutrition programs before and after surgery. The evidence suggests moderate confidence that this approach is safe and may help preserve muscle strength and physical function. Patients should work with their medical team to develop a personalized program that includes both exercise and adequate nutrition, especially after surgery. The research particularly supports maintaining good eating habits and staying physically active during recovery.

This research is most relevant for patients with esophageal cancer scheduled for surgery. It may also apply to patients undergoing other major abdominal surgeries, though more research is needed. Caregivers, surgeons, nutritionists, and physical therapists working with cancer patients should find this information valuable. People without esophageal cancer or those not facing surgery should not apply these specific findings to their situation.

Patients can expect to see muscle gains within the 3-week pre-surgery period if they follow the exercise and nutrition program. After surgery, the most critical period appears to be the first month, when maintaining nutrition and activity levels makes the biggest difference in preserving muscle. Longer-term benefits beyond one month are unknown and require further research.

Want to Apply This Research?

  • Track daily caloric intake and minutes of physical activity (walking, stretching, or prescribed exercises) both before and after surgery. Users should aim to meet personalized nutrition targets set by their healthcare team and gradually increase activity as cleared by their surgeon.
  • Users can set daily reminders for meals and snacks to maintain adequate nutrition, and schedule short exercise sessions (even 10-15 minutes of walking) into their daily routine. The app could provide pre-surgery and post-surgery specific activity recommendations and track adherence to these goals.
  • Establish baseline measurements before surgery (weight, activity level, nutrition intake) and monitor these weekly. After surgery, track the same metrics weekly for at least one month, noting any changes in physical function or energy levels. Users should share this data with their healthcare team to adjust the program as needed.

This research is preliminary and should not replace medical advice from your healthcare team. If you have esophageal cancer or are facing surgery, discuss any exercise or nutrition program with your surgeon, oncologist, and nutritionist before starting. This study involved a small number of patients and was conducted at specific hospitals; results may not apply to all patients or settings. Always follow your medical team’s specific recommendations for your individual situation, as they understand your complete medical history and condition.