Grant: Project Grant

Major abdominal cancer surgery can be life-saving, but recovery is often more difficult than patients expect. Hospital stays are shorter, and more recovery now happens at home. Prehabilitation (exercise, nutrition, and mental preparation) and guidelines (ERAS) improve short-term outcomes. However, they do not provide patients with structured support across the three surgery phases (before surgery, in-hospital, and after discharge). In Alberta, digital prehabilitation and ERAS are already standard care. However, no study has tested whether structured digital support that continues across all phases leads to better outcomes than digital prehabilitation alone. This feasibility study will test if it is possible to run a larger study comparing two approaches. Control: Digital prehabilitation (support before surgery) plus a wearable activity tracker. Extended support: The control intervention + extension of digital support during hospitalization (reminders to move, breathing exercises) and for 30 days after discharge (activity goals, symptom monitoring, recovery education). We will enroll 100 patients, age 40+ yrs, undergoing gynecologic or colorectal cancer surgery. Half will be controls and half will receive extended digital support. The intervention is delivered through a digital application. In addition to collecting feasibility data, we will collect information about acceptability, and recovery, including questionnaires about daily activities and quality of life, virtual physical tests (standing up from a chair, stepping in place), wearable activity data, and information about complications and healthcare use. If this study shows that a larger trial is feasible, we will move forward with a multicenter study to determine whether continuous digital support improves recovery and health system outcomes after cancer surgery. This could change how we care for surgical patients, providing support not just before surgery, but throughout the entire recovery journey.