Grant: Project Grant

Cancer surgery places significant stress on the body, and for many people recovery does not go smoothly. About one in three patients develops an infection after major cancer surgery. These infections can lead to longer hospital stays, slower recovery, and delays in returning to daily life. One of the few steps patients can take to support recovery is good nutrition. Many patients are advised to drink oral nutrition supplements (ready-made nutrition drinks) to help their bodies heal. There are two main types used before surgery. Standard supplements provide calories and protein. Immune-enhanced supplements contain added ingredients (omega-3 fatty acids, arginine, and nucleotides) and cost about twice as much. However, it is not clear whether these more expensive drinks work better. Without clear evidence, some patients and hospitals may be paying more without added benefit, while others may not use nutrition supplements at all. This study will answer an important question for patients and care teams: Which nutrition drink works best before cancer surgery? Participants will receive either a standard or an immune-enhanced nutrition drink before surgery. Both provide the same calories and protein; the only difference is the added immune-related ingredients. About 2,100 adults having major cancer surgery will take part at hospitals across Canada. To ensure fair results, neither patients nor doctors will know which drink is given. Researchers will follow recovery after surgery, including infections, hospital stay, quality of life, and healthcare costs. The study will also examine whether some patients, especially those who are undernourished, benefit more than others. This study will provide clear answers about whether immune-enhanced nutrition drinks offer added benefit, and for whom. The results will help patients make informed choices and ensure resources are spent on nutrition strategies that truly improve recovery.