70yo lady with ascending colon cancer.

Background

• Mild OSA – nil rx
• T2DM on insulin, Hba1c 8.4
• Guillan Barre / CIDP – pred 6mg / day + IVIG monthly
• Secondary adrenal insufficiency
• Uses 4WW, CFS 3
• Spiro and ECG normal
• Iron replete, not anaemic

Issues

• For prehabilitation?

Discussion

• Lap vs open risks NSQIP – long term functional decline high for both ~70%, open much higher risk of serious complications, risk of death ~1% for lap, 3.5% for open
•  Risks elevated by falls hx, chronic steroid use, SOBOE
• Would benefit from prehab. Patient motivated to reduce risks where possible as reluctant ++ to incur any loss to independence/function

Plan

• Discuss with prehab coordinator
• Discuss with surgeon – ? appropriate time frame for delay