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Background. The high rate of functional impairment and nutritional deficiency in patients with localized and locally advanced gastric tumors led to the concept of "pre-habilitation". Multimodal pre-habilitation refers to a combination of physical therapy, nutritional support, and psychological counseling during the preparation of patients for antitumor treatment. Aim. To present the outcomes of patients with cachexia after the program of remote multimodal pre-habilitation before surgical treatment of gastric cancer. Materials and methods. The outcomes of 10 patients with resectable gastric cancer and cancer cachexia were analyzed. Patients underwent comprehensive preoperative preparation, including nutritional support, physical therapy, and remote psychological counseling. Results. There was an improvement in functional parameters: an increase in walking speed in 8 patients, an increase in hand grip strength measured by dynamometry in 7 patients, and an increase in exercise tolerance in 2 patients. No early or late postoperative complications were reported. Conclusion. Multimodal remote pre-habilitation is a promising option for preparing patients with cachexia for surgical treatment of gastric cancer.

Background. The high frequency of cachexia and sarcopenia (skeletal muscle depletion) in patients with cancer led to the development of prehabilitation concept. Multimodal prehabilitation includes physical training, nutritional and psychological support before anticancer treatment. Aim. To present the results of treatment of a patient with cachexia who underwent a multimodal prehabilitation program before surgery for gastric cancer. Materials and methods. A 74-year-old woman with early stage cancer of the gastric antrum had lost 28% of total body weight in the previous 6 months because of a dysphoric disorder. The patient underwent a multimodal prehabilitation for 2 weeks prior to surgery, which included nutritional (600 ml siping per day) and psychological support as well as a supervised remote physical exercise program based on nordic walking. Results. The patient increased functional walking capacity from low to medium, grip strength and gait speed. The postoperative period went uneventfully and the patient was discharged home 8 days after surgery. Conclusion. Multimodal remote prehabilitation is a potentially beneficial option in cachectic patients with gastric cancer who need surgery.