Investigating the feasibility of a combined exercise and nutrition prehabilitation program for women with endometrial cancer scheduled for surgery

Length of intervention: 6 weeks Exercise: The exercise component involves both aerobic and resistance exercise. Resistance exercise sessions will take place three times per week. Participants will be provided with elastic bands and will be asked to do a combination of upper and lower body exercises, such as sit-to-stands, standing rowing and standing chest press with the elastic band. Each session will be approximately 30 minutes long. One of these weekly sessions will take place in the gym at the King Edward Memorial Hospital (Perth, Western Australia) and will be supervised by an accredited exercise physiologist from the Edith Cowan University Exercise Medicine Research Institute. Two of the sessions each week will not be supervised and will take place in participants’ homes. The exercise physiologist will inform participants each week about the type, volume and intensity of resistance exercises to be done at home. In addition to the resistance exercise sessions, participants will be asked to do 20 to 30 minutes of aerobic exercise such as walking, cycling, or swimming, three times per week. The amount of aerobic exercise will be designed specifically for participants, based on physical ability, during contact sessions with the exercise physiologist. Participants can break up their aerobic exercise into shorter bouts (of 10 - 15 min) throughout the week. To determine adherence and compliance, participants will be asked to keep a record of their home-based exercise in a logbook that will be provided to them by the exercise physiologist. Nutrition: The nutrition component involves education and support from the Department of Nutrition and Dietetics at King Edward Memorial Hospital. During their initial visit (seven weeks before surgery), participants will meet a dietician with oncology experience when they attend the Gynaecological Oncology Outpatient Clinic at King Edward Memorial Hospital. Participants will be offered the choice of either: 1. A very low calorie pre-operative diet with Optifast, a nutritionally complete very low-calorie program to help rapid, safe weight loss in the weeks prior to their surgery. Optifast is a safe dietary preparation that provides 800 kcal per day. Optifast products in the form of shakes, soups, desserts, or bars replace regular main meals in addition to a minimum of 2 cups of low starch vegetables per day. It works by helping to reduce appetite and can help patients to lose 1.0 - 2.5kg per week. It can also lead to improvements in blood pressure, cholesterol, and blood sugar control. This option is not suitable for women over 65 years of age or for those with Type I diabetes. Participants choosing this option will need to pay for the Optifast themselves. 2. A low-calorie diet (1200 kcal per day). The Dietician will provide education, meal plans and recipes to assist with following a 1200 calorie diet for weight loss. This will be tailored to individual patients’ current dietary preferences and habits. 3. Tailored healthy eating strategies for weight loss. The Dietitian will assess current dietary intake and make suggestions for changes to assist with reduced calorie intake and healthier eating. Participants will be asked to follow the nutrition plan of their choice until the day prior to their surgery (six to seven weeks) and to record their food intake in a food diary. The dietician will provide ongoing support to all participants with weekly telephone consultations until the time of their surgery.