Inclusion criteria, exclusion criteria and study summary
In the UK 42,000 people each year are diagnosed with bowel cancer. Surgery to remove the cancer is the best treatment. However, it has a risk of complications, which is doubled for people with overweight/besity. Patients experiencing complications recover more slowly, stay in hospital longer, and need more care. This isn’t good for patients or the NHS. Physical fitness and well-controlled blood sugar are linked with fewer complications from surgery. For people with overweight, weight loss improves both of these factors, so it may reduce complications. One reliable way to lose a meaningful amount of weight in the short period before surgery (3-4 weeks) is through a low-calorie diet programme: eating only special nutritious soups and shakes. With weekly support from a dietitian, most people succeed. Typically, people lose 5% of their weight within 20 days. The NHS uses a version of this programme to treat type 2 diabetes. To start to find out if this treatment is in the best interests of patients physical and mental health, we will recruit 72 patients with overweight awaiting bowel cancer surgery. Half will be randomly allocated to continue with their usual care and half will be offered the weight loss programme. We will see whether enough patients are willing to take part, lose weight, and return for follow-up visits. We will monitor complications for 30 days after surgery and any reduction in muscle mass as a result of the weight loss. We will interview patients about their experience. This information will tell us if a full trial is worthwhile to test whether this programme can reduce complications from surgery, improve outcomes for people with bowel cancer, and if the financial costs are likely to be worth the benefits. It will also help us refine the treatment plans according to patient feedback.
