A new 6-month personalized program combining supervised exercise, nutrition education, and ongoing support is being tested to prevent older adults with bladder or kidney cancer from becoming weak after surgery. The FRAGECO study, a randomized controlled trial across multiple hospitals, began recruiting patients in December 2025 and will measure whether this comprehensive approach helps patients maintain strength, energy, and independence better than standard cancer care alone.
A major new study is testing whether a personalized 6-month exercise and nutrition program can help older adults with bladder or kidney cancer maintain their strength and independence after surgery. The FRAGECO program combines supervised exercise sessions before and after surgery with nutrition education and long-term support. According to Gram Research analysis, this approach addresses a critical gap in cancer care: while doctors focus on removing tumors, older patients often become weak and frail during recovery. The study will track whether this comprehensive program helps patients walk farther, feel less tired, and maintain better quality of life compared to standard cancer care alone.
Key Statistics
The FRAGECO randomized controlled trial, which began recruiting patients in December 2025, combines two weekly 60-minute supervised exercise sessions for two months (one month before and one month after surgery) with 12 weeks of community-based exercise support for older adults undergoing bladder or kidney cancer surgery.
According to the FRAGECO study protocol, the personalized intervention includes moderate-intensity endurance, strength, and balance exercises, plus optional education on physical activity, nutrition, cancer treatment management, and fatigue—addressing multiple factors that contribute to physical decline in older cancer patients.
The FRAGECO study will assess physical frailty using the six-minute walk test as the primary outcome measure at 6 months, along with secondary measurements of overall frailty status, nutritional health, muscle strength, balance, fatigue, depression, memory, and quality of life in older cancer patients.
The Quick Take
- What they studied: Whether a personalized 6-month program combining exercise, nutrition education, and ongoing support can prevent older cancer patients from becoming weak and frail after bladder or kidney cancer surgery.
- Who participated: Older adults scheduled for bladder or kidney cancer surgery. The study is being conducted across multiple hospitals and is currently recruiting patients (started December 2025).
- Key finding: This is a study protocol describing the research plan, not yet completed results. The study will measure success using a walking test and track changes in strength, nutrition, mood, and quality of life over 6 months.
- What it means for you: If proven effective, this program could become standard care for older cancer patients, helping them recover better and stay independent longer after surgery. Results are expected in coming years.
The Research Details
FRAGECO is a randomized controlled trial, which is the gold standard for testing whether a treatment works. Researchers are comparing two groups of older cancer patients: one group receives the new personalized program, while the other receives standard cancer care. The program includes two supervised exercise sessions per week for one month before surgery and one month after surgery. These sessions focus on walking, strength training, and balance exercises at moderate intensity. Patients also receive optional education about physical activity, nutrition, managing their cancer treatment, and dealing with fatigue.
After the initial two months of supervised exercise, patients are referred to local community exercise facilities for 12 more weeks of continued support. This helps patients maintain their progress long-term. The entire program lasts 6 months, with researchers measuring various outcomes at the end to see if the program group did better than the standard care group.
The study is being conducted at multiple hospitals to ensure the results apply to different settings and patient populations. Researchers will also interview patients and staff to understand what helped or hindered the program’s success in real-world conditions.
Older adults with cancer face a unique challenge: cancer surgery can cause them to become weak and frail, leading to falls, loss of independence, and complications. Standard cancer care focuses on removing the tumor but doesn’t always address the physical decline that happens during recovery. By testing a comprehensive program that combines exercise, nutrition, and education, researchers can determine whether supporting patients’ physical health throughout the cancer journey prevents this decline. If successful, this approach could change how hospitals care for older cancer patients.
This is a well-designed study with several strengths: it’s randomized (reducing bias), controlled (comparing to standard care), and multicenter (testing across different hospitals). The study was registered before recruitment began, which ensures transparency. However, this is a protocol paper describing the research plan, not the actual results. The study only recently began recruiting patients in December 2025, so findings are not yet available. The study will be stronger once results are published and peer-reviewed.
What the Results Show
This paper describes the research plan rather than actual results, as the study is still ongoing. The primary outcome the researchers will measure is physical frailty at 6 months, assessed using the six-minute walk test—a simple test where patients walk as far as they can in 6 minutes. This test is a reliable way to measure overall fitness and functional ability in older adults.
The study will also measure many secondary outcomes to get a complete picture of how the program affects patients’ health. These include overall frailty status, nutritional health, memory and thinking skills, quality of life, fatigue levels, depression, muscle strength, and balance. By measuring all these factors, researchers can understand whether the program helps patients recover more completely after cancer surgery.
Beyond the walking test, the study will examine whether patients in the program group experience less fatigue, maintain better nutrition, have stronger muscles, and report better quality of life compared to standard care. The researchers will also look at whether the program helps with mood and depression, which are common after cancer diagnosis and surgery. Additionally, they’ll assess whether patients maintain better balance and have fewer falls, which is important for preventing injuries in older adults.
Current cancer care for older adults typically focuses on surgery and immediate recovery, with limited ongoing support for physical rehabilitation. This study builds on growing evidence that exercise and nutrition support can help cancer patients recover better. The FRAGECO program is innovative because it combines supervised exercise before and after surgery with long-term community support—addressing the full recovery journey rather than just the immediate postoperative period. This comprehensive approach is relatively new in cancer care for older adults.
Since this is a protocol paper, the actual study results are not yet available, so we cannot assess limitations in the findings. However, potential limitations to watch for when results are published include: the study’s success depends on patients completing the exercise program, which can be challenging; results may vary depending on the type of cancer surgery and individual patient factors; and the program requires access to supervised exercise facilities, which may not be available everywhere. The study team is aware of these challenges and will examine them in their qualitative analysis.
The Bottom Line
This research is still in progress, so no clinical recommendations can be made yet. However, older adults with bladder or kidney cancer should discuss with their cancer care team whether participating in supervised exercise programs before and after surgery might be appropriate for them. Current evidence supports the general benefits of physical activity for cancer patients, and this study will provide specific guidance for this population. Confidence level: Awaiting results.
This research is most relevant to: older adults diagnosed with bladder or kidney cancer; their family members and caregivers; cancer surgeons and oncologists; geriatricians (doctors specializing in older adults); and hospital administrators developing cancer care programs. Once results are available, this will be particularly important for older patients who are concerned about losing strength and independence after cancer surgery.
The study began recruiting patients in December 2025 and will follow patients for 6 months. Results should be available in 2026-2027, with publication likely in 2027-2028. Patients should not expect to see changes in clinical practice until after results are published and reviewed by the medical community.
Frequently Asked Questions
Can exercise help older adults recover better after cancer surgery?
Research suggests yes. The FRAGECO study is testing whether supervised exercise before and after surgery, combined with nutrition support, helps older cancer patients maintain strength and independence. Early evidence supports exercise benefits for cancer patients, and this trial will provide specific guidance for older adults undergoing bladder or kidney cancer surgery.
What happens to older cancer patients’ strength after surgery?
Older adults often experience significant weakness and loss of function after cancer surgery, a condition called frailty. Standard cancer care focuses on removing tumors but doesn’t always address physical decline during recovery. The FRAGECO program aims to prevent this weakness through supervised exercise and nutrition support throughout the recovery period.
How long does it take to see benefits from exercise after cancer surgery?
The FRAGECO study measures outcomes at 6 months, suggesting this is a reasonable timeframe to expect meaningful improvements. The program includes supervised exercise for 2 months followed by 12 weeks of community-based support, indicating that sustained activity over several months is important for maintaining gains.
Is it safe to exercise before cancer surgery?
The FRAGECO program includes supervised exercise one month before surgery, suggesting it’s safe and potentially beneficial when done under professional guidance. However, patients should always discuss exercise plans with their cancer care team, as safety depends on individual health status and the specific type of cancer.
What should older cancer patients eat to stay strong during recovery?
The FRAGECO program includes optional nutrition education addressing diet during cancer treatment and recovery, though specific dietary recommendations aren’t detailed in the protocol. Patients should work with their healthcare team and a registered dietitian to develop a nutrition plan supporting muscle maintenance and overall recovery.
Want to Apply This Research?
- Track weekly exercise minutes and type (endurance, strength, balance), daily steps using a pedometer or phone, and weekly fatigue levels on a 1-10 scale. Compare these metrics month-to-month to visualize progress in fitness and energy levels.
- Users recovering from cancer surgery can use the app to schedule and log their twice-weekly exercise sessions, set reminders for nutrition goals (protein intake, hydration), and track energy levels throughout the day. The app can provide encouragement and connect users to local exercise facilities in their area.
- Establish a baseline of current fitness and fatigue levels, then track weekly progress in walking distance, exercise completion, and energy. Set monthly goals for increasing activity duration or intensity. Share progress with healthcare providers during follow-up appointments to adjust the program as needed.
This article describes a research study protocol that is currently ongoing. Results are not yet available. This information is for educational purposes only and should not replace professional medical advice. Older adults with bladder or kidney cancer should consult with their oncologist, surgeon, and primary care physician before starting any exercise program or making changes to their cancer treatment plan. The safety and effectiveness of the FRAGECO program have not yet been established, as the study is still recruiting and following participants. Individual results may vary based on overall health status, type of cancer, and other medical conditions.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.