Daniel Santa Mina

• PhD
• Professor (Associate) at University of Toronto

Background Women who are diagnosed and treated for breast cancer (WBC) encounter barriers engaging in adequate physical activity (PA). Pairing WBC with PA partners is a feasible approach to promote social support, potentially increasing PA levels. However, WBC may not perceive to have the expertise required to facilitate PA behavior. As such, provi...

Past research has indicated that individuals with Ehlers-Danlos Syndromes (EDS) and Generalized Hypermobililty Spectrum Disorder (G-HSD) report psychological and psychiatric symptoms, particularly anxiety disorders and depressive symptoms, at much greater rates than the general population. However, these studies have been primarily conducted in sma...

Chronic postsurgical pain (CPSP) is a prevalent yet unintended consequence of surgery with substantial burdens to the individual and their family, the healthcare system, and society at large. The present article briefly reviews the evidence for transitional pain services (TPSs) that have arisen in an effort to prevent and mange CPSP and persistent...

Importance Neoadjuvant therapy (NT) is an increasingly used treatment strategy for patients with localized pancreatic ductal adenocarcinoma (PDAC). Little research has been conducted on cancer care delivery during NT, and the standards for optimal delivery of NT have not been defined. Objective To develop consensus best practices for delivering NT...

We sought to assess the feasibility and estimate the effects on outcomes of a multimodal prehabilitation service implemented as an ancillary surgical service. We conducted a pragmatic, nonrandomized feasibility study of surgical prehabilitation. Patients were eligible if they were ≥ 18 yr of age, fluent in English, and referred by a health professi...

Background Intraoperative hypotension is associated with acute kidney injury after surgery. However, the definition (duration and magnitude) of hypotension during kidney transplantation (KT) surgery on early graft function remains unclear. Methods We conducted a retrospective cohort study of KT recipients from December 1, 2009, to December 31, 201...

Crohn’s disease (CD) is a complex clinical condition characterized by persistent gastrointestinal inflammation that leads to episodes of flare-ups and subsequent healing. The treatment options for this disease are heterogeneous as its impact on different patients is also different. This study aims to evaluate the effectiveness of recently approved...

Introduction Exercise training post-transplant has been shown to improve physical function and quality of life in solid organ transplant (SOT) recipients. Online resources in the form of websites and videos are commonly used to provide education and instruction on exercise and physical activity in SOT; however, the content and quality of these onli...

The link between the Epstein-Barr virus (EBV) and the development of certain types of lymphomas in patients with human immunodeficiency virus (HIV) is of noteworthy clinical importance. Their immunocompromised state increases the risk of cancers such as lymphomas. Gastrointestinal (GI) lymphomas, though, can occur due to the immunosuppression cause...

Introduction: Older adults with metastatic prostate cancer (mPC) experience high symptom burden associated with treatment. Frailty may exacerbate treatment toxicity. The aim of this study was to explore short-term treatment toxicity in patients with metastatic prostate cancer. Materials and Methods: Older adults with metastatic prostate cancer sta...

Background Although oncology clinical practice guidelines recognize the need and benefits of exercise, the implementation of these services into cancer care delivery remains limited. We developed and evaluated the impact of a clinically integrated 8‐week exercise and education program (CaRE@ELLICSR). Methods We conducted a mixed methods, prospecti...

Malnutrition is prevalent among surgical candidates and associated with adverse outcomes. Despite being potentially modifiable, malnutrition risk screening is not a standard preoperative practice. We conducted a cross-sectional survey to understand healthcare professionals’ (HCPs) opinions and barriers regarding screening and treatment of malnutrit...

Limited data exist regarding the role of multimodal prehabilitation during neoadjuvant chemotherapy (NACT) for breast cancer. Determining large trial feasibility and identifying signals of prehabilitation benefit are needed. We conducted a randomized controlled feasibility trial of multimodal prehabilitation versus usual care during NACT among wome...

Surgery and general anaesthesia have deleterious effects on sleep and disrupted perioperative sleep health is a risk factor for poor surgical outcomes. The objective of this systematic review was to summarise preoperative interventions that report sleep outcomes. Studies that delivered an intervention initiated >24 h prior to surgery among an adult...

Introduction Multimodal prehabilitation is intended to optimize a patient’s mental and physical health prior to surgery. Most multimodal prehabilitation interventions are delivered on a one-on-one format, which may limit benefits associated with social interactions that can be achieved in a group context, and are delivered in-person, which may limi...

Background Inadequate study reporting precludes interpretation of findings, pooling of results in meta-analyses, and delays knowledge translation. While prehabilitation interventions aim to enhance candidacy for surgery, to our knowledge, a review of the quality of reporting in prehabilitation has yet to be conducted. Our objective was to determine...

Background Recently, the number of prehabilitation trials has increased significantly. The identification of key research priorities is vital in guiding future research directions. Thus, the aim of this collaborative study was to define key research priorities in prehabilitation for patients undergoing cancer surgery. Methods The Delphi methodolog...

Introduction Technology-based exercise is gaining attention as a promising strategy for increasing physical activity (PA) in older adults with cancer (OACA). However, a comprehensive understanding of the interventions, their feasibility, outcomes, and safety is limited. This scoping review (1) assessed the prevalence and type of technology-based re...

Introduction: Physical activity may be associated with cancer treatment toxicity, but generalizability to geriatric oncology is unclear. As many older adults have low levels of physical activity and technology use, this area needs further exploration. We evaluated the feasibility of daily step count monitoring and the association between step coun...

12055 Background: Accelerometry research suggests physical activity may be associated with treatment toxicity, but generalizability to geriatric oncology is unclear. As many older adults have low levels of physical activity and technology use, further exploration is warranted. This study explores the feasibility of daily physical activity monitorin...

12054 Background: Advancements in metastatic prostate cancer (mPC) treatments have increased survival, but using multiple lines of therapy has increased the prevalence and severity of toxicities. Older men and those living with frailty experience higher symptom burden associated with treatment. Although toxicities have been described in previous tr...

Continuous advances in prehabilitation research over the past several decades have clarified its role in improving preoperative risk factors, yet the evidence demonstrating reduced surgical complications remains uncertain. Describing the potential mechanisms underlying prehabilitation and surgical complications represents an important opportunity t...

BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is a progressive condition associated with physical and cognitive impairments contributing to difficulty performing activities of daily living (ADL) that require dual tasking (e.g., walking and talking). Despite evidence showing that cognitive decline occurs among COPD patients and may contrib...

Background Chronic obstructive pulmonary disease (COPD) is a progressive condition associated with physical and cognitive impairments contributing to difficulty in performing activities of daily living (ADLs) that require dual tasking (eg, walking and talking). Despite evidence showing that cognitive decline occurs among patients with COPD and may...

Purpose Exercise and social support are non-pharmacological strategies that improve health and wellbeing in women treated for breast cancer (WTBC). However, strategies to facilitate support and exercise in WTBC are typically resource intensive. The purpose of this study was to examine whether various forms of social support received from a matched...

Introduction: Emerging data support multiple benefits of remote symptom monitoring (RSM) during chemotherapy to improve outcomes. However, these studies have not focused on older adults and do not include treatments beyond chemotherapy. Although chemotherapy, androgen receptor axis-targeted therapies (ARATs), and radium-223 prolong survival, toxici...

Barriers to exercise-oncology programs remain for those living with and beyond cancer in rural and remote communities, including geographic isolation and access to programs. The EXercise for Cancer to Enhance Living Well (EXCEL) study was designed to support exercise-oncology implementation in rural and remote communities across Canada. The purpose...

There is much controversy regarding enhanced recovery for recipients of liver transplants from deceased and living donors. The objectives of this Review were to summarise current knowledge on individual enhanced recovery elements on short-term outcomes, identify key components for comprehensive pathways, and create internationally accepted guidelin...

Introduction Individuals living with and beyond cancer from rural and remote areas lack accessibility to supportive cancer care resources compared with those in urban areas. Exercise is an evidence-based intervention that is a safe and effective supportive cancer care resource, improving physical fitness and function, well-being and quality of life...

BACKGROUND Introduction: Dyspnea is a prevalent symptom for individuals with hypermobile Ehlers-Danlos Syndrome (hEDS) and generalized hypermobility spectrum disorder (G-HSD). The characteristics and contributors to dyspnea in hEDS/G-HSD have not been well elucidated. One known contributor to dyspnea is respiratory muscle weakness. The feasibility...

Background: Dyspnea is a prevalent symptom in individuals with hypermobile Ehlers-Danlos Syndrome (hEDS) and generalized hypermobility spectrum disorder (G-HSD), yet its contributors have not been identified. One known contributor to dyspnea is respiratory muscle weakness. The feasibility and effectiveness of inspiratory muscle training (IMT) in c...

Introduction Patients’ unwillingness to be randomized to a mode of exercise may partly explain their poor recruitment, adherence, and attrition in randomized controlled trials (RCTs) of exercise in oncology. It is unknown whether a preference-based trial can improve recruitment, adherence, retention, and clinical outcomes compared to a RCT of the s...

Background: With >700 transplant surgeries performed each year, Toronto General Hospital (TGH) is currently one of the largest adult transplant centers in North America. There is a lack of literature regarding both the identification and management of chronic postsurgical pain (CPSP) after organ transplantation. Since 2014, the TGH Transitional Pa...

Research Objectives To evaluate the cost-effectiveness of a pragmatic model of prehabilitation for high-risk surgical candidates from a hospital perspective. Design A cost-effectiveness analysis (CEA) from a hospital perspective was performed using data from a nonrandomized clinical trial of a pragmatic model of prehabilitation compared to usual c...

Objective(s) In this narrative review, we synthesize the evidence for the biological plausibility of multimodal prehabilitation to reduce surgical complications. The goal of this review is to improve prehabilitation interventions by outlining biologically plausible mechanisms of benefit and generating hypotheses for future research. Data Sources S...

Background Lactate dehydrogenase (LDH) reflects tumor burden and is a prognosticator of all-cause mortality in patients with cancer. Objective measures of physical function are associated with clinically relevant outcomes in older adults with cancer. However, whether physical function is associated with LDH in geriatric oncology is unknown. The obj...

Introduction Exploring symptom experiences of older men during metastatic prostate cancer treatment can help clinicians identify unmet supportive care needs that, if addressed, could improve toxicity management and enhance patient wellbeing. Previous qualitative studies of older adults with advanced prostate cancer have focused on the psychological...

Background Whether individual, environmental, and psychosocial factors predict changes in moderate-to-vigorous physical activity (MVPA) is poorly addressed in prostate cancer (PC) survivors undergoing androgen deprivation therapy (ADT). Purpose This secondary analysis of a randomized controlled trial examined changes in MVPA following a supervised...

Purpose Many children, adolescents, and young adult survivors of childhood cancer experience fatigue following cancer treatment. Physical activity has been shown to be effective in improving cancer-related fatigue in adult survivors, but there is a lack of evidence on its effect in childhood cancer survivors. In addition, there are no guidelines fo...

Testicular cancer survivors report unmet supportive care needs that are associated with poorer physical and mental health, yet engagement in traditional supportive care is low. The Ball’s in Your Court intervention was designed to engage testicular cancer survivors in supportive care by leveraging a community-based sport and exercise model. Age-app...

Mounting evidence suggests that recovery begins before the surgical incision. The pre‐surgery phase of recovery – the preparation for optimal surgical recovery – can be reinforced with prehabilitation. Prehabilitation is the approach of enhancing the functional capacity of the individual to enable them to withstand a stressful event. With this narr...

Background: Emerging data support multiple benefits of RSM during chemotherapy to improve outcomes. These studies do not focus on older adults and do not include non-chemotherapy strategies. mPC represents a major burden in older men. Although both chemotherapy and androgen receptor axis-targeted therapies (ARATs) prolong survival, toxicities are s...

Objective: The objective of this scoping review is to identify the characteristics of pragmatic exercise interventions aimed to reduce cognitive impairment in cancer survivors, and their effectiveness in reducing this impairment and maintaining high adherence.Introduction: Cognitive impairment (CI) is a particularly troublesome side-effect of cance...

Background: The indication and surgical complexity of orthotopic liver transplantation underscore the need for strategies to optimize the recovery for transplant recipients. We conducted a systematic review aimed at identifying, evaluating, and synthesizing the evidence examining the effect of in-patient rehabilitation for liver transplant recipie...

Physical activity (PA) can help manage cancer treatment-related side effects and improve well-being following treatment; however, resuming PA after a period of inactivity due to cancer can be challenging. The purpose of this study was to explore adolescents and young adults (AYAs) experiences transitioning back into PA after a period of inactivity...

Background Prostate cancer survivors (PCS) experience long-term side effects beyond treatment such as fatigue, depression and anxiety. Quality and engaging supportive care programs are needed to reduce these chronic and debilitating effects. Independent of physical activity (PA), high volumes of sedentary behavior (SB) are associated with chronic d...

Background The majority of breast cancer survivors do not engage in sufficient levels of exercise. Community-based exercise programs (CBEP) may mitigate low rates of exercise participation; however, few programs exist. Previous research exploring the determinants of CBEP implementation for cancer survivors is limited in that it has predominantly fo...

Purpose of the Review Combining interventions into a multimodal prehabilitation approach is recommended to maximize benefits due to synergistic and cumulative effects of modalities. The purpose of this review was to (i) highlight the rationale for multimodal prehabilitation, (ii) summarize related contemporary literature, and (iii) discuss emerging...

Purpose of review This review aims to provide clinicians that work in the surgical realm with relevant exercise principles and related research as they consider incorporating prehabilitation into care plans. Recent Findings Exercise is a core component of preoperative health optimization strategies referred to as prehabilitation. The exercise comp...

Purpose of Review A growing body of evidence supports the use of prehabilitation to reduce the incidence and severity of surgical complications. However, the economic viability of prehabilitation must be evaluated and confirmed prior to its clinical integration as a routine perioperative health service. This article extends previous research-based...

Objectives : To conduct a systematic review examining the effect of exercise and rehabilitation in people with EDS. Data sources : The following databases were systematically searched: Medline, Medline In-Process/ePubs, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and Cumulative Index to Nursing and Allied Health. The final ti...

75 Background: Recruitment for most exercise trials is challenging and often hindered by participants’ inability to travel to the study centre and/or unwillingness to be randomized. Thus, patients in exercise randomized controlled trials (RCTs) are highly selected and may not reflect real-world experiences. Our objectives were to compare baseline c...

82 Background: Treatment options for older adults with mPC expanded significantly in recent years but commonly include chemotherapy with Docetaxel (Chemo), androgen receptor-axis-targeted therapies (ARAT), and Radium-223 (Ra-223). Symptom burden associated with Chemo, ARAT, and Ra-223 is frequently observed and often leads to treatment modification...

Purpose of Review Multimodal prehabilitation aims to improve preoperative health in ways that reduce surgical complications and expedite post-operative recovery. However, the extent to which preoperative health has been affected by the COVID-19 pandemic is unclear and evidence for the mitigating effects of prehabilitation in this context has not be...

Prehabilitation (prehab) and rehabilitation (rehab) offer multi-modal intervention strategies (primarily exercise, nutrition and well-being) aimed at addressing functional changes associated with cancer and at optimising peoples’ health across the cancer continuum. This is particularly important for older adults diagnosed with cancer and experienci...

For cancer survivors who also identify as athletes, a rigorous exercise that was once part of their daily routine and fundamental to their physical, psychological, and potentially financial well-being, may be temporarily or permanently altered in ways that exacerbate cancer-related changes in quality of life. This report presents an illustrative ca...

Introduction: Exercise and relaxation interventions have demonstrated benefits in allogeneic hematopoietic stem cell transplant (allo-HSCT) patients; however, little is known about the implementation enablers and barriers for in-patient rehabilitation or its impact on health outcomes. Objective: To conduct a program evaluation of group-based reh...

PURPOSE Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop...

Physical activity (PA) is important for managing the side effects and long-term outcomes of cancer treatment, yet many adolescents and young adults diagnosed with cancer (AYAs) are not meeting PA guidelines. Body image and social support are two factors that can influence PA behavior and require further attention in this population. The purpose of...

Background: Posttransplant metabolic syndrome (PTMS) is a common contributor to morbidity and mortality among solid organ transplant recipients in the late posttransplant period (≥1 year). Patients diagnosed with PTMS are at a higher risk of cardiovascular disease and frequently experience decreased physical function and health-related quality of...

BACKGROUND Post-transplant metabolic syndrome (PTMS) is a common contributor to morbidity and mortality in solid organ transplant recipients in the late post-transplant period (≥ 1-year). Patients diagnosed with PTMS are at higher risk of cardiovascular disease and frequently experience decreased physical function and health-related quality of life...

INTRODUCTION: Although prostate cancer survivorship rates are increasing, living longer may not necessarily translate into living well. Previous studies have shown that cancer patients often experience psychological distress, which has also been associated with poorer treatment outcomes. However, research investigating the burden of psychological d...

Background: The relationship between preoperative physical activity (PA) and hospital length of stay (LOS) following radical prostatectomy (RP) is poorly understood. In addition, the relationship between PA and the American Society of Anesthesiologists Physical Status score (ASA PS), an established prognosticator of surgical risk, has not been stu...

Introduction: The Ehlers-Danlos Syndromes (EDS) and Generalized Hypermobility Spectrum Disorders (G-HSD) comprise a heterogeneous group of genetic disorders of abnormal synthesis and/or maturation of collagen and other matricellular proteins. EDS is commonly characterized by manifestations such as multi joint hypermobility that can lead to musculos...

Background: Peer-based exercise interventions that cultivate new opportunities for support with a fellow cancer survivor may result in increased exercise volume. It is not clear whether adding qualified exercise professional (QEP) support to peer-based interventions improves health outcomes. Therefore, the purpose of this study is to determine whe...

Barriers, facilitators, and motivators to exercise for cancer survivors living in urban settings are well described in the literature. However, there is a lack of comparable information for cancer survivors living in rural communities. We describe the exercise behaviours, barriers, facilitators, and motivators to exercise participation of cancer su...

This study assessed the feasibility of a phase II randomized controlled trial of high-intensity interval training (HIIT), resistance training (RT), and usual care (UC) in men with prostate cancer (PCa) on active surveillance and evaluated changes in clinically relevant outcomes. Eighteen men undergoing active surveillance for PCa were randomized to...

Background Exercise has the potential to improve physical function and quality of life in individuals with bone metastases but is often avoided due to safety concerns. This systematic review summarizes the safety, feasibility and efficacy of exercise in controlled trials that include individuals with bone metastases. Methods MEDLINE, Embase, Pubme...

Ehlers-Danlos Syndrome (EDS) are a heterogeneous group of genetic connective tissue disorders, and typically manifests as weak joints that subluxate/dislocate, stretchy and/or fragile skin, organ/systems dysfunction, and significant widespread pain. Historically, this syndrome has been poorly understood and often overlooked. As a result, people liv...

Objective Evaluate the quality of exercise randomised controlled trial (RCT) reporting and conduct in clinical populations (ie, adults with or at risk of chronic conditions) and compare with matched pharmacological RCTs. Design Systematic review. Data sources Embase (Elsevier), PubMed (NLM) and CINAHL (EBSCO). Study selection RCTs of exercise in...

Background: Ehlers-Danlos Syndromes (EDS) and Hypermobility Spectrum Disorders (HSD) are a heterogeneous group of heritable genetic connective tissue disorders with multiple characteristics including joint hypermobility, tissue fragility, and multiple organ dysfunction. Respiratory manifestations have been described in EDS patients, but have not b...