Logan Briggs is a senior urology resident at Mayo Clinic Arizona.

Logan Briggs, MD

Timely Psychological, Nutritional, and Exercise Referrals Improve Outcomes for Kidney Cancer Survivors

After delivering a kidney cancer diagnosis, clinicians can use the disclosure window to initiate referrals for psychological, nutritional, or exercise support without needing to provide those interventions themselves.

Kidney cancer survivors who participated in prehabilitation or rehabilitation programs experienced consistent improvements in physical and psychological outcomes, according to a scoping review of 18 randomized trials, underscoring opportunities for clinicians to connect patients with supportive care.

“It can be intimidating to think about these kinds of extra things, rehab, prehab, exercise, and psychological support,” said Logan Briggs, MD, a senior resident at Mayo Clinic Arizona, in an interview with HCPLive. “But it’s a lot easier than you think to quickly screen patients who may be particularly anxious or depressed about their diagnosis and give them a referral. You don’t need to be the one counseling them.”

According to Briggs, these brief conversations form a pivotal foundation for supporting improved outcomes in patients after a cancer diagnosis. When a clinician takes 30 seconds to provide key referrals, patients can take an active role in their care without additional effort from the clinician.

The same principle applies to patients with physical limitations or nutritional concerns. “Patients who may be debilitated or have disability may need referral to physical therapy, while those who are underweight or overweight may also face challenges that affect optimal care,” he said.

The timing of these referrals may be especially important during diagnostic disclosure. In a questionnaire study of 460 patients treated in the oncology unit at the National Cancer Institute, 44% reported diagnosis discussions ≤ 10 minutes, while 53% reported discussions > 10 minutes. Patient satisfaction scores were significantly higher when discussions > 10 minutes. Satisfaction also increased when clinicians included treatment options during the discussion rather than excluding them.

To better characterize the role of supportive care interventions in kidney cancer, Briggs and colleagues conducted a scoping review of 18 randomized controlled trials involving patients enrolled in prehabilitation or rehabilitation programs. Interventions included psychological support, exercise-based programs, and nutritional or pharmacologic components. Investigators assessed whether each intervention demonstrated statistically significant positive, negative, or neutral effects across outcomes of interest.

The systematic search identified 2,774 unique participants, including 706 patients or survivors with kidney cancer. Of the 18 trials, 6 exclusively enrolled patients with kidney cancer, while the remaining 12 included kidney cancer survivors as a subset of a broader cancer population.

Across 18 randomized trials, nearly 80% demonstrated statistically significant benefits.

Psychological support, particularly mindfulness-based and therapist-led interventions, showed the most consistent benefit, with 9 of 10 trials demonstrating significant improvements in patient-reported outcomes. All 3 trials combining exercise and psychological support showed benefit. In 1 key study, exercise alone and cognitive behavioral therapy alone did not help, but the combination did.

Level 1 evidence supports preoperative carbohydrate drinks before radical nephrectomy, with improvements in quality of life and reduced postoperative weight loss. Exercise interventions were most effective when they met criteria for therapeutic validity, which was strongly associated with positive outcomes (r = 0.75; 

Notably, no trials evaluated caregiver outcomes or cost-effectiveness, and few included patients receiving contemporary immunotherapy, which are key gaps for future research.

“You don't necessarily need to be the one counseling them or providing any type of mindfulness therapy. There are online resources listed in the paper that the patients can be referred to,” explained Briggs. “They don't even need to be referred to a social worker. I would just encourage, you know, to take that 30 seconds to recommend the patient, check out some of these resources, or to provide a referral.”

Briggs LG, Parke SC, Gill VS, et al. Exercise, nutrition, and psychological support for kidney cancer: a scoping review. 

. Published online January 18, 2026. doi:

Figg WD, Smith EK, Price DK, et al. Disclosing a Diagnosis of Cancer: Where and How Does It Occur? 

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A scoping review of 18 trials finds psychological, nutritional, and exercise support consistently benefits kidney cancer patients.

Timely Psychological, Nutritional, Exercise Referrals May Improve Outcomes for Kidney Cancer Survivors

Kidney Cancer Survivors Benefit From Increased Psychological Support, With Logan Briggs, MD

Psychological support demonstrates significantly positive clinical outcomes for kidney cancer survivors enrolled in prehabilitation or rehabilitation programs, according to a new scoping review.

“This study is the first systematic search of the literature on prehabilitation, rehabilitation, exercise, psychological support, or nutrition interventions for KC survivors or their caregivers,” wrote Logan Briggs, a study investigator and senior urology resident at Mayo Clinic Arizona, and colleagues. “The broad scope of the search is a strength in that it provides a comprehensive review.”

The findings support strengthening psychological support services as part of comprehensive cancer care for patients with kidney cancer, while also acknowledging potential benefits associated with tailored exercise programs and preoperative carbohydrate supplementation.

“Across the board, these interventions improved anxiety and depression, and in many cases, also enhanced quality of life, sleep, post-traumatic symptoms, and even physical functioning,” explained Logan Briggs, in an interview with 

 “About half of the studies included patients with advanced cancer, which may contribute to higher anxiety levels, though the benefits of psychological support were consistent. The takeaway for clinicians is that any type of psychologist, psychiatrist, therapist, or social worker can provide meaningful support for these patients.”

As Briggs noted, prehabilitation and rehabilitation interventions for kidney cancer survivors remain largely unexplored, with substantial gaps in the literature. To date, only 18 randomized controlled trials have evaluated these approaches. Notably, no studies have assessed cost-effectiveness or stratified outcomes by socioeconomic or demographic characteristics.

To address these gaps, Briggs and colleagues conducted a scoping review of all 18 randomized controlled trials involving kidney cancer survivors enrolled in prehabilitation or rehabilitation programs. Interventions included psychological support, exercise-based programs, and nutritional or pharmacologic components. For each study, they recorded whether interventions yielded statistically significant positive, negative or no significant difference for the outcomes of interest.

The systematic search identified 2774 unique participants, including 706 patients or survivors with kidney cancer. Of the 18 trials, 6 exclusively enrolled patients with kidney cancer, while the remaining 12 included kidney cancer survivors as a subset of a broader cancer population.

Across intervention types, investigators found cognitive behavioral therapy, mindfulness meditation, yoga, body scanning, positive expressive writing, Morita therapy, and mindful eating were associated with positive clinical outcomes. Among the 7 trials focused solely on psychological support, 6 demonstrated improvement. Additionally, all 3 studies combining psychological support with exercise showed benefit.

In contrast, nutrition was a notably understudied area. Only 1 trial demonstrated significant findings, showing that preoperative carbohydrate drinks administered the night before and 2 hours prior to radical nephrectomy improved quality of life and reduced postoperative weight loss. Beyond this, evidence to guide nutritional interventions for this population was limited.

Exercise interventions varied widely, ranging from high-intensity interval training to step-count monitoring using wearable devices. Some studies evaluated exercise alone, while others combined physical activity with psychological support.

“One key finding is that well-designed exercise programs, those that are tailored to the patient, follow the FIT principles (frequency, intensity, time, type), and have a clear rationale, tend to produce the best outcomes,” said Briggs.

He described this concept as the “therapeutic validity” of an exercise intervention. Using the Therapeutic Content Scale developed by Hoojeboom, studies scoring >6 out of 9 were considered to demonstrate strong therapeutic validity. Investigators observed increased validity scores correlated with improved patient outcomes, including VO₂ max, step counts, and mobility measures such as the Timed Up and Go test.

Editor’s note: Briggs reports relevant disclosures with Delfina, Tolmar, Consens, and others.

Hoogeboom TJ, Kousemaker MC, van Meeteren NL, et al. i-CONTENT tool for assessing therapeutic quality of exercise programs employed in randomised clinical trials. 

https://doi.org/10.1136/bjsports-2019-101630

The first scoping review of kidney cancer pre/ rehabilitation suggests psychological support outdoes exercise and nutrition. 

Logan Briggs, MD

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