Understanding the intersection of frailty, sepsis and cancer: Rehabilitation to improve survivor outcomes

This project is co-funded with Sepsis Canada as part of the 2022 Springboard Grants Program: Early Career Researcher Competition.

About the Project

Frailty, sepsis and cancer are commonly diagnosed conditions in Canadians. While these conditions have been investigated individually, the interaction of these conditions is not well understood, nor is the potential for rehabilitation to improve survivor outcomes. To address this gap, we propose the I-CaRe project examining the intersection of frailty, sepsis, and cancer and potential for rehabilitation to manage these conditions.

There are two parts to the I-CaRe project. Firstly, we will conduct a review to explore the literature on the intersection of frailty, sepsis and cancer (Part 1) and then work with patients/caregivers and health professionals to create meaningful educational modules describing these conditions and the potential of rehabilitation services for individuals with these conditions (Part 2). To create the educational modules, we will interview patients/caregivers and health professionals and conduct focus groups to ask about their experiences with frailty, cancer, and sepsis, and their rehabilitation needs. We will also ask about preferred content and format of educational modules. These stakeholders will assist in creating the modules and will provide feedback in many project stages. The I-CaRe project will be the first step in exploring the intersection of frailty, sepsis, and cancer and describing the potential for rehabilitation services for these populations. Study outputs will include three manuscripts, three conference presentations, communication materials, and two modules to be distributed to diverse stakeholder groups. Results will help to improve outcomes for Canadians living with cancer, sepsis, and frailty, and will inform future research and clinical practice.

Anticipated Findings

This project will be the first step in exploring the intersection of frailty, sepsis and cancer and describing the potential for rehabilitation services for these populations. Project deliverables include two modules that will be disseminated for clinical use and future research projects.

Project Team

Principal Investigator:

Jenna Smith-Turchyn – McMaster University


Marla Beauchamp – McMaster University
Linda Li – University British Columbia
Hira Mian – McMaster University
Som Mukherjee – Hamilton Health Sciences: Juravinski Cancer Centre
Bram Rochweg – Hamilton Health Sciences: Juravinski Hospital

Keywords: frailty; cancer; neoplasms; sepsis; rehabilitation; physical therapy modalities; exercise; patient participation; scoping review

Background & Rationale


One in four Canadians will be diagnosed with cancer in their lifetime. Cancer survivors have more than double the risk of developing sepsis compared to those with no history of cancer. Sepsis is a life-threatening illness caused by the body’s overreaction to an infection. More than 20% of sepsis hospitalizations are cancer related and sepsis is associated with 5% of all cancer deaths. Both cancer and sepsis increase the risk of frailty.


Rehabilitation is beneficial in minimizing the consequences of cancer and can prevent frailty. However, limited research exists on the intersection of these conditions and the role of rehabilitation in improving outcomes for this group of survivors.

Research Plan & Hypothesis

Research Plan

This project has two stages:

Stage 1: Literature will be searched for the most relevant references related to the intersection of cancer, sepsis, and frailty. Results will be pooled to determine how these conditions co-exist and identify potentials for rehabilitation.
Stage 2: Co-design will be used in stage 2. Stakeholders will take part in interviews and focus groups discussing their experience with frailty, cancer, and sepsis. Data from these focus groups will be used to create two educational modules (one patient facing, one health professional facing). Stakeholders will provide feedback during all phases of development.


We hypothesize that frailty has a bidirectional effect on cancer and sepsis and rehabilitation has the potential to play a significant role in improving outcomes.


The overall goal of the I-CaRe project is to explore the intersection of frailty, sepsis and cancer and create educational tools describing the potential for rehabilitation services for these populations.