Comprehensive Multimodal Prehabilitation Alone or With Neoadjuvant Therapy Before Major Cancer Surgery

This study tests a comprehensive pre-surgery preparation program called Multimodal Prehabilitation (CMMP) — which includes exercise, nutrition, and psychological support — for people who are frail or pre-frail and scheduled for major cancer surgery. Some participants will also receive pre-surgery cancer treatment (chemotherapy or radiation) alongside the program. **You may be eligible if:** - You are 18 or older, in a frail or pre-frail health state - You have confirmed or suspected cancer of the pancreas, bile ducts, ovary, kidney, or bladder - Your cancer is potentially resectable (able to be removed surgically) - You are scheduled for major elective cancer surgery at least 28 days away - You can eat by mouth, walk without a wheelchair, and speak/read English - You have a smartphone or access to one **You may NOT be eligible if:** - You depend on oxygen at rest or with activity - You have serious active heart disease (e.g., recent heart attack or stroke) - You have active brain or bone metastases - You have a significant disability that prevents exercise participation - You cannot eat normally (e.g., fed by tube) Talk to your doctor to see if this trial is right for you.