Comment on recent publication : A invited review article on optimisation of patients for oesophageal cancer treatment. Historically there was a focus on enhanced recovery following surgery (i.e. structured programmes that aim to set targets for patients on a daily basis to help their recovery after surgery). Increasingly there is an appreciation that preparing patients for surgery (and chemotherapy) needs to start right at the beginning of the treatment pathway. Surprisingly there is relatively little evidence in the literature on this subject, and best current practice is reviewed in this article.