S2663
RTT - Patient experience and quality of life
ESTRO 2026
Mini-Oral 2221 A pilot study evaluating the impact of a prehabilitation programme on reducing anxiety for prostate cancer radiotherapy patients. Nisha Bhudia 1 , Robert Appleyard 2 , David Walton 1 , Paula Wells 1 , Karen Tipples 1 , Ewan Chapman 1 , Hamoun Rozati 1 , Luke Eggerton 1 , Melanie Clarkson 2 1 Radiotherapy, Barts Health NHS Trust, London, United Kingdom. 2 AHP, Sheffield Hallam University, Sheffield, United Kingdom Purpose/Objective: Prostate cancer patients may experience significant anxiety about their treatment, which can negatively affect outcomes and quality of life. The efficacy of prehabilitation in reducing anxiety associated with a cancer diagnosis has been widely explored in oncology. This study evaluates the impact of a prehabilitation programme on reducing anxiety for patients prior to radiotherapy. The prehabilitation involved a half-day group session offering multidisciplinary education and support, including topics on radiotherapy planning, side-effect management, hormone therapy, diet and exercise, pelvic floor training, psychological wellbeing, and
more likely to have a large rectum on pCT (Table 2). Median (IQR) pCT rectal volume was significantly higher in those with diabetes than those without, 73 (60-97) versus 64 (52-87) cm3 (p<0.05).
Conclusion: We have confirmed a high prevalence of obesity, physical inactivity, diabetes and pelvic floor weakness, proving a need to integrate more health and wellbeing improvement measures into our PCa RT pathway. Crucial, as strong association exists between the first 3-factors and cardiovascular disease, a major killer in men with PCa[7].Having diabetes increased the risk of a large rectum on pCT, likely due to reduced rectal sensation and longer GI transit times[8,9]. Individuals with diabetes are therefore expected to benefit most from rectal preparation or online adaptive RT to account for rectal volume variations[10]. References: 1.Alexander SE, et al. GI factors predicting prostate motion in radiotherapy: a scoping review. CTRO. 2023.2.Heemsbergen WD, et al. Large rectum raises failure risk in prostate RT (68 vs 78 Gy). IJROBP. 2007.3.Kroenke K, et al. PHQ-8 for depression. J Affect Disord. 2009.4.Löwe B, et al. GAD-7 validation. Med Care. 2008.5.Vaizey CJ, et al. Faecal incontinence grading. Gut. 1999.6.Godin G. Leisure-time physical activity questionnaire. 2011.7.Luo Z, et al. Cardiovascular mortality in prostate cancer. Front Cardiovasc Med. 2023.8.Reszczy ń ska M, et al. GI symptoms in diabetes. J Clin Med. 2021.9.Sangnes DA, et al. GI transit in diabetes. UEG J. 2021.10.Alexander SE, et al. MRI-guided adaptive prostate RT. CTRO. 2025. Keywords: Prostate, personalised, prehabilitation, wellbeing
erectile dysfunction. Material/Methods:
A mixed-methods design was employed. All non- metastatic prostate cancer radiotherapy referred to the prehabilitation programme between May and June 2024 were invited to participate. Questionnaires were given at baseline, and two weeks after attending the prehabilitation programme. Pre and post questionnaires included The Generalised Anxiety Disorder-7 (GAD-7) scale to measure anxiety levels. The post-intervention questionnaire also gathered qualitative feedback to determine how the programme influenced anxiety levels. Results: Twenty-one patients were included. At baseline, 71.4% (n=15) reported mild to severe anxiety (GAD-7 ≥ 5), which decreased to 42.9% (n=9) two weeks post- intervention, with, 95.2% (n=20) showing improvement. The Wilcoxon Signed-Rank Test demonstrated a statistically significant reduction in anxiety (Z = -3.298, p < 0.001), supported by the Hodges-Lehmann estimate (difference = 4, 95% CI = 1).Qualitative analysis identified three main themes: Fear of the Unknown, Empowerment Through Knowledge, and Peer Support, highlighting the programme's effectiveness in reducing anxiety through group education, pelvic floor training, and peer support. Conclusion: This pilot study suggests that a multimodal prehabilitation programme can effectively reduce
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