# The Transdiagnostic Oncology Program (TOP): a multidomain lifestyle intervention to improve the quality of life of cancer survivors - a before-and-after pilot study in primary care

## TL;DR

A primary care-led aftercare program for cancer survivors improved quality of life, physical functioning, and reduced fatigue and anxiety in a pilot study.

## Contribution

A novel transdiagnostic primary care program for cancer survivors is proposed and tested for feasibility and preliminary effectiveness.

## Key findings

- The program improved physical and social functioning and reduced fatigue and anxiety in participants.
- The program was found to be feasible and acceptable with satisfactory attendance and satisfaction rates.
- Participants showed significantly better outcomes compared to controls after 12 months.

## Abstract

There is a need for interdisciplinary primary care-led aftercare programs for the common (transdiagnostic) problems cancer survivors experience to increase their quality of life. The aim of this before-and-after (pre-post) pilot study was to examine the feasibility and preliminary effectiveness of a transdiagnostic, family doctor-led interdisciplinary program to increase quality of life in a heterogeneous group of cancer survivors.

Cancer survivors (n = 19) followed a 12-month interdisciplinary aftercare program in the primary care setting, consisting of: family doctor consultation, exercise, mind-body therapy, sleep hygiene, nutrition recommendations, and optional psychological therapy. Eligible cancer survivors who declined participation, were recruited as controls (n = 16). Feasibility and acceptance were assessed through attendance and attrition rates, and an evaluation form. The primary outcome was the change in quality of life from baseline (T0) to post-intervention (T2; 12 months from baseline), as measured with the EORTC QOL-C30, covering global health status, various functional domains, and symptoms. Secondary outcomes included assessments of changes in fatigue (Multidimensional Fatigue Inventory), psychological symptoms (Depression, Anxiety and Stress scale), happiness (Happiness Index), and work ability (Work Ability Index). Intention-to-treat multilevel analyses were conducted.

Dropout (n = 3) during the program was related to personal and health issues, and attendance rates and satisfaction scores were satisfactory. At baseline, the intervention group scored significantly worse on several quality-of-life indices, and on secondary outcomes, compared to controls. The intervention group showed significantly larger increases at T2 in physical and social functioning, and decreases in fatigue and anxiety, compared to the control group.

The results suggest that this primary care-led aftercare program is feasible and acceptable. Due to the small sample size and non-randomized design, improvements in quality of life and related outcomes should be interpreted with caution. A randomized controlled trial is warranted.

This study was retrospectively registered at clinicaltrials.gov (NCT06809452).

The online version contains supplementary material available at 10.1186/s12885-025-15063-2.