In recent years, the long-term wellbeing of cancer survivors has come under increased scrutiny within the medical community. As advances in oncology improve survival rates, the focus has shifted towards enhancing quality of life post-treatment. A groundbreaking pilot study published in BMC Cancer introduces the Transdiagnostic Oncology Program (TOP), a novel, multidomain lifestyle intervention designed to address the complex and varied challenges faced by cancer survivors in primary care settings. This innovative approach seeks not only to repair physical health but also to nurture psychological and social functioning, marking a significant paradigm shift in survivorship care.
The foundation of the TOP lies in its transdiagnostic framework, which means it targets a broad spectrum of symptoms and problems common across different cancer types and treatments. Traditional aftercare programs often focus on disease-specific issues or singular dimensions of recovery. In contrast, TOP integrates family doctor-led consultations with a carefully orchestrated suite of therapies including exercise, mind-body techniques, sleep hygiene education, personalized nutritional guidance, and optional psychological therapy. This multidisciplinary model reflects an understanding that cancer survivorship is multifaceted, requiring interventions that address physical, emotional, and lifestyle domains concurrently.
This before-and-after pilot study enrolled nineteen cancer survivors who participated in the 12-month interdisciplinary program in primary care. An equally composed group of sixteen survivors who declined participation were recruited as controls to gauge preliminary effectiveness. Attendance and attrition rates were carefully monitored to assess feasibility and acceptance, as these metrics are critical for evaluating real-world applicability. Participants underwent thorough assessments at baseline and after 12 months, employing validated instruments like the EORTC QOL-C30 to evaluate global health status, functional domains, and symptom burden, alongside measures for fatigue, psychological distress, happiness, and work ability.
One of the most striking findings emerged from analysis of quality-of-life measures. Despite starting with significantly lower baseline scores than controls, individuals in the intervention group exhibited substantial improvements in physical and social functioning by the end of the study period. This suggests that the multidomain approach not only arrests decline but may actively restore function and wellbeing in areas long compromised by cancer and its treatment. These gains in physical and social domains are particularly salient as they directly contribute to survivors’ capacity to engage in daily activities, maintain relationships, and reintegrate into work and community life.
Fatigue and anxiety, two of the most pervasive and debilitating symptoms reported by cancer survivors, also showed notable reductions in the intervention cohort. Fatigue in cancer survivors is widely acknowledged as a complex, multifactorial condition with physical, psychological, and behavioral components. By incorporating exercise, mind-body therapy, and sleep hygiene strategies, TOP addresses fatigue from multiple angles, presumably mitigating its impact more effectively than monodimensional treatments. Similarly, the decrease in anxiety levels highlights the potential psychological benefits of integrated aftercare programs rooted in primary care, where continuous and trusted relationships with family doctors can enhance therapeutic alliances and adherence.
The pilot study also provides valuable insights into the practical delivery of such programs. Dropout was low, with only three participants leaving due to personal or health-related challenges. Attendance rates were satisfactory, indicating strong acceptance among participants despite the program’s comprehensive and demanding nature. Satisfaction scores further corroborated the program’s feasibility, suggesting that patients appreciate a holistic approach addressing their unique constellation of needs rather than fragmented or disease-centric care. These operational successes underpin the rationale for scaling and rigorously testing TOP in larger, randomized controlled trials.
The transdiagnostic nature of TOP allows it to transcend traditional siloed care approaches. Cancer survivors frequently experience overlapping symptoms such as sleep disturbances, mood disorders, cognitive impairments, and physical deconditioning, which do not neatly fit into isolated treatment categories. By targeting these transdiagnostic issues, the program embodies precision medicine principles, tailoring interventions to individual symptom clusters irrespective of cancer types or stages. This inclusivity fosters equity in survivorship care and mitigates disparities stemming from disease-specific resource allocation.
From a mechanistic standpoint, the integration of lifestyle interventions in primary care post-cancer treatment has a solid theoretical basis. Exercise modulates inflammation, enhances cardiovascular fitness, and improves muscle strength, all important in counteracting cancer-related fatigue and functional decline. Mind-body therapies such as meditation and relaxation techniques reduce stress, which is implicated in both psychological symptoms and immune function. Sleep hygiene education addresses a critical yet underserved domain, as sleep disorders exacerbate both fatigue and mood disturbances. Nutritional counseling supports metabolic balance and overall vitality, completing the multifaceted approach necessary for holistic recovery.
Importantly, the study highlights the central role of family doctors as coordinators of survivorship care. Primary care physicians are well-positioned to deliver continuous, personalized, and accessible care, often having longstanding relationships with patients. Their leadership within interdisciplinary teams ensures consistent monitoring, early identification of emerging problems, and seamless referrals to specialized services when needed. This approach not only reduces care fragmentation but also addresses workforce sustainability challenges in oncology by leveraging primary care resources more effectively.
Despite promising outcomes, the authors caution that the small sample size and non-randomized design limit definitive conclusions regarding efficacy. Confounding variables inherent to pilot studies can influence observed effects, necessitating careful interpretation. Nonetheless, these initial results provide compelling pilot data to justify larger scale investigations. Randomized controlled trials comparing TOP with standard care are essential to establish its true impact on quality of life, symptom management, and possibly survival outcomes.
This study’s implications extend beyond oncology to survivorship paradigms in chronic diseases more broadly. The transdiagnostic, multidomain model could inform aftercare for a spectrum of conditions characterized by complex symptom burdens and psychosocial sequelae. Integrating lifestyle medicine principles into primary care-led programs promises a more sustainable and patient-centered approach to long-term health management, emphasizing prevention, rehabilitation, and quality of life enhancement simultaneously.
In conclusion, the Transdiagnostic Oncology Program represents a visionary step towards reimagining survivorship care as a holistic, interdisciplinary endeavor embedded within primary care. Its multidomain lifestyle interventions address the intricate tapestry of physical, psychological, and social challenges facing cancer survivors, marking a crucial advancement in post-treatment medicine. While further research is required to substantiate these preliminary findings, TOP lays an important foundation for improving quality of life where it matters most: in the communities where survivors live, work, and thrive.
Subject of Research: Quality of life improvement in cancer survivors through a primary care-led, multidomain lifestyle intervention program.
Article Title: 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.
Article References:
Booij, S.H., Pieper, A., Wester, C.D. et al. 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. BMC Cancer 25, 1745 (2025). https://doi.org/10.1186/s12885-025-15063-2
Image Credits: Scienmag.com
DOI: 10 November 2025
Keywords: Cancer survivorship, quality of life, transdiagnostic intervention, multidomain lifestyle program, primary care, fatigue management, psychological symptoms, exercise therapy, mind-body therapy, sleep hygiene, nutrition, interdisciplinary care, feasibility, pilot study
