Evaluating the effectiveness of psychological therapy in prehabilitation pathways for cancer patients

Background: Prehabilitation aims to optimise patients’ physical and psychological readiness for surgery. Evidence for exercise-based prehabilitation is well-established, but evidence on the effectiveness of embedded psychological therapy in cancer prehabilitation remains limited. Aims: To evaluate whether brief, rapid‑response psychological therapy embedded within a multimodal cancer prehabilitation pathway improves mental health and functional outcomes, and to compare outcomes for patients who received specialist psychological support versus those who did not . Methods: This study applied a non‑randomised, prospective cohort comparison design using routine data from two UK NHS multimodal prehabilitation services. Participants were cancer patients using the prehabilitation pathway who reported clinically significant symptoms of anxiety and/or depression. Analysis 1 examined longitudinal change in depression and anxiety in patients referred for specialist psy chological support (n = 135) across baseline, mid‑therapy, and post‑intervention. Analysis 2 compared standardised mean differences in affective and functional outcomes for patients who accessed psychological support (n = 60) with eligible patients who declined (n = 418). Results: In Analysis 1, mean depression scores decreased by 54.1% and anxiety by 39.2%, with recovery rates comparable to and achieved in fewer sessions than national benchmarks for NHS Talking Therapies. In Analysis 2, both groups improved across all measures; standardised mean differences were numerically larger in the supported group for depression, anxiety, and sit‑to‑stand assessments. Conclusions: Initial indications suggest that embedding brief psychological input within prehabilitation is associated with clinically meaningful improvements in both mental health and functional outcomes linked to recovery. F urther research with randomised controlled designs is warranted to confirm causality and inform implementation.