Lifestyle patterns of cancer patients during radiotherapy : a cross-sectional study from Malta

Abstract

Purpose/Objective Lifestyle behaviours such as physical activity, hydration, sleep quality, and other health-related practices can influence treatment tolerance, recovery, and overall quality of life among cancer patients undergoing radiotherapy [1,2]. Maintaining healthy habits during treatment may help patients manage treatment-related side effects and support overall well-being [3]. Despite growing recognition of the role of lifestyle factors in cancer care, limited research has examined the lifestyle behaviours of patients actively receiving radiotherapy, particularly within smaller healthcare systems such as Malta. Assessing these behaviours is important to identify modifiable factors that may influence patient well-being and to guide supportive care strategies during treatment. This study aimed to evaluate the lifestyle behaviours of cancer patients undergoing radiotherapy at the national oncology centre in Malta and identify areas where lifestyle interventions may enhance patient well-being. Material/Methods A prospective cross-sectional quantitative study was conducted among patients receiving external beam radiotherapy at the national oncology hospital in Malta. Lifestyle behaviours were assessed using an adapted 25-item questionnaire covering domains such as physical activity, hydration, sleep patterns, and general health behaviours, scored on a four-point Likert scale [4]. Face validity was assessed by three healthcare professionals (oncologist, general practitioner, nutritionist), yielding a content validity index of 0.86. Reliability testing showed moderate to strong correlations between corresponding items (Spearman’s rho r = 0.39– 1.00; p ≤ 0.05) and acceptable internal consistency (Cronbach’s α = 0.77). Demographic and treatment site data were also collected. Results Thirty participants were included in the study. Participants demonstrated a relatively positive lifestyle profile with a mean lifestyle score of 72/100. Females (n=14) showed slightly higher average lifestyle scores compared with males (n=15). Participants aged over 65 years (n=16) reported marginally higher lifestyle scores than those younger than 65 years (n=14). Patients receiving radiotherapy for head and neck cancers (n=3) recorded the lowest lifestyle score (69.33). Several modifiable behaviours were identified: 43.33% of participants (n=13) reported sleeping only 5–7 hours per night, 73.33% (n=22) did not perform weekly stretching exercises, and 65.52% (n=19) reported drinking less than the recommended two litres of water per day. Conclusion Cancer patients receiving radiotherapy in Malta demonstrated a moderately positive lifestyle profile, although several modifiable behaviours remain suboptimal, particularly regarding hydration, physical activity, and sleep patterns. These findings highlight the importance of assessing lifestyle behaviours during radiotherapy and suggest that integrating lifestyle education and supportive interventions into routine radiotherapy care may promote healthier habits and improve patient well-being.