457: A Digital?Mindset?Intervention for Young Cancer Survivors With and Without Chronic Pain.

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic cancer related pain, Psychology, Digital Health Technologies , Pain in special populations (e.g. neonates, children, teens, elderly, neurodegenerative diseases)

Background and Aims: Pain, impaired functioning, and reduced quality of life are common consequences of cancer and its treatment. Among adolescent and young adult cancer survivors, pain is both prevalent and persistent, affecting up to 44% of young survivors and often continuing years beyond treatment. Despite this, post-cancer pain is under-recognised and under-treated, especially in youth populations. This study aimed to evaluate the efficacy of EMBody (Exploring Mindsets about the Body), a novel digital mindset intervention co-designed with young cancer survivors, cancer clinicians, and documentary filmmakers to foster adaptive mindsets about the body and cancer and thereby improve health related quality of life (HRQoL) in young cancer survivors.

Methods: A pre-registered [NCT06702371], multisite UK randomised controlled trial (RCT) evaluated the EMBody intervention. Adolescents and young adults aged 16-25, who completed cancer treatment up to seven years previously, were recruited from four NHS sites and UK cancer charities (December 2024-September 2025). A total of 105 young cancer survivors were randomised 1:1 to receive EMBody (n=51) or to a waitlist control (n=54). Participants allocated to the EMBody intervention completed the 6-week programme comprising seven (5-12 minute), short documentary-style films with guided reflection exercises, integrating insights from mindset researchers, clinicians, and lived experience narratives using a digital storytelling approach. The primary outcome was HRQoL at 10 weeks (T4). Secondary outcomes included mindsets, fear of cancer recurrence, mental and physical health symptoms, and physical activity. Analyses followed a pre-registered Statistical Analysis Plan (OSF), using intention-to-treat principals and linear mixed-effects models, conducted by a blinded statistician.

Results: At baseline, 40% of participants reported chronic pain, including 18% reporting high-impact chronic pain, aligning with prevalence estimates of post-cancer pain. Compared to waitlist control, the intervention group reported significantly better HRQoL at T4 (Mdiff=5.15, 95% CI 9.71–.59; p=.027) with a small effect size (g=.27) sustained at 18 weeks (T5) (g=.26). Participants in the intervention group also showed significant small-to-moderate improvements at T4 in adaptive body mindsets (g=.50) and illness domains including catastrophe (g=.55), manageable (g=.38), and opportunity mindsets (g=.24), as well as fear of cancer recurrence (g=.35), with effects sustained at T5 (mindsets g=.22-.65; fear of cancer recurrence g=.41). No significant group difference was observed in pain scores (T4) (g=.03), however exploratory analyses are ongoing and treatment effect by pain status will be reported. Semi-structured qualitative interviews with 22 intervention-group participants, suggest the value of mindsets in helping young people cope with and manage post-cancer pain.

Conclusions: In conclusion, a brief, highly scalable digital intervention was effective in fostering adaptive body and illness mindsets and improving overall HRQoL and fear of cancer recurrence in young cancer survivors. Future research could include adaptations of mindset interventions for cancer survivors living with high-impact chronic pain, as well as non-cancer chronic pain conditions, in which holding adaptive mindsets about the body can be particularly helpful for wellbeing and functioning.

References: n/a

Presenting Author: Emily Todd
Submitting Author: Emily Todd

Senior Author: Dr Lauren Heathcote

IASP 2026 Global Year theme of Neuropathic Pain: No

• Abigail Smakowski - King’s College London, United Kingdom
• Anika Petrella - King’s College London, United Kingdom
• Claudia Knowles - King’s College London, United Kingdom
• Alia Crum - Stanford University, United States
• Emily Dowling - King’s College London, United Kingdom
• Lisa-Marie Mcmonagle - University College London NHS Foundation Trust, United Kingdom
• Joanna Grout - University Hospital Southampton NHS Foundation Trust, United Kingdom
• Elise Longworth - Oxford University Hospitals NHS Foundation Trust, United Kingdom
• Amy Mitchell - Oxford University Hospitals NHS Foundation Trust, United Kingdom
• Sam Norton - King’s College London, United Kingdom
• Matthew Brown - The Royal Marsden Hospital and Institute of Cancer Research, United Kingdom
• Lauren Heathcote - King’s College London, United Kingdom