Background: Cancer and its treatment are frequently associated with significant psychological distress. Radiotherapy, despite being an essential modality in cancer management, exposes patients to prolonged treatment duration, physical side effects, and emotional stress, predisposing them to anxiety and depression. These psychological morbidities often remain underdiagnosed, adversely affecting treatment compliance, quality of life, and overall outcomes. To assess the prevalence and severity of anxiety and depression among patients undergoing radiotherapy using the Hospital Anxiety and Depression Scale (HADS) and to evaluate their association with selected sociodemographic and clinical variables.

Methods: A hospital-based cross-sectional observational study was conducted among 160 adult patients receiving external beam radiotherapy at a tertiary care teaching hospital. Sociodemographic and clinical details were collected using a pre-tested semi-structured questionnaire. Anxiety and depression were assessed using HADS. Data were analyzed using appropriate descriptive and inferential statistics, with p < 0.05 considered statistically significant.

Results: Clinically significant anxiety was observed in 22.5% of patients, while 28.7% had borderline anxiety. Depression was present in 17.5% of patients, with 25.0% showing borderline depressive symptoms. Anxiety and depression were significantly more prevalent among patients with advanced-stage cancer (Stage III–IV) compared to early-stage disease (p < 0.05). Higher psychological distress was also noted among patients receiving concurrent chemotherapy and those in the later phase of radiotherapy.

Conclusion: A substantial proportion of patients undergoing radiotherapy experience anxiety and depression, particularly those with advanced disease. Routine psychological screening using simple tools such as HADS should be integrated into radiotherapy services to enable early identification and timely psychosocial interventions.

KEYWORDS: Anxiety, Depression, Radiotherapy, Cancer, Hospital Anxiety and Depression Scale, Psychological Distress.