Acceptance and commitment therapy (ACT) significantly decreased fatigue interference and improved quality of life in patients with metastatic breast cancer six months after treatment, according to recent findings published in the Journal of Clinical Oncology.
Fatigue is a common and often disabling symptom for patients with metastatic breast cancer, which currently impacts an estimated 168,000 women in the United States, according to the National Breast Cancer Foundation. Effective treatments for cancer-related fatigue, which can be detrimental to patients’ quality of life, are urgently needed.
“Fatigue is one of the most common and bothersome symptoms in people with cancer, and yet we have very few evidence-based treatments for it. Nearly two-thirds of people with metastatic breast cancer are affected by fatigue, which can erode quality of life and interfere with mood, cognition, and ability to participate in important activities,” said Elizabeth Addington, PhD, assistant professor of Medical Social Sciences in the Division of Intervention Science, who was a co-author of the study.
In the current study, women with stage IV breast cancer who had moderate to severe fatigue were randomly assigned to have six weekly telephone-delivered sessions of either ACT on fatigue interference, a mindfulness-based psychotherapy approach to help patients better accept their symptoms of chronic cancer-related fatigue and maintain engagement in personally meaningful activities, or standard education and support. Follow-up assessments occurred at two weeks, three months, and six months.
Overall, patients who received ACT demonstrated a decrease in fatigue interference and improved functional quality of life after two weeks and six months compared to patients who received standard care. ACT patients also demonstrated a steady decline in sleep interference, which was not observed in education and support patients, according to the findings.
“By offering treatment over the phone, we were able to increase accessibility,” Addington said. “For example, fatigue itself can be a barrier to treatment, and for many people with cancer, having to attend additional in-person appointments, beyond those that are medically necessary, can be burdensome. Moreover, telephone-delivered therapy reaches people without reliable internet access, such as those living in rural areas.”
Addington said her team is now examining whether ACT can improve fatigue and quality of life in patients with other types of advanced cancer, such as gastrointestinal cancers.
“As the evidence base grows, we will work towards ensuring that this treatment is incorporated into clinical guidelines and practice,” Addington said.
This work was supported by the National Cancer Institute grant R01CA230542.
