Complementary medicine for fatigue and cortisol variability in breast cancer survivors

Abstract

BACKGROUND: Fatigue is a chief complaint in cancer patients, and warrants effective treatment. Biofield therapies are complementary medicine approaches used by cancer populations. There is little information about their efficacy. METHODS: This blinded, randomized controlled trial examined the effects of 4 weeks (eight 1-hour sessions) of biofield healing compared with mock healing and a waitlist control group on fatigue in 76 fatigued breast cancer survivors (stages I-IIIa). Secondary outcomes were diurnal cortisol variability (via estimates of cortisol slope), depression, and quality of life (QOL). Treatment belief was assessed to explore whether belief predicted outcomes. Data were analyzed via hierarchical linear modeling. RESULTS: There were no significant differences between biofield healing and mock healing on belief; 75% thought they received biofield healing. Compared with controls, biofield healing significantly decreased total fatigue (P < .0005, Cohen's d ¼ 1.04), as did mock healing (P ¼ .02, Cohen's d ¼ 0.68), with no significant differences between biofield healing and mock healing. Cortisol slope significantly decreased for biofield healing versus both mock healing and control (P < .04 in both cases; Cohen's d ¼ 0.58). Belief predicted changes in QOL over and above group (P ¼ .004, Cohen's d ¼ 0.84). Belief did not impact fatigue or cortisol variability. CONCLUSIONS: Nonspecific factors are important in responses to biofield interventions for fatigue. Belief predicts QOL responses but not fatigue or cortisol variability. Biofield therapies increase cortisol variability independent of belief and other nonspecific factors. There is a need to further examine the effects of specific processes of biofield healing on outcomes for cancer populations.

Biofield Research: A Roundtable Discussion of Scientific and Methodological Issues

“…Susan has looked at HT on cervical cancer patients, 14 while Shamini has assessed biofield healing on fatigue in cancer survivors. 18 Garret has examined external Qigong and other biofield therapies on human glioblastoma cell cultures, 21 and I have studied cell culture and animal models of TT on osteosarcoma cells. 19,20 It is clearly of major interest to determine whether cancer cells have receptor systems in common for the various biofield treatments.…”

“…Shamini Jain: Our NIH-funded clinical randomized controlled trial focused on persistent cancer-related fatigue, 18 a symptom that affects about a third of the cancer population up to 10 or more years post-treatment. We compared a touch-based biofield healing intervention (energy chelation) to mock healing and wait-list control groups in 76 fatigued breast cancer survivors.…”

Yoga for persistent fatigue in breast cancer survivors

“…To date, only 2 published behavioral intervention trials have specifically targeted cancer survivors with persistent fatigue. 3,4 Other psychological (eg, stress reduction) and activity-based (eg, exercise) interventions have reduced fatigue in cancer populations [5][6][7] ; however, because these trials have not targeted fatigued patients, the feasibility and efficacy of these approaches for treating postcancer fatigue is unclear. Indeed, fatigue is a significant barrier to participation in exercise programs for cancer survivors.…”

The effectiveness of biofield therapies for decreasing symptoms of pain and anxiety, and improving QoL

“…Without such information, mock/sham designs are best viewed as non‐specific controls and do not necessarily represent placebo effects. Results from our recent RCT 2 suggest that treatment belief must be specifically assessed when utilising sham/mock healing designs, as belief itself may predict outcomes over and above group status.…”