Randomized Controlled Trial of a Cognitive-Behavioral Therapy Plus Hypnosis Intervention to Control Fatigue in Patients Undergoing Radiotherapy for Breast Cancer

Abstract

Purpose The objective of this study was to test the efficacy of cognitive-behavioral therapy plus hypnosis (CBTH) to control fatigue in patients with breast cancer undergoing radiotherapy. We hypothesized that patients in the CBTH group receiving radiotherapy would have lower levels of fatigue than patients in an attention control group. Patients and Methods Patients (n = 200) were randomly assigned to either the CBTH (n = 100; mean age, 55.59 years) or attention control (n = 100; mean age, 55.97 years) group. Fatigue was measured at four time points (baseline, end of radiotherapy, 4 weeks, and 6 months after radiotherapy). Fatigue was measured using the Functional Assessment of Chronic Illness Therapy (FACIT) –Fatigue subscale and Visual Analog Scales (VASs; Fatigue and Muscle Weakness). Results The CBTH group had significantly lower levels of fatigue (FACIT) at the end of radiotherapy (z, 6.73; P < .001), 4-week follow-up (z, 6.98; P < .001), and 6-month follow-up (z, 7.99; P < .001) assessments. Fatigue VAS scores were significantly lower in the CBTH group at the end of treatment (z, 5.81; P < .001) and at the 6-month follow-up (z, 4.56; P < .001), but not at the 4-week follow-up (P < .07). Muscle Weakness VAS scores were significantly lower in the CBTH group at the end of treatment (z, 9.30; P < .001) and at the 6-month follow-up (z, 3.10; P < .02), but not at the 4-week follow-up (P < .13). Conclusion The results support CBTH as an evidence-based intervention to control fatigue in patients undergoing radiotherapy for breast cancer. CBTH is noninvasive, has no adverse effects, and its beneficial effects persist long after the last intervention session. CBTH seems to be a candidate for future dissemination and implementation.

The experience of pain severity and pain interference in vulvodynia patients: The role of cognitive-behavioural factors, psychological distress and fatigue

“…Furthermore, given the success of tailored psychological interventions on other chronic conditions (27,28), it is of paramount importance to investigate the contributions of these factors which will help inform the future development of interventions designed to help support women manage their pain.…”

Hypnosis in Breast Cancer Care

“…34,35,38 One of those studies also included women with breast cancer who underwent lumpectomy. 35 Three studies included patients undergoing breast cancer radiotherapy 36,37,39 ; 2 studies included women with metastatic breast cancer 28,40 ; 2 studies included breast cancer survivors experiencing hot flashes 29,33 ; and 1 study included women without a history of breast cancer who experienced hot flashes. 30 Patients' mean age ranged from 46.4 to 58.2 years.…”

“…32 Seven studies used single intervention sessions. [32][33][34][35][36][37][38][39] Six of those studies reported length of the intervention. [34][35][36][37][38][39] Median intervention length was 15 minutes (range = 10-15 minutes).…”

“…Three hundred and thirty-three records were retrieved in literature search, and 16 full-text articles were assessed for eligibility [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] ( Figure 1). Two articles were excluded because they included women undergoing elective breast surgery.…”

Intérêt et utilisation de l’hypnose pour améliorer le bien-être physique et psychologique en oncologie

“…Différentes études réalisées avecd es patientes atteintes d'un cancer du sein ont montré l'efficacité d'une intervention combinant hypnose et thérapie cognitivo-comportementale [79][80][81] et d'une intervention combinant auto-hypnose et techniques d'autobienveillance, consistant à apprendre à prendre soin de soi-même, à s'écouter et se respecter davantage [82], pour diminuer la fatigue des participantes. Différentes interventions basées sur l'hypnose et disponibles sur Internet ont été proposées à des patients ayant terminé leurs traitements contre un cancer (tous diagnostics acceptés) depuis plusieurs années.…”