Psychological therapies to reduce tiredness in patients with incurable cancer

Poort H, Peters M, Bleijenberg G, Gielissen MFM, Goedendorp M, Jacobsen P, Verhagen S, Knoop H


Patients with incurable cancer often experience tiredness (fatigue) during cancer treatment. Psychological therapies may help to reduce this symptom. Tiredness in cancer patients receiving cancer treatment may be treated with psychological therapies aimed at influencing or changing thoughts, emotions, behaviours, social interactions, or a combination of these (e.g. cognitive-behavioural therapies, supportive-expressive group therapies). This review looked at how effective psychological therapies are in reducing tiredness in patients with incurable cancer receiving cancer treatment.

Study characteristics

In November 2016, we searched for clinical trials looking at psychological therapies in patients with incurable cancer receiving cancer treatment. We found 14 small studies of very low quality reporting data on tiredness outcomes, 12 of which provided data for analyses. A limited number (three studies) reported results about side effects; these studies investigated a psychological therapy combined with medication.

Key findings

Review authors found no support for the effectiveness of psychological therapies in reducing tiredness when assessed directly following the intervention. Very low-quality evidence suggests that psychological therapies may improve physical functioning directly after the intervention and may improve tiredness at first follow-up. Evidence shows no support for the effectiveness of psychosocial therapies in improving other domains of functioning. Limited evaluation of potential harm suggests no differences in side effects between patients receiving psychological therapy and those given usual care. Limited good quality evidence allows no conclusions on the use of psychological therapies in people with incurable cancer. Larger, high-quality trials are needed to find out whether psychological therapies help reduce tiredness for people with incurable cancer during cancer treatment.

Quality of the evidence

We rated the quality of study evidence using four levels: very low, low, moderate, and high. Very low-quality evidence means that we are very uncertain about the results. High-quality evidence means that we are very confident in the results. Included studies had design problems and included a very small number of participants. Therefore, the quality of the evidence in this review is very low, and results of this review should be interpreted with caution.

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