Cognitive behavioural therapy for fatigue and distress
Cancer-related fatigue and anxiety respond to structured talking therapy that targets the thoughts and habits that keep them going. Randomised trials show benefits during treatment and, for persistent fatigue, years afterwards; guidelines recommend it.
Overview
Cognitive behavioural therapy adapted to cancer addresses unhelpful beliefs about fatigue, irregular sleep and activity patterns, fear of recurrence and low mood. A randomised trial of 112 severely fatigued disease-free survivors (Gielissen et al., JCO 2006) found that a course of CBT produced clinically significant improvement in fatigue in more than half of patients compared with a quarter on the waiting list, with gains maintained at two years. The 2024 SIO-ASCO fatigue guideline recommends CBT for fatigue during and after treatment and the 2023 SIO-ASCO anxiety and depression guideline recommends it for anxiety and depressive symptoms. Delivery by trained psychologists, nurses or online programmes all have trial support. CBT sits within psycho-oncology alongside distress screening and, where needed, medication.
How it works
Behavioural activation, graded activity and cognitive restructuring interrupt the cycle in which rest, worry and deconditioning perpetuate fatigue and low mood.
- Durable effects at long follow-up
- Recommended in SIO-ASCO 2023 and 2024 guidelines
- Deliverable remotely
- Therapist capacity
- Requires engagement over weeks
- Trials mostly in survivors rather than advanced disease
Latest papers
topQuery for this technology: (TITLE:"Cognitive behavioural therapy for fatigue and distress" OR ABSTRACT:"Cognitive behavioural therapy for fatigue and distress") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Cognitive behavioural therapy for fatigue and distress, not a curated reading list.
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