Cognitive Behavioral Therapy in Breast Cancer Patients - a Feasibility Study of an 8 Week Intervention for Tumor Associated Fatigue Treatment

Background: Tumor associated fatigue (TAF) or cancer related fatigue (CRF) is not a new concept. Nonetheless,no real headway has been made in the quantitative analysis of its successful treatment via cognitive behavioraltherapy. Since 20 to 30% of all breast cancer patients suffer from anxiety and/or depression within the first yearof their diagnosis, this issue needs to be addressed and a standard treatment protocol has to be developed. Thisstudy focused on developing a simple, reproducible and short (8 weeks) protocol for the cognitive behavioraltherapy support of tumor associated fatigue patients. Materials and
Methods: Between the year 2011 and2012, 23 breast cancer patients fulfilled the diagnosis TAF requirements and were introduced into this study.Our method focused on a psycho-oncological support group using a predetermined, highly structured andreproducible, cognitive behavioral therapy treatment manual. Eight weekly, 90 minute sessions were conductedand patients were evaluated before and after this eight session block. Tumor fatigue specific questionnaires suchas the multidimensional fatigue inventory (MFI) as well as the hospital anxiety and depression scale (HADS)were used in order to quantitatively evaluate patient TAF.
Results: Of the 23 patients enrolled in the study, only7 patients fulfilled the TAF diagnostic criteria after the psycho-oncological group treatment. This represents a70% reduction in diagnosable tumor associated fatigue. The HADS analysis showed a 33% reduction in patientanxiety as well as a 57% reduction in patient depression levels. The MFI scores showed a significant reductionin 4 of the 5 evaluate categories. With the exception of the “mental fatigue” MFI category all results werestatistically significant.
Conclusions: This study showed that a highly structured, cognitive behavioral therapygroup intervention will produce significant improvements in breast cancer patient tumor associated fatiguelevels after only 8 weeks.