'Quality-of-life' therapy improves health during cancer treatment

Therapy to ease stress, fatigue, and other quality-of-life issues significantly improves patients' sense of well-being during cancer treatment, according to new research from a randomized trial. Patients who kept to their standard routines showed a decline in quality-of-life measures.

Specialists created a six-session program to address cognitive, physical, emotional, social, and spiritual well-being. Each session included physical therapy exercises to improve fatigue, discussions of topics such as developing coping strategies or addressing spiritual concerns, and deep breathing or guided imagery to reduce stress.

For people with cancer, fighting the disease understandably takes highest priority. But other factors—including stress, fatigue, pain, and spiritual uncertainty—can severely diminish patients' quality of life during and after treatment, said the study's lead author, psychologist Matthew M. Clark, PhD, of the Mayo Clinic Department of Psychiatry and Psychology in Rochester, Minnesota. Many studies have tested strategies to improve patients' experience, but most approaches have focused on only one quality-of-life issue at a time and typically after cancer treatment, he explained.

In the randomized trial, researchers studied a group of 113 patients with advanced cancer; 63% were male, mostly in their late 50s. All were receiving radiation therapy at the Mayo Clinic Cancer Center. Family members caring for cancer patients also often experience a lower quality of life, and the study included them. While half of participants stayed with their usual psychosocial routine during treatment (for instance, seeing their own therapists, counselors, or clergy), the other half attended the formal, 90-minute program 3 days a week.

“Much of the success may be that the program is active and engaged, and patients participated in the sessions as part of a group. They received support and encouragement to go home and practice things like physical activity, spirituality, and relaxation,” Clark said. These findings were published in Cancer (2013; 119[4]:880-887).

While the study showed that the intervention can improve quality of life for cancer patients, Clark said there were two surprising results. First, researchers found the program did not improve quality of life for caregivers during the treatment time period.

“We were hoping the program would also help caregivers who tend to experience significant emotional and physical fatigue,” he said. “We still have to find ways to help them.”

Second, in a follow-up questionnaire conducted 6 months after treatment, the patients who took part in the program showed a lack of improvement in quality-of-life measures over time.

“The intervention is helpful at a critical time, but doesn't have a lasting continuous enhancing effect,” Clark says. “Our hope is to develop strategies to help people maintain and then improve their quality of life throughout survivorship.”

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