Breast cancer patients receiving radiotherapy showed decreased fatigue as a result of cognitive behavioral therapy plus hypnosis, according to a new study. The results of a randomized controlled trial of 200 patients showed that the treatment group had significantly less fatigue than a control group both during treatment and for up to 6 months afterward.

The study, recently published in the Journal of Clinical Oncology (2014; doi:10.1200/JCO.2013.49.3437), was led by Guy Montgomery, PhD, associate professor and director of the Integrative Behavioral Medicine Program in the Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai in New York, New York.

The average patient in a treatment group had less fatigue than 79% of patients in a control group at the end of radiotherapy. Six months after the end of radiotherapy, the average patient in a treatment group had less fatigue than 95% of patients in a control group.

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Patients were taught the ABC model of cognitive-behavioral therapy: A, activating events; B, beliefs; and C, consequences. They were taught to identify beliefs that were negative and unhelpful and their consequences. They completed a thought worksheet based on the ABC model, and they were taught behavioral strategies such as activity scheduling and distraction to help them manage fatigue.

“These results support cognitive behavioral therapy plus hypnosis as an evidence-based complementary intervention to control fatigue in patients undergoing radiotherapy for breast cancer,” said Montgomery. “Cognitive behavioral therapy plus hypnosis works to reduce fatigue for patients who have few other treatment options. It is also noninvasive, has no adverse side effects, and its beneficial effects persist long after the last intervention.”

In addition, patients also reported that participating in cognitive behavioral therapy plus hypnosis was relaxing and helpful. “This study is important because it shows a new intervention that helps to improve patients’ quality of life during taxing course of breast cancer radiotherapy and for long after,” said Montgomery. The authors of the study suggested that cognitive behavioral therapy plus hypnosis should be further disseminated and implemented.