Abstract
BackgroundCancer related fatigue (CRF) is one of the most prevalent and distressing long-term complaints reported by (non-) Hodgkin survivors. To date there has been no standard treatment for CRF in this population. A novel and promising approach to treat CRF is exposure to bright white light therapy. Yet, large scale randomized controlled trials testing its efficacy in these patients and research on potential mechanisms is lacking. The objective of the current study is to investigate the efficacy of light therapy as a treatment for CRF and to explore potential mechanisms.Methods/designIn a multicenter, randomized controlled trial we are evaluating the efficacy of two intensities of light therapy in reducing CRF complaints and restrictions caused by CRF in survivors of Hodgkin lymphoma or diffuse large B-cell lymphoma. Secondary outcomes include sleep quality, depression, anxiety, quality of life, cognitive complaints, cancer worries, fatigue catastrophizing, self-efficacy to handle fatigue, biological circadian rhythms of melatonin, cortisol and activity, and biomarkers of inflammation. We will recruit 128 survivors, with fatigue complaints, from academic and general hospitals. Survivors are randomized to either an intervention (exposure to bright white light) or a comparison group (exposure to dim white light). The longitudinal design includes four measurement points at baseline (T0), post-intervention at 3.5 weeks (T1), 3 months post-intervention (T2) and 9 months post-intervention (T3). Each measurement point includes self-reported questionnaires and actigraphy (10 days). T0 and T1 measurements also include collection of blood and saliva samples.DiscussionLight therapy has the potential to be an effective treatment for CRF in cancer survivors. This study will provide insights on its efficacy and potential mechanisms. If proven to be effective, light therapy will provide an easy to deliver, low-cost and low-burden intervention, introducing a new era in the treatment of CRF.Trial registrationThe study is registered at ClinicalTrials.gov on August 8th 2017(NCT03242902).
Highlights
Cancer related fatigue (CRF) is one of the most prevalent and distressing long-term complaints reported by Hodgkin survivors
Light therapy has the potential to be an effective treatment for CRF in cancer survivors
Results showed that fatigue decreased to normal levels in survivors exposed to bright white light (BWL) (n = 18) while survivors exposed to dim red light (DRL) (n = 18) stayed at clinically significant levels of fatigue. These results showed a significant decrease in depressive symptoms and better sleep quality in survivors exposed to BWL compared to DRL
Summary
Cancer related fatigue (CRF) is one of the most prevalent and distressing long-term complaints reported by (non-) Hodgkin survivors. The objective of the current study is to investigate the efficacy of light therapy as a treatment for CRF and to explore potential mechanisms. Treatment of lymphoma is associated with various late adverse effects, including cancer related fatigue (CRF) [3]. CRF is defined as “a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer and/or cancer treatment that is not proportional to recent activity and interferes with usual functioning” [4, 5]. CRF is one of the most frequently reported long-term symptoms in (non-) Hodgkin survivors with prevalence ratings between 25 to 60% compared to 10 to 25% in the general population [7, 8]. CRF significantly affects patients’ quality of life [5] and seems to be influenced by symptoms of depression, anxiety, and the presence of comorbid conditions [8]
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