A recent clinical trial has revealed that acceptance and commitment therapy (ACT) delivered over the phone effectively reduces fatigue’s impact on daily functioning and enhances the quality of life for individuals battling metastatic breast cancer. The ACT approach enabled participants to achieve better sleep quality. Fatigue poses a significant hurdle for these survivors, influencing up to 63 percent of them and severely hindering their everyday activities.
With advancements in medicine, over 169,000 individuals in the U.S. are currently living with metastatic breast cancer, making it increasingly vital to address the debilitating symptoms associated with the condition. Fatigue is a primary concern, affecting as many as 63 percent of patients and greatly impairing their daily lives.
A study illustrates the success of telephone-based acceptance and commitment therapy (ACT) in alleviating fatigue’s interference with daily life and boosting the quality of life for those living with metastatic breast cancer. ACT is a behavioral therapy that has shown promise in preliminary studies involving advanced cancer cases. Instead of merely focusing on symptom reduction, ACT aims to enhance psychological flexibility through mindfulness and behavioral change strategies.
The researchers also noted that this remote ACT intervention is feasible and appears effective in lessening the negative effects that sleep disturbances have on the patients’ functioning. Cancer-related fatigue can often worsen due to the physical impacts of inadequate sleep.
“The women I collaborated with in this study frequently mentioned improvements in their sleep quality as they practiced mindfulness techniques at bedtime, which granted them a heightened sense of tranquility in their lives,” explained Shelley Johns, PsyD, a research scientist at Regenstrief Institute and an associate professor of medicine at Indiana University School of Medicine, as well as a clinician-scientist at the IU Melvin and Bren Simon Comprehensive Cancer Center.
“The ACT intervention facilitated a smoother transition into sleep for participants. We believe the enhancement in sleep quality for some participants resulted from their engagement in mindfulness practices that are known to improve sleep outcomes.”
In the course of the clinical trial, 250 survivors of metastatic breast cancer were randomly placed into groups for six weekly sessions of either ACT or education/support. The findings suggest that short remote sessions with a therapist encourage survivors to integrate mindfulness into their daily routines, which in turn decreases fatigue’s negative influence on their functioning.
“Breast cancer is among the most prevalent types of cancer affecting women globally. Effective medications to combat fatigue in advanced cancer are lacking,” stated Catherine Mosher, PhD, an affiliate scientist at Regenstrief Institute and the primary author. “I was interested in acceptance and commitment therapy as a possible behavioral intervention to alleviate the adverse effects of fatigue on functioning because it has demonstrated effectiveness for individuals dealing with chronic pain and various mental health challenges.”
“Mindfulness entails concentrating on the present and accepting one’s symptoms, thoughts, and feelings with compassion,” Dr. Mosher noted, who is also a behavioral scientist in the Department of Psychology at Indiana University Indianapolis School of Science. “Our hypothesis was that this approach would help reduce negative reactions to fatigue, such as overthinking or catastrophizing. Being more attuned to one’s physical state allows individuals to make choices that can improve their quality of life.”
This research contributes to clinical practice by showing that an innovative, telephone-based ACT intervention can mitigate fatigue’s interference with functioning in patients with metastatic breast cancer, while also holding promise for reducing sleep disruptions. ACT training is accessible for clinicians from various backgrounds, and future steps involve testing the intervention across diverse cultural cancer populations and spreading awareness about the program.
