Abstract
Purpose
Fatigue is one of the most disturbing complaints of cancer patients and is often the reason for discontinuing treatment. This randomized controlled study tested the hypothesis that increased morning bright light, compared to dim light, would result in less fatigue in women with breast cancer undergoing chemotherapy.
Methods
Thirty-nine women newly diagnosed with stage I–III breast cancer were randomized to either bright white light (BWL) or dim red light (DRL) treatment and were instructed to use the light box for 30 min every morning throughout the first four cycles of chemotherapy. The Multidimensional Fatigue Symptom Inventory was administered prior to the start of chemotherapy (baseline), during the chemotherapy treatment week of cycle 1 (C1TW), the last week (recovery week) of cycle 1 (C1RW), the chemotherapy treatment week of cycle 4 (C4TW), and the last week (recovery week) of cycle 4 (C4RW).
Results
The DRL group reported increased fatigue at C1TW (p = 0.003) and C4TW (p < 0.001) compared to baseline, while there was no significant change from baseline in the BWL group. A secondary analysis showed that the increases in fatigue levels in the DRL group were not mediated through nor associated with changes in sleep or in circadian rhythms as measured with wrist actigraphy.
Conclusions
The results of this study suggest that morning bright light treatment may prevent overall fatigue from worsening during chemotherapy. Although our hypothesis that overall fatigue would improve with bright light treatment was not supported, the lack of deterioration in total fatigue scores suggests that bright morning light may be a useful intervention during chemotherapy for breast cancer.
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Acknowledgement
The authors would like to thank Sherella Johnson, Feng He, and Lee Cohen for their help with aspects of the study, the participants who volunteered their time, and Drs. Andrew Hampshire, Peter Reissman, and William Stanton of Internal Medicine Associates, Dr. Sabina Wallach of Scripps/Ximed Medical Group, Hillcrest Internal Medicine, Inc., the Moores UCSD Cancer Center, Oncology Associates of San Diego, Pacific Oncology and Hematology Group, San Diego Pacific Oncology & Hematology Associates for helping in the recruitment by informing their patients about the research protocol.
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This study was supported by the California Breast Cancer Research Program 11 IB-0034, a grant from Litebook, Inc., NCI CA112035, NIH M01 RR00827, P60MD00220, and The Rebecca and John Moores UCSD Cancer Center (NCI P30 CA23100).
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Ancoli-Israel, S., Rissling, M., Neikrug, A. et al. Light treatment prevents fatigue in women undergoing chemotherapy for breast cancer. Support Care Cancer 20, 1211–1219 (2012). https://doi.org/10.1007/s00520-011-1203-z
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DOI: https://doi.org/10.1007/s00520-011-1203-z