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Are the effects of cognitive behavior therapy for severe fatigue in cancer survivors sustained up to 14 years after therapy?

Discussion in 'Health News and Research unrelated to ME/CFS' started by Dolphin, Apr 17, 2018.

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  1. Dolphin

    Dolphin Senior Member (Voting Rights)

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    Free full text:
    https://link.springer.com/article/10.1007/s11764-018-0690-z

    Some of these researchers are active in the CFS field


    Journal of Cancer Survivorship

    pp 1–9| Cite as

    Are the effects of cognitive behavior therapy for severe fatigue in cancer survivors sustained up to 14 years after therapy?
    • Lidewij D. Van Gessel
    • Harriët J. G. Abrahams
    • Hetty Prinsen
    • Gijs Bleijenberg
    • Marianne Heins
    • Jos Twisk
    • Hanneke W. M. Van Laarhoven
    • Stans C. A. H. H. V. M. Verhagen
    • Marieke F. M. Gielissen
    • Hans Knoop Email author
    • Open Access
    Article
    First Online: 12 April 2018
    Abstract
    Purpose
    Cognitive behavior therapy (CBT) reduces cancer-related fatigue (CRF) in cancer survivors in the short term. We examined fatigue levels up to 14 years after CBT.

    Methods
    Eligible participants of two randomized controlled trials who had completed CBT for CRF and a post-treatment assessment were contacted (n = 81). Fatigue was assessed with the subscale “fatigue severity” of the Checklist Individual Strength (CIS-fatigue). The course of fatigue over time was examined with linear mixed model analyses. Fatigue levels of participants were compared to matched population controls at long-term follow-up. We tested with multiple regression analysis if fatigue at follow-up was predicted by the patients’ fatigue level and fatigue-perpetuating factors directly after CBT (post-CBT).

    Results
    Seventy-eight persons completed a follow-up assessment (response rate = 96%, mean time after CBT = 10 years). The mean level of fatigue increased from 23.7 (SD = 11.1) at post-CBT to 34.4 (SD = 12.4) at follow-up (p < 0.001). Population controls (M = 23,9, SD = 11.4) reported lower fatigue levels than participants. Half of the patients (52%) who were recovered from severe fatigue at post-CBT (CIS-fatigue < 35) were still recovered at long-term follow-up. Patients with lower fatigue levels at post-CBT were less likely to show relapse.

    Conclusion
    Despite initial improvement after CBT, levels of fatigue deteriorated over time. Half of the patients who were recovered from severe fatigue after CBT still scored within normal ranges of fatigue at long-term follow-up.

    Implications for Cancer Survivors
    It should be explored how to help patients with a relapse of severe fatigue following an initially successful CBT. They may profit from CBT again, or another evidence-based intervention for fatigue (like mindfulness or exercise therapy). Future research to gain insight into reasons for relapse is warranted.

    Keywords
    Cognitive-behavioral therapy Cancer-related fatigue Cancer survivors Long-term follow-up
     
  2. John Mac

    John Mac Senior Member (Voting Rights)

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    Or what should we do when the brain-washing wears off.
     
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  3. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    I personally can't understand why anyone would think that CBT should help with fatigue caused by cancer or aggressive treatment. Is this The assumption the fatigue can be behavioured away or is caused by psychological factors? If it is I think it's wrong. It seems a rotten platform for understanding fatigue in illness and we have had the sharp end of it.
    Mindfulness and exercise aren't magic treatments either
     
  4. John Mac

    John Mac Senior Member (Voting Rights)

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    I honestly think that CBT is just a service offered by psychiatrists to doctors allowing them to get rid of patients who they can't help but who keep coming back to them asking for help.
     
  5. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    From the manuscript:

    Notice the language used: "assume" "possible" "perhaps" "could".

    The simplest conclusion is that there is no long term effect of CBT on chronic fatigue, regardless of the underlying cause.
     
    Last edited: Apr 17, 2018
  6. Cheshire

    Cheshire Moderator Staff Member

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    :jawdrop:
    I can imagine the "therapist" explaining a cancer survivor; "you've just been so loosy at coping with a life threatening illness with difficult to bear side effects, you know".
    Of course there are people who cope better than others with cancer, but using the word "insufficient" is just infuriating.
    I am really starting to wonder what the skills to become a psychotherapist are.
     
    Last edited: Apr 17, 2018
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  7. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    Coping with cancer is just a walk in the park these days. Didn't you know? It says right here in my psychotherapist training manual.
     
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  8. Indigophoton

    Indigophoton Senior Member (Voting Rights)

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    So once again they acknowledge that CBT can change perceptions without influencing the underlying biology.
     
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  9. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    It is just bullshit. The model is wrong, it's dangerous to assume anything, how does it haveany place in the science world why is this not seem as the baloney it is. I hadn't read this paper but have read many others on illness CBT claims to treat where medicine can't, ugh.
    At least they recognise that cancer and treatment itself might have caused some somatic processes that CBT doesn't address (YOU DONT SAY :banghead:) but then they relapse into their dysfunctional coping, behaviour and cognitions causing the fatigue .,.,

    Given that I doubt cancer fatigue is anywhere as disabling as CFS, these people are still living semi normal lives , they've got to be really anxious, hyperchondriac, dysfunctional to be causing pervasive life limiting fatigue and I bet they're not.
     
  10. Marco

    Marco Senior Member (Voting Rights)

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    'Lily the Pink' should sue them for intellectual property theft.
     
  11. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    In other words, the answer to the question is 'No'
     
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  12. Amw66

    Amw66 Senior Member (Voting Rights)

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    I have nit read the paper so this may be bullshit, but if these people still had cancer why would they not be fatigued.

    Cancer highjacks metabolic processes ( there are striking similarities to glucose mechanisms with some pwme) , immune processes etc - if these do not return fully to normal ( are there any studies on this?), then why would fatigue itself change- you can only kid yourself on about how you perceive it for so long...

    Most people i know who have had cancer have seen it return elsewhere at a later date.
     
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  13. Lidia

    Lidia Senior Member (Voting Rights)

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    Interesting use of the word “profit” in the Implications section. “Benefit” would be more appropriate. Freudian slip?
     
  14. alktipping

    alktipping Senior Member (Voting Rights)

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    where is the proof that cbt addresses the fatigue self report forms are not proof.
     
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  15. Sean

    Sean Senior Member (Voting Rights)

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    An old propaganda trick, found in many of their CFS/ME papers.

    Another trick to watch out for is the language of certainty/risk, etc, changing throughout a paper.
     
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  16. Esther12

    Esther12 Senior Member (Voting Rights)

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    These researchers also released a paper showing null results for actimeters with CBT for CRF, and I remember their justifications for that being pretty funny.
     

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