Treatment of Cancer-related-Fatigue in Acute Hematological Malignancies: Results of a Feasibility Study of using Cognitive Behavioral Therapy 2022

Abstract
Background
Despite cancer related fatigue (CRF) being the most common, and debilitating symptom in patients with recently diagnosed acute hematological malignancies (HM), there are limited effective treatments for CRF in HM. The aim of this study was to determine the feasibility of cognitive behavioral therapy (CBT) for CRF in HM.
Methods
In this preliminary longitudinal prospective study, HM patients diagnosed a median of one month previously with moderate to severe fatigue were enrolled. Patients received CBT in 7 weekly sessions for 8 weeks. Change in Functional Assessment of Cancer Illness Therapy (FACIT) - Fatigue (primary), FACT-G, Pittsburg Sleep Quality Index (PSQI), Hospital Anxiety Depression Scale (HADS), M.D. Anderson Symptom Inventory - Acute Myeloid Leukemia (MDASI-AML/MDS), and Herth Hope Index (HHI) were analyzed.
Results
27 of 36 (75 %) patients were evaluable. Adherence and satisfaction rates to the CBT intervention were 78.6% (95% CI 67.2%, 89.9%), and 92% (95% CI 76.7%, 98.3%) respectively. The median age 66, 64% female, the most common HM was AML (60%), median FACIT-F was 27. The mean (SD) improvement at end 8 weeks for FACIT-F was 5.5(13.6), Cohen δ 0.4, P=0.046; and for PSQI total was 2.9 (3), Cohen δ -1, P=0.006. We also found significant improvement in HADS anxiety -2.7(4.5), P=0.049, MDASI Sleep -1.8(3.0), P=0.022, MDASI mean module symptom severity -0.7(1.6), P=0.006. However, no significant improvements were found in FACT-G, HHI, and HADS-depression scores.
Conclusions
The use of CBT was feasible with improvement of CRF, sleep quality, and anxiety scores in HM. Randomized controlled trials are justified.

paywalled
https://www.jpsmjournal.com/article/S0885-3924(22)00964-2/fulltext

 

I am genuinely confused at the utility of those studies. Under what circumstances could this not be feasible? Most people are willing to do anything to recover their health, this is very close to putting people under duress and making them agree to things they should be scoffing at if it wasn't for the fake legitimacy provided by this pseudoscience being wildly popular in the profession.

Giving people unlimited beers is feasible. So is switching CBT for homeopathy or a clown show. It seems to simply allow biased trials with no controls that can find anything by sheer randomness, as if that's evidence that this is worth pursuing. Then despite BS methodology, they claim improvements? With no controls? What is even this madness? No one in their right mind would make decisions about anything as flimsy as this.

I'm really growing into the idea that market forces are probably necessary in healthcare, giving people choice because clearly the fully top-down expert system is not working as sold. There is a complete mismatch between supply and demand/need. The top-down approach with experts has very diminishing returns and pretty much run its full course already. Instead there is massive oversupply of BS like this with the needs of hundreds of millions completely ignored.

I don't mean a US-style free-for-all system but the ability of people to "vote" with their wallet is seriously missing here. The vast majority of trials and studies in EBM are completely unneeded but the system doesn't have the ability to correct it, doesn't even see the problem. Very few people would actually choose any of this. And frankly if most people end up choosing alternative medicine over medicine then that'd be just about the strongest indictment of how little they manage to deliver, all thanks to the endless obsession with woo.