Document Detail


Efficacy of Cognitive Behavioral Therapy and Physical Exercise in Alleviating Treatment-Induced Menopausal Symptoms in Patients With Breast Cancer: Results of a Randomized, Controlled, Multicenter Trial.
MedLine Citation:
PMID:  23045575     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSEThe purpose of our study was to evaluate the effect of cognitive behavioral therapy (CBT), physical exercise (PE), and of these two interventions combined (CBT/PE) on menopausal symptoms (primary outcome), body image, sexual functioning, psychological well-being, and health-related quality of life (secondary outcomes) in patients with breast cancer experiencing treatment-induced menopause. PATIENTS AND METHODSPatients with breast cancer reporting treatment-induced menopausal symptoms (N = 422) were randomly assigned to CBT (n = 109), PE (n = 104), CBT/PE (n = 106), or to a waiting list control group (n = 103). Self-report questionnaires were completed at baseline, 12 weeks, and 6 months. Multilevel procedures were used to compare the intervention groups with the control group over time.ResultsCompared with the control group, the intervention groups had a significant decrease in levels of endocrine symptoms (Functional Assessment of Cancer Therapy-Endocrine Symptoms; P < .001; effect size, 0.31-0.52) and urinary symptoms (Bristol Female Lower Urinary Tract Symptoms Questionnaire; P = .002; effect size, 0.29-0.33), and they showed an improvement in physical functioning (36-Item Short Form Health Survey physical functioning subscale; P = .002; effect size, 0.37-0.46). The groups that included CBT also showed a significant decrease in the perceived burden of hot flashes and night sweats (problem rating scale of the Hot Flush Rating Scale; P < .001; effect size, 0.39-0.56) and an increase in sexual activity (Sexual Activity Questionnaire habit subscale; P = .027; effect size, 0.65). Most of these effects were observed at both the 12-week and 6-month follow-ups. CONCLUSIONCBT and PE can have salutary effects on endocrine symptoms and, to a lesser degree, on sexuality and physical functioning of patients with breast cancer experiencing treatment-induced menopause. Future work is needed to improve the design and the planning of these interventions to improve program adherence.
Authors:
Saskia F A Duijts; Marc van Beurden; Hester S A Oldenburg; Myra S Hunter; Jacobien M Kieffer; Martijn M Stuiver; Miranda A Gerritsma; Marian B E Menke-Pluymers; Peter W Plaisier; Herman Rijna; Alexander M F Lopes Cardozo; Gertjan Timmers; Suzan van der Meij; Henk van der Veen; Nina Bijker; Louise M de Widt-Levert; Maud M Geenen; Gijsbert Heuff; Eric J van Dulken; Epie Boven; Neil K Aaronson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-8
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  -     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Kennemer Hospital, Haarlem; Alexander M.F. Lopes Cardozo, Medical Center Alkmaar, Alkmaar; Gert Jan Timmers, Amstelland Hospital, Amstelveen; Suzan van der Meij, Flevo Hospital, Almere; Henk van der Veen, Rode Kruis Hospital, Beverwijk; Louise M. de Widt-Levert, Waterland Hospital, Purmerend; Gijsbert Heuff, Spaarne Hospital, Hoofddorp, the Netherlands; Myra S. Hunter, King's College London, Institute of Psychiatry, London, United Kingdom.
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