Feasibility and Acceptability of Light Therapy to Reduce Fatigue in Adolescents and Young Adults Receiving Cancer-Directed Therapy

ABSTRACT

Objective/Background

Fatigue is one of the most consistent and distressing symptoms reported by adolescent/young adult (AYA) oncology patients. Bright white light (BWL) is used to treat fatigue in adult oncology but has not been explored in AYA oncology patients. The purpose of the current study was to determine the feasibility and acceptability of BWL for AYA who were receiving cancer-directed therapy.

Participants

51 AYA patients with newly diagnosed solid tumors, including lymphoma.

Methods

Participants were randomized to dim red light (DRL, n = 25) or BWL (n = 26) from devices retrofitted with adherence monitors for 30 minutes upon awakening daily for 8 weeks. Side effects were assessed via modified Systematic Assessment for Treatment-Emergent Effects (SAFTEE). Participants completed the PedsQL Multidimensional Fatigue Scale.

Results

Of patients approached, 73% consented and participated. Mean adherence was 57% of days on study with 30.68 average daily minutes of usage. BWL did not cause more extreme treatment-emergent effects over DRL. Patients in the BWL group demonstrated significant improvement on all fatigue outcomes by both self-report and parent proxy report, which was not observed in the DRL group.

Conclusions

This is the first study to evaluate the feasibility and acceptability of light therapy to reduce fatigue in AYA patients receiving cancer-directed therapy. These findings demonstrate the feasibility and acceptability of the intervention and provide preliminary evidence of the potential benefits of BWL, which warrants further study in a confirmatory efficacy trial.

ClinicalTrials.gov Identifier Number: NCT02429063

Acknowledgments

The authors acknowledge with sincere gratitude Sonia Ancoli-Israel, PhD, for assistance in the design of the study as well the assistance of Leigh Ann Christy and Jamilla Griffith, MSW, in data collection and Danielle Graef, PhD, Brooklee Tynes, PhD, Kristin Niel, PhD, and Kimberly Klages, MS, in study design and motivational interviewing. We also greatly appreciate the assistance of the physicians and staff within the solid tumor and leukemia/lymphoma services at St. Jude Children’s Research Hospital for their collaboration in this effort. Finally, we thank the patients and families for their participation. This research was funded by a St. Jude Auxiliary Cancer Center Support Grant for National Cancer Institute–designated cancer centers (CA21765) from the National Cancer Institute and by the ALSAC.

Author contributions

All authors have contributed substantially to the work. Drs. Crabtree, Zhang, Wilson, and Pappo contributed to conceptualization. Dr. LaRosa, Ms. MacArthur, and Ms. Brigden contributed to data curation and project administration. Drs. Russell, Pan, and Zhang and Ms. Wang contributed to formal analysis. Drs. Crabtree and LaRosa and Ms. MacArthur and Ms. Schwartz contributed to writing the original draft, and all authors contributed to reviewing and editing the manuscript.

Data sharing

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Disclosure statement

This study was presented in part at the International Society of Pediatric Oncology, Society of Pediatric Psychology, and Sleep 2019 conferences. None of the authors have received or will receive any financial interest or benefit from the work reported in this manuscript and have no competing interests to declare.

Additional information

Funding

This work was supported by the American Lebanese Syrian Associated Charities; Cancer Center Support Grant [CA21765].