By: Lidia Schapira, MD
Efficacy of Internet-Based Cognitive Behavioral Therapy for Treatment-Induced Menopausal Symptoms in Breast Cancer Survivors: Results of a Randomized Controlled Trial
Adjuvant endocrine therapy for breast cancer, through treatment-induced profound estrogen deprivation, leads to hot flashes (HF) and night sweats (NS). These symptoms affect women’s daily functioning and health-related quality of life and, if severe, may lead to early discontinuation of endocrine therapy.
Prior studies have demonstrated that cognitive-behavioral therapy (CBT) interventions decrease the impact of these symptoms among breast cancer survivors.
Internet-based CBT (iCBT) presents a more accessible and flexible alternative to face-to-face sessions. The investigators hypothesized that it could lead to higher participation rates and better compliance.
In this study, 254 breast cancer survivors in academic and community settings in the Netherlands were enrolled and randomly assigned to a therapist-guided or a self-managed iCBT group or to a waiting list control group. Patients were < 50 years at diagnosis and had undergone chemotherapy and/or oophorectomy and/or endocrine therapy, and had self-reported problematic HF/NS. The 6-week iCBT program included psychoeducation, behavior monitoring, and cognitive restructuring. Questionnaires were administered at baseline and at 10 weeks and 24 weeks post-randomization.
Compared with the control group, the guided and self-managed iCBT groups reported a statistically significant decrease in the perceived impact of HF/NS, as well as improved sleep quality. The guided group also reported significant improvement in overall levels of menopausal symptoms and NS frequency. At 24 weeks the effects remained significant.
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