Effects of tandem cognitive behavioral therapy and healthy lifestyle interventions on health-related outcomes in cancer survivors: a systematic review

Abstract

Purpose Healthy lifestyle (HL) behaviors and cognitive behavioral therapy (CBT) have been individually shown to improve adverse effects of cancer treatment. Little is known about how such programs in tandem affect health-related outcomes. This review evaluates extant literature on tandem CBT/HL interventions on health-related outcomes in cancer survivors. Methods A comprehensive search of PubMed, PsychINFO, CINAHL, and Embase databases revealed numerous studies involving CBT and HL tandem interventions in cancer survivors in the last 20 years. Studies meeting the inclusion criteria were examined and assessed by the authors. Results The 36 studies included 5199 participants. Interventions involved the use of CBT in combination with a HL condition (stress reduction, increasing physical activity, etc.). These tandem conditions were compared against no intervention, usual care, and/or CBT alone or HL alone. Interventions were delivered by a variety of interventionists, and over different durations. The most common HL target outcomes were stress, and insomnia. Most studies (31 of 36) reported a reduction in adverse treatment and/or cancer-related effects. Conclusion Findings were biased with the overrepresentation of breast cancer survivors, and underrepresentation of minority groups, and those with advanced cancer. Thus, this review highlights the need for further research to test tandem interventions against CBT alone and HL alone, and toward identifying the most efficacious interventions for dissemination and implementation across diverse groups of cancer survivors. Implications for cancer survivors Tandem CBT/HL interventions can improve health-related outcomes for cancer survivors when compared to usual care, but there is a paucity of knowledge to suggest differential outcomes when compared to CBT or HL alone.

Lifestyle and Pain following Cancer: State-of-the-Art and Future Directions

“…Interestingly, pain is one of the manageable risk factors for distress creating a problematic back loop because distress, in turn, promotes pain by dysregulating the autonomic, endocrine, and immune response [ 44 , 48 ]. This vicious cycle can be interrupted by cognitive behavioural stress management (CBSM) consisting of aspects of cognitive behavioural therapy (CBT) [ 49 , 50 , 51 ] or, more precisely, coping skills for stress management combined with relaxation training [ 45 , 52 , 53 , 54 ]. According to recent published systematic reviews and meta-analyses, CBT has a beneficial effect on cortisol secretion, distress, anxiety, depression, emotional well-being, and negative thoughts in CSs [ 49 , 50 , 51 ].…”

“…This vicious cycle can be interrupted by cognitive behavioural stress management (CBSM) consisting of aspects of cognitive behavioural therapy (CBT) [ 49 , 50 , 51 ] or, more precisely, coping skills for stress management combined with relaxation training [ 45 , 52 , 53 , 54 ]. According to recent published systematic reviews and meta-analyses, CBT has a beneficial effect on cortisol secretion, distress, anxiety, depression, emotional well-being, and negative thoughts in CSs [ 49 , 50 , 51 ]. Mindfulness-based stress reduction (MBSR) and yoga have also shown promising results on distress in CSs ( Figure 2 ) [ 52 , 53 , 54 ].…”

The efficacy of cognitive behavioral therapy for cancer: A scientometric analysis

“…Cancer is one of the world’s most incurable diseases and has the second highest mortality rate after cardiovascular disease ( 1 ). According to statistics of GLOBOCAN 2020, 19.3 million new cancer cases and almost 10 million cancer deaths were indicated in 2020.…”

“…However, this also brings with other aspects of problems. Long-term ongoing cancer treatment can take a huge physical toll and psychological burden on patients ( 1 ). Survivors may face months to years of cancer triggering and/or treatment-related symptoms such as fright of cancer recurrence, fatigue, insomnia, obesity, etc.…”

A randomized controlled trial of WeChat-based cognitive behavioral therapy intervention to improve cancer-related symptoms in gynecological cancer survivors: study protocol

“…Hersch et al showed that CBT reduced psychological pain, anxiety, and depression [ 19 ]. However, current studies on CBT intervention for cancer patients are mainly focused on breast cancer, followed by prostate cancer [ 20 ]. Few studies have been carried out on patients with gynecological malignant tumors.…”