Affiliation:
1. 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,...
Abstract
Purpose The 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 Methods Patients 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. Results Compared 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. Conclusion CBT 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.
Publisher
American Society of Clinical Oncology (ASCO)
Cited by
167 articles.
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