Prevention of quality-of-life deterioration with light therapy is associated with changes in fatigue in women with breast cancer undergoing chemotherapy

Abstract

Purpose: During chemotherapy, women with breast cancer not only experience poor quality of life (QOL), they also have little exposure to bright light, which has been shown to be associated with depression, fatigue, and poor sleep in other chronic illnesses. This study examined whether increased light exposure would have a positive effect on QOL.

Methods: Thirty-nine women with stage I-III breast cancer scheduled to receive ≥ 4 cycles of chemotherapy were randomized to a bright white light (BWL, n = 23) or dim red light (DRL, n = 16) treatment group. Data were collected before (baseline) and during cycles 1 and 4 of chemotherapy. Light was administered via a light box (Litebook(®), Ltd.). QOL was assessed with the Functional Assessment of Cancer Therapy-Breast (FACT-B) and the Functional Outcomes of Sleep Questionnaire (FOSQ).

Results: Compared with baseline, the DRL group demonstrated significant decline in QOL during the treatment weeks of both cycles (all ps < 0.02), whereas the BWL group had no significant decline (all ps > 0.05). Mixed model analyses revealed that there was a group-by-time interaction for FOSQ at the treatment week of cycle 4, and this interaction was mediated by fatigue.

Conclusion: The data suggest that increased exposure to bright light during chemotherapy may prevent the decline in QOL via preventing the increase in fatigue.

Figures

Figure 1

Consort table of participant recruitment and retention

Figure 2. Total FACT-B scores by group and time

Total FOSQ Scores (mean ± SEM) at Baseline and During Chemotherapy. The error bars are depicted as being one tailed to avoid overlap across measures. There was an overall time effect for the DRL group (p

Figure 3. Total FOSQ scores by group and time

Total FACT-B Scores (mean ± SEM) at Baseline and During Chemotherapy. The error bars are depicted as being one tailed to avoid overlap across measures. There was an overall time effect for the DRL group (p=0.001) but not for the BWL group. Compared to baseline, total FACT-B scores decreased significantly at C1TW and C4TW in the DRL group while no significant changes in the BWL group. Compared to baseline: ** p

Figure 4. Total CES-D scores by group and time

Total CES-D Scores (mean ± SEM) at Baseline and During Chemotherapy. The error bars are depicted as being one tailed to avoid overlap across measures. There was an overall time effect for the DRL group (p=0.005) but not for the BWL group. Compared to baseline, the total CES-D scores decreased significantly at C1TW and at C4TW in the DRL group. Compared to baseline: * p