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

• Published in: Quality of life research 2013-08, Vol.22 (6), p.1239-1244
• Main Authors: Jeste, Neelum, Liu, Lianqi, Rissling, Michelle, Trofimenko, Vera, Natarajan, Loki, Parker, Barbara A., Ancoli-Israel, Sonia
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Agents - therapeutic use; Biological rhythms; Breast cancer; Breast Neoplasms - complications; Breast Neoplasms - drug therapy; Breast Neoplasms - psychology; Cancer therapies; Chemotherapy; Clinical psychology; Depression - diagnosis; Depression - psychology; Depressive disorders; Fatigue; Fatigue - etiology; Fatigue - prevention & control; Female; Humans; Light; Light therapy; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Neoplasm Staging; Oncology; Phototherapy; Phototherapy - methods; Phototherapy - psychology; Pilot Projects; Public Health; Quality of Life; Quality of Life Research; Questionnaires; Sleep; Sleep disorders; Sociology; Surveys and Questionnaires; Time Factors; Treatment Outcome; Womens health
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-012-0243-2

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.