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1 November 2017

Online interventions successfully reduce post-cancer fatigue

Severe fatigue is one of the most common complaints after cancer. About 20 to 40 percent of those who have successfully completed cancer treatments struggle with this problem. The ‘Fitter na Kanker (fitter after cancer) study shows that two online interventions are proving to be successful in reducing complaints of severe chronic fatigue.

The aim of the ‘Fitter na Kanker’ study was to investigate if two online interventions would be effective in reducing fatigue. These studies involved an intervention with support from a psychologist and an intervention accompanied by a physical therapist. These interventions were compared to minimal intervention in which people received emailed limited information about fatigue and cancer. The study showed both online interventions to be successful and help to reduce fatigue related to cancer, more so than the minimal intervention.

Chronic fatigue after cancer

There are differences between fatigue after a hard day's work or intensive exercise and fatigue after cancer. Fatigue after cancer can occur suddenly, without any warning and not usually due to physical effort. This fatigue is often experienced as extreme, feels like exhaustion and needs a recovery period that is longer than for 'normal' fatigue. Such fatigue is therefore very restrictive to activities of everyday life such as work and relationships with others. In addition it can also be quite frightening because you don’t actually know when such fatigue will strike, what causes it and if it will ever pass. 

Online interventions

For chronic fatigue after cancer, various treatment approaches have been developed. In general, psychological therapies and programmes that focus on movement offer a promising approach to this type of fatigue. However, when you are feeling very tired, travelling to a healthcare facility is quite a task. It is therefore necessary to search for alternatives of care. “With a growing number of people getting cancer and an increasing life expectancy, there is a great need for effective and accessible treatments aimed at reducing chronic fatigue related to cancer. Online interventions are very promising because treatment can be completely followed at home”, said Fieke Bruggeman-Everts who is one of the researchers.

Fitter after Cancer

The interventions involved in the ‘Fitter na Kanker’ study were developed by the Helen Dowling Institute (HDI) and Roessingh Research and Development (RRD). The HDI intervention, facilitated by a psychologist, focusses on behavioural change and perceptions about stress and fatigue (MBCT). The intervention facilitated by a physiotherapist was developed by RRD and focusses on finding an effective balance in activity and movement. It uses a motion detector and a smartphone to provide online feedback about motion patterns.

Improvement

This research also provided information about how to improve interventions. The HDI collaborated with Karify to provide a new improved version of the existing online intervention. The intervention is available at www.mindermoebijkanker.nl. The KWF (Dutch Cancer Society) wants to assist further research into the motion intervention related to cost-effectiveness and wants to facilitate accessibility. The ‘Fitter na Kanker’ project is funded by the Alpe d'Huzes/KWF-Fund. The study was conducted by Fieke Bruggeman-Everts and Dr Marije Wolvers facilitated by Dr Marije van der Lee (HDI) and Prof. Dr Miriam Vollenbroek-Hutten (University of Twente, Hospital Group (ZiekenhuisGroep) Twente).

For more information about the research study: https://www.jmir.org/2017/10/e336.