title: Light treatment prevents fatigue in women undergoing chemotherapy for breast cancer.
abstract: OBJECTIVE
  Fatigue is one of the most disturbing complaints of cancer patients and is often the reason for discontinuing treatment. This randomized controlled study tested the hypothesis that increased morning bright light, compared to dim light, would result in less fatigue in women with breast cancer undergoing chemotherapy.
  
  
  METHODS
  Thirty-nine women newly diagnosed with stage I-III breast cancer were randomized to either bright white light (BWL) or dim red light (DRL) treatment and were instructed to use the light box for 30 min every morning throughout the first four cycles of chemotherapy. The Multidimensional Fatigue Symptom Inventory was administered prior to the start of chemotherapy (baseline), during the chemotherapy treatment week of cycle 1 (C1TW), the last week (recovery week) of cycle 1 (C1RW), the chemotherapy treatment week of cycle 4 (C4TW), and the last week (recovery week) of cycle 4 (C4RW).
  
  
  RESULTS
  The DRL group reported increased fatigue at C1TW (p = 0.003) and C4TW (p < 0.001) compared to baseline, while there was no significant change from baseline in the BWL group. A secondary analysis showed that the increases in fatigue levels in the DRL group were not mediated through nor associated with changes in sleep or in circadian rhythms as measured with wrist actigraphy.
  
  
  CONCLUSIONS
  The results of this study suggest that morning bright light treatment may prevent overall fatigue from worsening during chemotherapy. Although our hypothesis that overall fatigue would improve with bright light treatment was not supported, the lack of deterioration in total fatigue scores suggests that bright morning light may be a useful intervention during chemotherapy for breast cancer.
authors.affiliation: Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, # 0733, La Jolla, CA 92093-0733, USA. sancoliisrael@ucsd.edu
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Michelle
authors.initials: M
authors.lastname: Rissling
authors.forename: Ariel
authors.initials: A
authors.lastname: Neikrug
authors.forename: Vera
authors.initials: V
authors.lastname: Trofimenko
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Parker
authors.forename: Susan
authors.initials: S
authors.lastname: Lawton
authors.forename: Paul
authors.initials: P
authors.lastname: Desan
authors.forename: Lianqi
authors.initials: L
authors.lastname: Liu
mesh_terms: D056044:Actigraphy; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002940:Circadian Rhythm; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008027:Light; D008875:Middle Aged; D009367:Neoplasm Staging; D010789:Phototherapy / Q000379:methods*; D013997:Time Factors