Ancoli-Israel, S., Rissling, M., Neikrug, A., Trofimenko, V., Natarajan, L., Parker, B. A., . . . Liu, L. (2012). Light treatment prevents fatigue in women undergoing chemotherapy for breast cancer. Supportive Care in Cancer, 20, 1211–1219.

To test the hypothesis that increased exposure to morning bright light would result in less fatigue during chemotherapy.

Women were randomly assigned to bright white light or dim red light groups. Light was administered via a light box. Sixty LED lights were used (red LEDs for the dim light groups and lights with a distribution of energy concentrated in the middle and long wavelengths for the bright light group). The light box was placed on a table or countertop at a distance of about 18 inches and was to be used for 30 minutes every morning on awakening. The boxes were modified to include an integrated meter that recorded the duration of light box use each day. Study measures were obtained at baseline, during cycle 1 treatments, the last week of cycle 1, a treatment week of cycle 4, and the last week of cycle 4.

• The study included 39 women, primarily Cacausian, with a mean age of  53.92 years (range 32–70).
• All patients were newly diagnosed with breast cancer who were set to receive four cycles of chemotherapy containing araC.

Patient homes in California

Patients were undergoing the active antitumor treatment phase of care.

The study was a repeated-measures, randomized, controlled trial.

• Wrist actigraphy
• Multidimensional Fatigue Symptom Inventory–Short Form (MFSI-SF)

No significant changes were observed in fatigue scores for women in the bright light group. Those in the dim light group showed an average increase in fatigue of 11.7 points (p = 0.003) to the last week in cycle 1, and a 22.2-point increase (p < 0.001) by the last week of cycle 4. Scores on the emotional fatigue subscale showed improvement in the bright light group compared to baseline over all study time points, with significant differences shown at the end of cycle 1 (p = 0.006). All other subscales showed increased fatigue in both groups over time. No relationship existed between fatigue scores and actigraphy results. Patients adhered to light box use for an average of 48.7% of the days in the study, with no difference in compliance between groups.

Findings suggested that light therapy may be of some benefit to prevent worsening of fatigue during chemotherapy treatment.

• The study had a small sample size, with less than 100 patients.
• The study had a risk of bias due to no blinding.
• Unintended interventions or applicable interventions not described could influence the results.
• Patient withdrawals were 10% or greater.
• No other interventions that could have influenced fatigue were described or mentioned.

Light therapy may be helpful to patients in reducing fatigue during chemotherapy, particularly in the area of emotional fatigue. This is a low-risk intervention that might be useful. Patients could increase light exposure by spending more time outdoors or by using a light box.