Effects of Managing Cancer and Living Meaningfully on Cancer-Related Fatigue and Cytokine Levels in Gastrointestinal Cancer Patients

Objective:To evaluate the effects of managing cancer and living meaningfully (CALM), a psychological intervention with semi-structured interviews, on cancer-related fatigue (CRF), quality of life (QOL), and sleep quality in patients with gastrointestinal (GI) cancer, which may be accompanied by changes in cytokine levels. Methods:A total of 152 GI cancer patients with CRF were enrolled in the study during treatment. Patients were randomly assigned to CALM or usual care (UC) groups. Patients in the CALM group received 12 weeks of CALM plus usual care, and patients in the UC group received usual care plus usual health education. All study participants were evaluated at baseline and at 12 weeks using the Revised Piper Fatigue Scale, the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire-Core 30, and the Pittsburgh Sleep Quality Index scale, while cytokine levels were measured. Results:At 12 weeks, the differences in total CRF, QOL, sleep quality, IL-6, IL-4, and TNF-alpha levels were statistically significant not only in the CALM group compared to patients in the UC group (t = -7.902, t = 2.163, t = -2.187, t = 3.313, t = -4.120, t = -3.853, respectively; P < .05), but also in the CALM group compared to baseline (t = 11.331, t = -5.492, t = 5.450, t = -2.418, t = 2.186, t = 2.699, respectively; P < .05). Additionally, the total CRF at 12 weeks was correlated with IL-4, IL-6, and TNF-alpha levels (r = -.30, r = .31, r = .32, respectively; P < .001). Conclusions:CALM alleviated CRF and improved QOL and sleep quality in patients with GI cancer, and these improvements were accompanied by changes in IL-4, IL-6, and TNF-alpha levels.