Rummans, T.A., Clark, M.M., Sloan, J.A., Frost, M.H., Bostwick, J.M., Atherton, P.J., . . . Hanson, J. (2006). Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: A randomized controlled trial. Journal of Clinical Oncology, 24, 635–642.

Intervention consisted of structured sessions, which began with 20 minutes of conditioning exercises conducted by a physical therapist followed by an educational session with cognitive-behavioral strategies for coping with cancer and open discussion with group leaders and other participants. Sessions were balanced with didactic material, a question and answer period, sharing, reflecting, relaxation, and physical activity. Participants attended eight sessions throughout four weeks following enrollment . Intervention was delivered three days per week. After the fourth week, patients filled out quality of life questionnaires, and questionnaires were collected at 8 and 27 weeks after enrollment via mail.

• N= 103 patients
• MEAN AGE = 59.6 years
• AGE RANGE = 31–85 years (85.7% older than 50 years)
• MALES: 66, FEMALES: 37
• KEY DISEASE CHARACTERISTICS: Dominant disease status most commonly gastrointestinal (36.7%)
• OTHER KEY SAMPLE CHARACTERISTICS: 59.2% undergoing current chemo, 77.6% married, 57.1% currently employed
• INCLUSION CRITERIA: Diagnosed within the past year, an expected survival time of at least six months, and a treatment recommendation of radiation therapy of at least two weeks
• EXCLUSION CRITERIA: Previous radiation therapy, recurrent disease after a disease-free period longer than six months, psychiatric disorders or active suicidality

• LOCATION: Mayo Clinic Rochester

• PHASE OF CARE: Active treatment

• Randomized, stratified, two-group, controlled clinical trial
  • Structured intervention arm (N = 49)
  • Standard medical care arm (N = 54)

• Linear Analogue Self Assessment (LASA)
• Profile of Mood States (POMS)
• Spielberger State-Trait Anxiety Inventory (STAI)
• Symptom Distress Scale (SDS)
• Functional Assessment of Cancer Therapy (FACT)

Mean score for fatigue scale of the LASA was lower at week four for the intervention group in comparison to the standard care group, but this difference was not significant. No significant differences were observed between groups for the SDS and FACT measures of fatigue at week four. Although intervention may have impact on overall quality of life, no significant effects were observed on fatigue.

• Sample was primarily white and from the Midwest; therefore, results may not be generalizeable.
• Cost and availability of multidisciplinary team to deliver intervention may limit its application/implementation in areas that are not large academic health centers.
• Cost was approximately $2,000 per participant for the entire eight-session period. However, costs would be reduced if more individuals participated.