PURPOSE: Persistent fatigue is a long-term adverse effect experienced by 30% to 
40% of patients cured of cancer. The main objective of this randomized 
controlled trial was to show the effectiveness of cognitive behavior therapy 
(CBT) especially designed for fatigue in cancer survivors.
PATIENTS AND METHODS: A total of 112 cancer survivors with somatically 
unexplained fatigue were allocated randomly to immediate cognitive behavior 
therapy or to a waiting list condition for therapy. Both conditions were 
assessed two times, at baseline and 6 months later. The primary outcome 
variables were fatigue severity (Checklist Individual Strength) and functional 
impairment (Sickness Impact Profile). Data were analyzed by intention to treat.
RESULTS: Analyses were based on 50 patients in the intervention condition and 48 
patients in the waiting list condition. Patients in the intervention condition 
reported a significantly greater decrease than patients in the waiting list 
condition in fatigue severity (difference, 13.3; 95% CI, 8.6 to 18.1) and in 
functional impairment (difference, 383.2; 95% CI, 197.1 to 569.2). Clinically 
significant improvement for the CBT group compared with the waiting list group 
was seen in fatigue severity (54% v 4% of the patients, respectively) and in 
functional impairment (50% v 18% of the patients, respectively).
CONCLUSION: Cognitive behavior therapy has a clinically relevant effect in 
reducing fatigue and functional impairments in cancer survivors.