Systematic Light Exposure for Fatigue in Breast Cancer Patients

Cancer related fatigue (CRF) is a stressful and constant tiredness related to cancer and/or
its treatment. CRF is the most intense during treatment and can severely interfere with
activities of daily living, such as tasks that require physical strength or thinking clearly.
Prevalence of CRF has been reported to be as high as 94% during chemotherapy and as high as
34% five years after completion of treatment (Rotonda et al. 2013; Minton & Stone 2008).
There is currently no generally-accepted treatment for CRF. However, there is evidence to
suggest that light therapy can help with CRF. Non-pharmacological interventions for CRF have
also been studied but are costly to implement and involve significant patient burden,
particularly among those in active treatment. Given the clinical impact of CRF, the goal of
this project is to investigate a novel, low-cost and low-burden intervention for Breast
Cancer patients using a particular kind of light treatment called systematic light exposure
(sLE) to treat CRF. Two hundred forty-eight breast cancer (BC) patients undergoing adjuvant
or neoadjuvant chemotherapy will be recruited from Mount Sinai Medical Center, Memorial Sloan
Kettering Cancer Center, and Hackensack University Medical Center. The light will be
administered by light glasses daily throughout entire duration of chemotherapy. Outcomes will
be assessed at eight timepoints during chemo, and a series of follow up assessments at 1
week, 1-month, 3-months and 6-months post-chemotherapy. This study will have major public
health relevance as it will determine if an easy-to-deliver, inexpensive, and low patient
burden intervention effectively reduces CRF or prevents it from worsening during
chemotherapy. Specific Aims: Aim 1: Determine if sLE prevents CRF from worsening in BC
patients undergoing chemotherapy Aim 2: Determine whether sLE affects sleep, depression and
circadian activity rhythms. Exploratory Aim 3: Investigate sLE normalizes circadian cortisol
rhythms. Exploratory Aim 4: Examine whether the effects of sLE on fatigue are
moderated/mediated by sleep quality, depression, and/or circadian rhythms.