The LITE study was a novel intervention we tested to tackle the difficult problem of ongoing cancer-related fatigue (CRF). CRF is a chronic condition for many cancer survivors and makes it nearly impossible to return to normal work and social roles due to extreme exhaustion that is not relieved by rest. There are no very good evidence-based treatments for fatigue except physical activity, but not everyone benefits from exercise and many people are unwilling or unable to engage in the amount necessary to realize benefit. We felt that bright white light therapy might be a possible treatment given the potentially similar mechanisms that may maintain CRF as seen in seasonal affective disorder, which responds quite well to light therapy. We chose to compare bright white light (BWL) to dim red light (DRL) as a placebo intervention that was not thought to have the same beneficial effects of BWL, in a two-armed RCT for cancer survivors with diagnosed CRF.
Protocol & Primary Outcomes
This was a PhD project for Dr. Jill Johnson, fully described in the protocol paper:
Johnson, J.A., Garland, S.N., Carlson, L.E., Savard, J., Simpson, S.A., Ancoli-Israel, S., Campell, T.S. (2016). The LITE study: Rationale and protocol for a randomized controlled trial of light therapy for cancer-related fatigue in cancer survivors. Contemporary Clinical Trials 49 (2016) 166–173
In the primary outcomes paper, we found that the BWL therapy did have benefit for improving fatigue levels, as hypothesized:
Johnson, J.A.*, Garland, S.N.*, Carlson, L.E., Savard, J., Simpson, S.A., Ancoli-Israel, S., Campbell, T.S. (2018). Bright light therapy improves symptoms of fatigue in cancer survivors with cancer-related fatigue: A blinded randomized controlled trial. Journal of Cancer Survivorship
Secondary Analysis & Measuring Effects
In a secondary analysis of the effect of the light therapy on sleep measures, we also found that those with severe insomnia and fatigue at the outset benefited more from the light therapy intervention than those without as many sleep difficulties:
Garland S N, Johnson J A, Carlson LE, Rash, J A, Savard J, Campbell T S. (2020) Light therapy for insomnia symptoms in fatigued cancer survivors: a secondary analysis of a randomized controlled trial. Journal of Psychosocial Oncology Research and Practice. e (2020) 2:3(e27) 18 September 2020. http://doi.org/10.1097/OR9.0000000000000027
We also measured the effects of the light therapy on cortisol and cytokines; here we reported the cortisol results showing that both the bright and dim light groups improved on cortisol slopes after the intervention, but cortisol did not mediate the impact on fatigue:
Johnson JA, Subnis U, Carlson LE, Garland SN, Santos-Iglesias P, Piedalue KL, Deleemans JM, Campbell TS. Effects of a light therapy intervention on diurnal salivary cortisol in fatigued cancer survivors: A secondary analysis of a randomized controlled trial. J Psychosom Res. 2020 Dec;139:110266. doi: 10.1016/j.jpsychores.2020.110266. Epub 2020 Oct 6. PMID: 33070045.