Light Therapy… A Simple Tool to Ease Cancer’s Side Effects

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The Wall Street Journal 4/12/16 By LUCETTE LAGNADO

BN-NJ234_LIGHT0_H_20160401165658

William Redd, a Mount Sinai psychologist, professor of medicine and a lead researcher in the trial. Light therapy “has had a major impact on cancer patients with fatigue and depression,” he says. PHOTO: LUCIA LEE/MOUNT SINAI

In a test, researchers at Mount Sinai try light therapy to help the fatigue and depression that many cancer patients feel.

After Wanda Cwiecek began treatment for multiple myeloma, a cancer of the blood, she had trouble sleeping and felt emotionally drained. She would get home from work so tired she immediately needed to lie down.

Ms. Cwiecek, who received chemotherapy in 2014 and a stem-cell transplant for her cancer, last year took part in one of a series of randomized clinical trials at the Icahn School of Medicine at Mount Sinai to test whether regular exposure to bright white light could reduce the extreme fatigue and feelings of depression that affect many cancer patients.

For 30 minutes every morning over four weeks, Ms. Cwiecek, a 64-year-old paralegal in New York City, sat near a special light box that emitted an intense white light. She would usually have coffee and watch TV news during the sessions. She quickly felt improvements. “Life got easier,” she says. She began to sleep better at night and was less tired during the day. “I felt happier. I had more energy with the light,” she says.

Overall, 54 cancer patients participated in the latest trial—about half were exposed to bright white light and the rest, a control group, were given a dim red light to use. One of the lead researchers, Heiddis Valdimarsdottir, reported preliminary results at the annual meeting of the American Psychosomatic Society in March. Patients exposed to the white light had significant improvements in relieving symptoms of depression, while the control group had no real changes in their condition, says Dr. Valdimarsdottir, an assistant professor of oncological sciences at Mount Sinai who is also with the University of Reykjavik in Iceland.

An earlier study the researchers conducted found light therapy, known as systematic light exposure, also helped patients feel less fatigued.

“We know that cancer patients are light-deprived,” says William Redd, a Mount Sinai psychologist and professor of medicine and another of the lead researchers in the trial. “You feel lousy, you stay at home, you feel even worse.” Light therapy “has had a major impact on cancer patients with fatigue and depression,” he says.

Scientists have long observed that bright light can help treat various conditions, including seasonal affective disorder, or SAD, a type of depression that occurs in winter months in the absence of sunlight, and the effects of jet lag. And an analysis of 20 studies, involving nearly 900 patients, that was published in March in the British Journal of Psychiatry Open found light therapy may be “a helpful additional therapeutic intervention” for classic, year-round depression.

The Mount Sinai research is among the first to look at light therapy in cancer patients.

Not every patient may benefit from light therapy, says Sonia Ancoli-Israel, a professor emeritus at the University of California, San Diego who is working with the Mount Sinai team. It may not treat severe depression, she says, and it won’t necessarily replace medication or traditional therapy. What light therapy does offer is “the potential to improve quality of life in cancer patients,” she says.

Why light seems to give patients a boost isn’t fully understood. Researchers theorize light therapy might help by affecting people’s circadian rhythms, the roughly 24-hour biological cycle that influence sleep patterns, among other things. Cancer patients often have disrupted circadian rhythms, Dr. Valdimarsdottir says. Her research aims to find out if light therapy can normalize those rhythms.

In the earlier study at Mount Sinai, involving 36 cancer patients, Dr. Valdimarsdottir and Dr. Redd found that light therapy reduced cancer-related fatigue, which differs from ordinary tiredness. “Patients feel tired even after resting, have reduced capacity to carry out normal activities, experience slow physical recovery from tasks, and report diminished concentration,” according to the study, which was published in 2014 in the journal Psycho-Oncology.

The latest study, which focuses on signs of depression in cancer patients, like the prior fatigue study, asked participants to fill out questionnaires exploring their levels of fatigue, depressive symptoms and difficulties sleeping. All the patients were found to be suffering from clinical fatigue.

Patients were told to sit every day for half an hour by a special light box provided by Mount Sinai. They could sip coffee, read a book, check their email, so long as they sat still and positioned the lamp at a 45-degree angle, about 18 inches from their face. The box emits a light of 10,000 lux, a measurement of brightness. By comparison, a typical room has light of under 200 lux, while a walk on a sunny day outdoors exposes a person to 10,000 to 50,000 lux or more. Mount Sinai researchers tracked at the end when and for how long they had the light on.

The researchers are now beginning a five-year study of light therapy funded with a $3.4 million grant from the National Cancer Institute. The study, which will involve 200 cancer patients recruited from both Mount Sinai and Memorial Sloan Kettering Cancer Center, will also focus on cancer patients’ fatigue, depression and sleep problems as well as circadian rhythms.

“There is medication, there is cognitive behavior therapy, but this is so simple,” says Katherine DuHamel, the Sloan Kettering psychologist involved in the study.

Sean Merriam, who participated in the Mount Sinai clinical trial, says he felt tired and drained from his treatment for multiple myeloma. His fatigue intensified after he underwent a stem-cell transplant last year.

Mr. Merriam, a 48-year-old video editor in New York City, was skeptical at first that the light therapy could help him. “Logically, how is a light shining in your face going to make a difference?” But it did help, though the changes were subtle and he didn’t realize how much he had improved until the experiment was over. “I felt different when I stopped. It was like, wow, I am tired again,” he says.

Denise George, another participant in the Mount Sinai trial, says she began feeling improvements in her fatigue after about a week of starting the light study. The Brooklyn, N.Y., resident also believes the light therapy helped improve her memory, which had suffered from a decline in cognitive skills that often accompanies chemotherapy.

“I saw a total difference,” Ms. George says. For cancer patients who need a stem-cell transplant, “they should be able to use the light the rest of their lives not only for a couple of weeks.”