$3.1 million awarded to School of Science professor to battle cancer-induced fatigue

Cancer is the second leading cause of death in the United States and among the top 10 worldwide. The burden of the disease and its treatment is not only physical; it can be just as taxing psychologically, often leaving patients with chronic fatigue.

Catherine Mosher is a psychology professor in the School of Science at IU Indianapolis. Catherine Mosher’s research centers on developing, evaluating and disseminating novel psychosocial approaches to improving symptom management and quality of life for people with cancer, as well as their family caregivers. A psychology professor in the Indiana University School of Science at IU Indianapolis and a faculty research member at the IU Simon Comprehensive Cancer Center, Mosher has spent the past decade researching efficient ways to help patients manage their fatigue, most notably through acceptance and commitment therapy, or ACT for short. Using a five-year, $3.1 million grant from the National Cancer Institute, Mosher will put the method to use once more through a phone-based, multi-city intervention that seeks to help patients with gastrointestinal cancer and their family caregivers.

“Acceptance and commitment therapy aims to break the cycle of symptoms interfering with functioning,” Mosher said. “ACT involves identifying personal values or directions in life and taking a number of action steps to orient the patient with their values. For some patients, being a loving parent could be a value to them, or their spirituality.”

For a healthy individual, fatigue is often regarded as nothing more than a minor hindrance. For a patient with cancer, it can interfere with all aspects of their life, such as activity, mood, and the ability to think and concentrate, so breaking the cycle presents a challenge. In addition to using personal values and action steps, this study also looks toward practicing mindfulness, or focusing attention on the present moment with an attitude of acceptance.

“For patients, mindfulness involves paying attention to their thoughts, feelings and symptoms rather than avoiding or attempting to avoid thinking about their fatigue, or feeling their fatigue,” Mosher said.

Another key focus of the intervention is family caregivers’ health. Caring for someone with advanced cancer is a difficult task, and Mosher’s team wants to address this burden. Caregiver burden is the strain or stress borne by a person who cares for a chronically ill, disabled or elderly family member. This can negatively impact a caregiver’s health, relationships and day-to-day activities.

To target these feelings, Mosher urges caregivers to set small, obtainable health and wellness goals, as well as use mindfulness to process and accept their thoughts and feelings about caregiving.

“What I noticed in my pilot study is that many caregivers set small goals to reengage in activities that they had neglected due to caregiving, like taking walks, for example,” Mosher said. “We think helping caregivers take these small acts to improve their own health will help improve their burden and later quality of life.”

In previous studies, ACT has produced positive findings, with results showing feasibility and promise in improving fatigue and sleep-related outcomes. Ultimately, through her work, Mosher wants to ensure that patients and caregivers alike have the best possible outcome.

“If I can improve patient functioning and quality of life during those final years or months, and also help the caregiver cope more effectively with the illness and their own thoughts and feelings, that’s ultimately the impact I hope to have,” Mosher said.