Internet-based cognitive behavioral therapy (CBT) can improve quality of life (QOL), psychological distress, anxiety, and depression in patients with cancer and has sustainable effects, according to a study published in Cancer Nursing.

A group of researchers conducted a systematic review and meta-analysis of randomized, controlled trials to learn more about the effect of Internet-based CBT on physical outcomes, psychological outcomes, and daily life outcomes in patients with cancer.

The meta-analysis included data from 3249 participants from 20 studies. Participants were at least 18 years old and using Internet-based interventions as their primary mode of communication, using interventions based on CBT principles (including at least 2 CBT techniques), and had at least 1 personalized patient contact (eg, messaging) during the intervention. The analysis included both self-guided and therapist-guided CBT methods.

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Psychological distress is 4 times more prevalent in patients with cancer than in the general population; however, Internet-based CBT improved distress (P =.03) and was found to have long-term effects. Additionally, Internet-based CBT improved anxiety and depression symptoms in these patients (P <.05), with evidence of a sustained effect.

Similarly, Internet-based CBT also had an impact on postintervention quality of life (standardized mean difference [SMD], 0.34, P <.01). However, the effect disappeared with extended time (SMD, 0.18; P =.14).  

Overall, the researchers found that therapist-directed Internet-based CBT was more effective. In addition, Internet-based CBT was found more effective when the control group in the study was on usual care.

“In terms of intervention duration, interventions of 6 weeks or less were more effective in improving psychological distress, whereas the longer intervention was more effective in improving QOL,” the researchers concluded. “However, because of differences in subject characteristics and components of [Internet-based CBT], more high-quality studies are needed to explore the differences between them further.”


Yu S, Liu Y, Cao M, et al. Effectiveness of Internet-based cognitive behavioral therapy for patients with cancer: a systematic review and meta-analysis of randomized controlled trials. Cancer Nursing. Published online August 8, 2023. doi:10.1097/NCC.0000000000001274

This article originally appeared on Oncology Nurse Advisor