A cancer diagnosis brings fear, exhaustion and worry about the future, and many patients struggle with their emotions long after treatment begins. Psychological support is not always easy to find, so it matters which kinds actually work. A new review of trials suggests that cognitive behavioural therapy can ease distress and fatigue in adults with cancer, and improve their quality of life.
Researchers at Nanfang Hospital and the School of Nursing at Southern Medical University in Guangzhou combined the results of randomised trials in a systematic review and meta-analysis. The findings appear in BMC Psychology. The team searched five major databases from their start to January 2026.
Thirteen trials with 1,193 adult patients met the criteria. Each tested cognitive behavioural therapy, or a treatment built on it, against a comparison group. Two of the trials had three arms, so they were split into separate comparisons, which gave 15 comparisons for the main analysis on distress.
Cognitive behavioural therapy is a structured talking treatment that helps people spot unhelpful thoughts and change how they respond to them. Psychological distress covers anxiety, low mood and general emotional strain. Fear of cancer recurrence is the persistent worry that the disease will return.
Therapy reduced psychological distress by a moderate amount, and the result was statistically significant. It also reduced fatigue and fear of recurrence, though by smaller amounts. Quality of life improved by a moderate amount as well.
The reviewers also looked at how the therapy was delivered. Group sessions appeared to bring bigger benefits for distress than individual sessions. Online therapy and face-to-face therapy did not differ significantly, which is encouraging for patients who cannot easily travel to a clinic.
The review rated the risk of bias in each trial with a standard tool and graded the certainty of the evidence. Only randomised trials were included, which gives the fairest comparison between treated and untreated patients. The review followed international reporting guidance for systematic reviews, and the combined analysis was run in standard review software.
The study has clear limits. Thirteen trials is a modest number for a field this broad, and the comparisons of group and individual therapy, and of online and face-to-face delivery, are subgroup results that are less reliable than the main finding. The review cannot say how long the benefits last, and the authors call for further high-quality trials with long-term follow-up.
Earlier reviews have found that psychological therapies help cancer patients cope, and cognitive behavioural therapy is already offered in many cancer services. This review adds support for the approach across several outcomes at once, covering distress, tiredness, worry about recurrence and day-to-day quality of life. It also suggests that online and group formats are worth considering when services are stretched, and when patients live far from a hospital.
