Many cancer patients struggle with their conditions by having negative thoughts, behaviors and emotions.

However, when they identify and “talk back” to these unhelpful thoughts through cognitive behavioral therapy, their mental health and quality of life significantly improve, according to a new study.

This therapy—which redirects the patients to think differently about their cancer and the meaning of cancer—is particularly beneficial among young cancer patients. Patients typically deal with depression, anxiety and decreased general wellness due to these psychosocial burdens associated with cancer treatment and its side-late-effects.

Prior research has been done on Cognitive Behavioral Therapy related to specific cancer populations, but a more inclusive investigation is lacking, said Anao Zhang, associate professor of social work at the University of Michigan and the study’s corresponding author.

Zhang and colleagues reviewed 132 clinical trials that involved Cognitive Behavioral Therapy. More than 13,000 people, mostly female (79%) and ranging from ages 4 to 76, participated.

The study showed that age and how the therapy was delivered—in-person vs. virtual—influenced how effective the treatment was for cancer patients.

The therapy was significant for cancer patients and survivors younger than age 40, but researchers failed to find CBT being overall effective for 65 and older when pooling all available research evidence together. This meant there was not enough evidence to claim the effectiveness for this group, Zhang said.

In addition, the older clients’ priorities may also differ from their younger peers, which may contribute to a lower/smaller treatment effect, he said. When it comes to delivery, the findings suggest a therapist or clinician who provides care in person ensures treatment effectiveness compared to a telehealth consultation.

“For patients who choose to receive interpersonal therapy, they expect some level of human-to-human in-person connection, which can be difficult to be replaced by any technological format, for example, having a live human therapist on the other end of Zoom,” Zhang said.

Zhang co-authored the study, which appears in Cancer Medicine, with Alexander Dils, Kathryn O’Keefe, Nada Dakka and Michelle Azar of Central Michigan University College of Medicine, and Meiyan Chen from the University of Texas.