TOPLINE:

Music therapy delivered via telehealth demonstrates noninferiority to cognitive behavioral therapy (CBT) for anxiety reduction in cancer survivors, with both treatments producing clinically meaningful improvements lasting up to 26 weeks. Among 300 study participants, both interventions achieved response rates exceeding 67% at final follow-up.

METHODOLOGY:

• Anxiety affects nearly half of all cancer survivors and is associated with worse fatigue, increased healthcare costs, and negative quality-of-life outcomes. CBT is recommended as first-line treatment by American Society of Clinical Oncology guidelines, but access barriers and stigma limit its effectiveness. Music therapy may have shown effectiveness for short-term anxiety reduction.
• Overall, 300 English- or Spanish-speaking cancer survivors were randomly assigned to receive seven weekly telehealth sessions of either music therapy or CBT.
• Participants were required to have elevated anxiety symptoms, defined as scoring ≥ 8 on the Hospital Anxiety and Depression Scale (HADS) anxiety subscale, and to have completed active cancer treatment.
• Primary endpoints were changes in the HADS anxiety score at weeks 8 and 26, with a noninferiority margin of 0.35 SDs, informed by a minimal clinically important difference of 1.7 points.
• Secondary outcomes included measures of fatigue, depression, insomnia, pain, cognitive dysfunction, and health-related quality of life.

TAKEAWAY:

• At week 8, mean changes were -3.12 (95% CI, -3.59 to -2.65) for music therapy and -2.97 (95% CI, -3.45 to -2.50) for CBT, with a between-group difference of -0.15 (95% CI, -0.78 to 0.49; P for noninferiority < .001).
• At week 26, mean changes were -3.31 (95% CI, -3.78 to -2.85) for music therapy and -3.00 (95% CI, -3.47 to -2.53) for CBT, with a between-group difference of -0.31 (95% CI, -0.95 to 0.32; P for noninferiority < .001).
• Treatment response rates were comparable between music therapy and CBT at week 8 (73.5% vs 71.5%, P = .7) and week 26 (72.6% vs 67.4%, P = .4).
• According to the researchers, music therapy showed consistent effectiveness across years since diagnosis and education levels, whereas CBT was less effective with increasing time since diagnosis and more effective among those with graduate degrees.

IN PRACTICE:

“Music therapy delivered via telehealth by board-certified music therapists may be considered in place of telehealth-delivered CBT as a treatment option for anxiety symptoms in survivors of cancer,” the authors of the study wrote.

SOURCE:

The study was led by Kevin T. Liou, MD, Memorial Sloan Kettering Cancer Center in New York City, and Jun J. Mao, MD, MSCE. It was published online on January 6 in Journal of Clinical Oncology.

LIMITATIONS:

The study population was predominantly female and highly educated, and comprised largely of breast cancer survivors, which affects generalizability. The telehealth format may limit accessibility for those with poor digital access or literacy. CBT showed slightly higher attrition and lower adherence than music therapy, potentially due to treatment preferences. The researchers also noted that the study lacked a usual care control group.

DISCLOSURES:

This study was supported by a Patient-Centered Outcomes Research Institute Program Award, a National Institutes of Health/National Cancer Institute Cancer Center Support Grant to the Memorial Sloan Kettering Cancer Center, and the Laurance S. Rockefeller Fund. Mao received research funding from Tibet Cheezheng Tibetan Medicine Co., EyePoint Pharmaceuticals, and Kyverna Therapeutics. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.