Placebo pills prescribed honestly help cancer survivors manage symptoms

February 9, 2018 by Alicia Rohan, University of Alabama at Birmingham
Credit: CC0 Public Domain

Long after cancer treatment ends, many continue to deal with one particular symptom that refuses to go away: fatigue. In a new study, researchers at the University of Alabama at Birmingham and Harvard Medical School have found that the power of placebos, even when fully disclosed to patients, might be harnessed to reduce fatigue in cancer survivors.

For , few treatments are available to alleviate fatigue after treatment, and the most effective pharmacological interventions come with side-effect warnings that include panic, psychosis and heart failure. In a study published in Nature Scientific Reports, investigators found that cancer survivors who knowingly took pills reported a 29 percent, clinically meaningful, improvement in fatigue severity, and a 39 percent improvement in the extent to which fatigue disrupts quality of life.

The placebo pills are made of cellulose, so there is no "active ingredient," pharmacologically speaking. Upon enrollment, researchers told participants the pills are simply placebos, or inert pills, and each participant had a clear understanding of the placebo effect up-front. Investigators found that patients' opinions of the did not matter in the outcome of the study.

"Some people who thought the placebo wouldn't do anything had a good response; others who believed it would help didn't have a response," said Teri Hoenemeyer, Ph.D., lead author and director of Education and Supportive Services at the UAB Comprehensive Cancer Center. "Fooling or deceiving patients may be unnecessary for placebo effects to produce benefits, with automatic neurological processes being a possible mechanism for the effects. This has revolutionary implications for how we might exploit the power of placebo effects in clinical practice."

The study involved 74 survivors of different types of cancer who reported moderate to severe fatigue. They were randomized either to the open-label placebo condition or to treatment as usual. Patients prescribed the open-label pills were told they were receiving placebos and asked to take two of the pills, twice per day, for three weeks.

After the three weeks, patients being treated as usual were offered the opportunity to take the placebo pills for three weeks, while those who originally took the placebo pills discontinued them. After another three weeks, those knowingly taking placebo pills significantly reduced their fatigue. The group taken off the placebos maintained their reduction in fatigue, as well.

"Cancer survivors report that fatigue is their most distressing symptom, even more distressing than other symptoms like nausea or pain, and clinicians struggle to find ways to help them with it," Hoenemeyer said. "The effects of the placebo pills on were so dramatic that we had a number of the study patients ask if they could be given more placebo pills. For ethical reasons, we were unable to do so."

Ted Kaptchuk, study co-author and director of the Harvard-wide Program in Placebo Studies, has previously shown that open-label placebos can bring relief to patients with irritable bowel syndrome, chronic low-back pain and migraine headache. This is the first study to test the effects of open-label placebos with survivors.

"Participants still had benefits three weeks after they stopped taking the placebo pills, which hasn't been shown before," said Kevin Fontaine, Ph.D., co-author and chair of the Department of Health Behavior in the UAB School of Public Health. "The extension of benefits even when the placebo pills are discontinued has been a surprise finding that has many placebo researchers excited."

Explore further: Placebo reduces back pain—even when patients know they're taking placebo

Related Stories

Placebo reduces back pain—even when patients know they're taking placebo

October 18, 2016
For patients with chronic back pain, "open" treatment with placebo—informing patients that they are taking an inactive pill, and why it might be helpful—leads to reductions in pain and disability, reports a study in Pain, ...

Even open-label placebos work—if they are explained

September 26, 2017
For some medical complaints, open-label placebos work just as well as deceptive ones. As psychologists from the University of Basel and Harvard Medical School report in the journal Pain, the accompanying rationale plays an ...

Study finds knowingly taking placebo pills eases pain

October 14, 2016
Conventional medical wisdom has long held that placebo effects depend on patients' belief they are getting pharmacologically active medication. A paper published today in the journal Pain is the first to demonstrate that ...

How 'open-label' placebos turn fake pills into real treatment

June 23, 2015
This may not sound like a good idea:

Recommended for you

Researchers publish study on new therapy to treat opioid use disorder

May 22, 2018
Better delivery of medications to treat opioid use disorder (OUD) is key to addressing the opioid crisis and helping the 2.6 million Americans affected by the disease.

Could nonprofit drug companies cut sky-high prices?

May 17, 2018
(HealthDay)—Generic prescription drugs should be cheap, but prices for some have soared in the United States in recent years. Now a group of U.S. hospitals thinks it has a solution: a nonprofit drug maker.

Fewer antibiotics for kids, but more ADHD drugs

May 15, 2018
(HealthDay)—American kids are taking fewer prescription medications these days—but certain drugs are being prescribed more than ever, a new government study finds.

Opioid makers' perks to docs tied to more prescriptions

May 14, 2018
Doctors who accept perks from companies that make opioid painkillers are more likely to prescribe the drugs for their patients, new research suggests.

Less is more when it comes to prescription opioids for hospital patients, study finds

May 14, 2018
In a pilot study published in JAMA Internal Medicine, Yale researchers significantly reduced doses of opioid painkillers given to hospital patients. By delivering the opioids with a shot under the skin or with a pill instead ...

Generic options provide limited savings for expensive drugs

May 7, 2018
Generic drug options did not reduce prices paid for the cancer therapy imatinib (Gleevec), according to a Health Affairs study released today in its May issue.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.