Managing Cancer and Living Meaningfully (CALM) Therapy for Improving the Quality of Life of Patients With Cancer: A Meta‐Analysis of Randomised Controlled Trials

Cancer patients, at both early and advanced stages, face complex bio-psycho-social-spiritual problems impacting their quality of life (QoL). Managing Cancer and Living Meaningfully (CALM) therapy is a psychotherapeutic approach that helps cancer patients find hope and meaning in life, thereby improving QoL. This study aimed to critically assess the effects of CALM therapy on the QoL in cancer patients. This was a systematic review and meta-analysis of randomised controlled trials (RCTs). The main outcome was QoL, and the secondary outcomes were anxiety, depression, spiritual well-being, fatigue and sleep quality. Five English databases (PubMed, Embase, Scopus, Cochrane Library and ProQuest) and one trial registry site (Clinicaltrial.gov) were searched from their inception until March 2024. The pooled effect sizes were calculated using random-effects models and expressed as standard mean difference (SMD) or weighted mean difference (WMD). Review Manager 5.4 was used for data analysis. A sensitivity analysis was done by excluding one trial at a time to check the consistency of the results on QoL. The study protocol was prospectively registered on PROSPERO (CRD42023398655). Fifteen trials met the inclusion criteria for the systematic review and twelve for the meta-analysis, with a total of 1635 cancer patients. CALM therapy showed significant benefits on QoL (SMD = 1.97), spiritual well-being (WMD = 1.93) and sleep quality (SMD = -1.56) compared with usual care. It also reduced anxiety (SMD = -1.94), depression (SMD = -1.28) and fatigue (SMD = -5.86) significantly. The sensitivity analysis confirmed the stability of these results when each trial was removed one by one. CALM therapy may improve QoL, spiritual well-being, sleep quality and relieve anxiety, depression and fatigue in cancer patients. This therapy should be promoted clinically as a comprehensive psychotherapeutic approach in cancer care. CRD42023398655.