Acceptance and commitment therapy for adults with advanced cancer (CanACT): A feasibility randomised controlled trial
Open accessAbstract
Objective: To understand the feasibility of recruiting people with advanced cancer into a randomised controlled trial of acceptance and commitment therapy (ACT) vs a standardised talking control (TC) and delivering ACT to this population; to explore the acceptability of outcome measures and generate normative data. Methods: This was a feasibility two‐arm randomised controlled trial. Participants were attendees with advanced cancer at one of three hospice‐based day‐therapy units in London, United Kingdom, who demonstrated low scores on the Functional Assessment of Cancer Therapies—General (FACT‐G). The primary end point was 3 months. Results: The recruitment target was 54 participants; 42 people were recruited and randomised to up to eight individual sessions of ACT (n = 20) or TC (n = 22). Eighteen out of 42 (43%) of participants completed the primary outcome at 3 months, and at least one follow‐up was available in 30/42 (71%) participants. An exploratory analysis revealed a non‐significant adjusted mean difference after 3 months in the main outcome FACT‐G of −3.41 (CI = −18.61‐11.79) with TC having better functioning. Over 6 months, the adjusted mean difference between trial arms was 2.25 (CI = −6.03‐10.52) in favour of ACT. Conclusions: It is feasible to recruit people with advanced cancer in a trial of ACT versus TC. Future research should test the effectiveness of ACT in a fully powered trial.
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Six studies showed improvements in valued living post intervention, although only one RCT showed statistically significant improvements.
“Six studies showed improvements in valued living post intervention,46,52,60,63,66 although only one RCT showed statistically significant improvements. 66”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [60]
The citation numbered 66 is attached to the claim that this RCT found a statistically significant improvement in valued living. In the paper’s “Process of ACT” section, the three-month adjusted difference on the Valued Living Questionnaire is 0.22, with a 95% confidence interval of −19.42 to 19.87. Because that interval includes zero, the reported result does not support statistical significance. (LLM, conf=0.91)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredACT has shown significant and lasting results in reducing emotional distress and depressive symptoms, anxiety, fatigue, and sleep, and improving health-related quality of life, acceptance, and psychological flexibility in advanced cancer.
“Ha mostrado resultados significativos y duraderos en reducción del distrés emocional y síntomas depresivos, ansiedad, fatiga y sueño, y en mejora de calidad de vida relacionada con la salud, de la aceptación y de la flexibilidad psicológica (19,47 ,49,66-68)”
From AVANZACT: protocolo e intervención psicoterapéutica en cáncer avanzado basados en Terapia de Aceptación y Compromiso. (2025) · cites this paper as [47]
The Abstract reports that an earlier trial in advanced ovarian cancer suggested improved quality of life and reduced psychological distress with ACT. But this feasibility trial did not establish significant or lasting benefits: the three-month confidence intervals for distress and quality of life include no difference, and the cited passages do not report benefits for depression, anxiety, fatigue, sleep, or acceptance. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSix studies showed improvements in distress, with three RCTs showing statistically significant improvements.
“Six studies showed improvements in distress, with three RCTs showing statistically significant improvements53,54,60”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [60]
The Psychological distress section reports a lower mean distress score in the ACT group at three months, so this trial shows a descriptive improvement. But its adjusted between-group difference was 0.6 (95% CI −7.25 to 8.53), which does not support counting it as an RCT with a statistically significant improvement. This paper alone cannot establish the claimed counts across six studies or three RCTs. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn the other hospice-based study, only 8 of 20 (40%) allocated to the 8-week intervention condition completed the 1.5 month follow-up due to death, feeling too unwell, feeling overburdened and related reasons.
“in the other, only 8 of 20 (40%) allocated to the 8-week intervention condition completed the 1.5 month follow-up due to death, feeling too unwell, feeling overburdened and related reasons. 60”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [60]
The Interventions section describes eight weekly sessions, and Timing of measures places a FACT-G follow-up at six weeks (1.5 months). The paper also reports substantial follow-up attrition and deaths, but the Uptake of therapy sessions section says 21 participants were allocated to ACT, not 20; the available passages do not establish that eight ACT participants completed the six-week follow-up or that the listed reasons account for noncompletion at that time point. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCompared with previous studies on ACT for patients with advanced cancer, this work showed high attendance and retention rates.
“Compared with previous studies on ACT for patients with advanced cancer,54,55 this work showed high attendance and retention rates.”
Use of ACT among people with cancer has increased over the past two decades.
“There has been increasing use of ACT among individuals with cancer in the past two decades [23–25].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [24]
The Abstract (page unavailable) says studies of ACT in life-threatening illnesses were limited and identifies one earlier trial in advanced ovarian cancer. The Clinical and research implications section (page unavailable) discusses ACT's acceptability in this trial. Neither passage establishes that ACT use among people with cancer increased over two decades; searches for that trend found no supporting passage. (LLM, conf=0.75)
Experimental — accuracy not yet measured
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- Authors
- Serfaty, M., Armstrong, M., Vickerstaff, V., Davis, S., Gola, A., McNamee, P., Omar, R. Z., King, M., Tookman, A., Jones, L., & Low, J. T. S.
- Affiliations
- University College London (GB)
- St Pancras Hospital (GB)
- Marie Curie (GB)
- Corresponding author
- Armstrong, Megan
- ORCID
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2018-12-21
- Volume
- 28
- Issue
- 3
- Pages
- 488-496
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- OpenAlex
- W2903295109
- Cited by
- 50
- References
- 26
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 8 · 2023: 9 · 2022: 8 · 2021: 8 · 2020: 5 · 2019: 4
- FWCI
- 4.98
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health Research (NIHR): Research for Patient Benefit (PB-PG-1111-26043)
- Marie Curie core grant funding (MCCC-FPO-16-U)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- acceptance and commitment therapy, advanced cancer, feasibility, trial recruitment, FACT-G, quality of life, trial acceptability
- MeSH terms
- Adult, Cost-Benefit Analysis, Feasibility Studies, Female, United Kingdom, Humans, Male, Middle Aged, Neoplasms, Patient Compliance, Patient Satisfaction, Outcome Assessment, Health Care, Acceptance and Commitment Therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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