I wasn't really referring to CBT for cancer fatigue, but just in general. I don't know if it helps. I'd bet a lot of us don't know for sure that supplements we take help. Still, if I had cancer, and there seemed any chance it might help, I'd do it. And I'd do the surgeries, chemo, radiation, healthy diet, etc.
I think that CBT for 'cancer' has become seen as disreputable, and 'cancer faitgue' is something therapists and researchers are now fleeing to.
I don't take supplements, and don't like doctors who advise patients to do so in the absence of good evidence of benefit. There's always a chance that quackery might help, and that's how quacks go on making money; but patient's desperation doesn't legitimise the way in which they make their money.
I do not think CBT has potential to harm patients (unless it is focused on "false illness beliefs"). I don't think it has potential to cure ME, but rather I think of it more like taking an advil. It's not going to cure anything but it might put a small dent in symptoms. Or not.
There's really only one sort of CBT for CFS that can claim to be 'evidence based' (even if the evidence is dire):
"CBT was done on the basis of the fear avoidance theory of
chronic fatigue syndrome. This theory regards chronic fatigue
syndrome as being reversible and that cognitive responses
(fear of engaging in activity) and behavioural responses
(avoidance of activity) are linked and interact with
physiological processes to perpetuate fatigue."
[From the PACE trial Miller mentioned in his talk]
I have no illusions that it could get you back to normal. I wonder if perhaps it might get a few percentage points back in some. It might also cause harm in some. Depending on a patient's experiences, it might be worth trying.
Those conducting the PACE trial claimed that 28-30% of patients got back to normal following CBT and GET. Although because of the way they played with the presentation of results, patients could report a worsening of symptoms and yet still be classed as "back to normal". Miller gave a quote to promote their results:
Dr Alastair Miller, Consultant Physician at Royal Liverpool University Hospital, Clinical lead for CFS services in Liverpool, Independent assessor of trial safety data for PACE trial and Principal Medical Advisor, Action for ME, said:
"Although NICE have previously recommended graded exercise and CBT as treatments for ME/CFS, this was on the basis of somewhat limited evidence in the form of fairly small clinical trials. This trial represents the highest grade of clinical evidence a large randomized clinical trial, carefully designed, rigorously conducted and scrupulously analysed and reported. It provides convincing evidence that GET and CBT are safe and effective and should be widely available for our patients with CFS/ME.
"It is clearly vital to continue our research into biological mechanisms for ME/CFS but recent 'false dawns' for example, over the role of retroviruses (XMRV) have shown how difficult this can be. In the current absence of a biomedical model for the causation and the absence of any pharmacological intervention, we have a pragmatic approach to therapy that works and we should use it."
I suspect that Miller is foolish enough to believe that this is true: "This trial represents the highest grade of clinical evidence a large randomized clinical trial, carefully designed, rigorously conducted and scrupulously analysed and reported."
Graham did some videos on the PACE trial that could be of interest to people new to this:
https://www.youtube.com/channel/UCvWxvwftcLjIQniW3Dgzm5w