The Efficacy of the Managing Cancer and Living Meaningfully (CALM) Intervention across the Cancer Trajectory: A Systematic Review and Meta-Analysis of Outcomes in Diverse Oncological Populations
DOI:
https://doi.org/10.70112/ajsat-2026.15.1.4322Keywords:
CALM Intervention , Psycho-oncology, Transdiagnostic, Cross-cultural Applicability , Randomized Controlled TrialAbstract
The Managing Cancer and Living Meaningfully (CALM) intervention is a manualized, brief psychotherapy designed to address the multidimensional distress associated with cancer. Grounded in an integrative theoretical framework, it systematically targets four domains: symptom management and communication, changes in self-concept and relationships, spiritual well-being and meaning, and mortality-related concerns. A substantial body of evidence from 2018 to 2025 confirms its efficacy. The seminal trial demonstrated significant reductions in depressive symptoms and death anxiety among patients with advanced cancer. Subsequent research has validated its transdiagnostic utility, showing effectiveness for specific sequelae such as fear of cancer recurrence, chemotherapy-related cognitive impairment, and cancer-related fatigue. Furthermore, studies support its cross-cultural applicability in diverse contexts and its adaptability to various delivery formats, including telehealth. The consistency of these findings across psychological, existential, and quality-of-life outcomes positions CALM as an evidence-based cornerstone of comprehensive psycho-oncological care.
References
[1] Y. Cai, J. Zhao, W. Li, S. Yu, L. Tang, S. Yao, and H. Cheng, “The effects of Managing Cancer and Living Meaningfully (CALM) on psychological distress in esophageal cancer patients,” Future Oncology, vol. 19, no. 19, pp. 1357–1366, 2023, doi: 10.2217/fon-2023-0311.
[2] R. Caruso, S. Sabato, M. G. Nanni, S. Hales, G. Rodin, C. Malfitano, and L. Grassi, “Application of managing cancer and living meaningfully (CALM) in advanced cancer patients: An Italian pilot study,” Psychotherapy and Psychosomatics, vol. 89, no. 6, pp. 402–404, 2020.
[3] K. Ding, X. Zhang, J. Zhao, H. Zuo, Z. Bi, and H. Cheng, “Managing Cancer and Living Meaningfully (CALM) intervention on chemotherapy-related cognitive impairment in breast cancer survivors,” Integrative Cancer Therapies, vol. 19, 2020, doi: 10.1177/1534735420938450.
[4] Y. Jia, C. Gan, J. Chai, R. Huang, A. Li, H. Ge, and H. Cheng, “The effect of the CALM intervention on negative emotions and sleep quality in patients undergoing endocrine therapy for breast cancer,” Clinical Breast Cancer, 2025.
[5] Y. Jing, J. Zhao, Z. Yang, S. Yao, L. Tang, W. Li, S. Yu, and H. Cheng, “Managing cancer and living meaningfully (CALM) as an intervention for severe fatigue in gastrointestinal cancer survivors,” Jun. 15, 2022. [Online]. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC9251694/.
[6] C. Lo, S. Hales, A. Chiu, T. Panday, C. Malfitano, J. Jung, A. Rydall, M. Li, R. Nissim, C. Zimmermann, and G. Rodin, “Managing Cancer and Living Meaningfully (CALM): Randomised feasibility trial in patients with advanced cancer,” BMJ Supportive & Palliative Care, vol. 9, no. 2, pp. 209–218, 2016, doi: 10.1136/bmjspcare-2015-000866.
[7] F. A. Lynch, G. Rodin, M. Jefford, M. Duffy, J. Lai-Kwon, S. Heynemann, L. Mileshkin, L. Briggs, J. Burke, L. Leigh, T. Spelman, and M. Ftanou, “Evaluation of Managing Cancer and Living Meaningfully (CALM) in people with advanced non-small cell lung cancer treated with immunotherapies or targeted therapies: Protocol for a single-arm, mixed-methods pilot study,” BMJ Open, vol. 13, no. 7, e072322, 2023, doi: 10.1136/bmjopen-2023-072322.
[8] S. Miyamoto, T. Yamazaki, K. Shimizu, T. Matsubara, H. Kage, K. Watanabe, H. Kobo, Y. Matsuyama, G. Rodin, and K. Yoshiuchi, “Brief, manualised and semistructured individual psychotherapy programme for patients with advanced cancer in Japan: Study protocol for Managing Cancer and Living Meaningfully (CALM) phase 2 trial,” BMJ Open, vol. 12, no. 3, e056136, 2022, doi: 10.1136/bmjopen-2021-056136.
[9] L. Pang, S. Yao, W. Li, Y. Jing, X. Yin, and H. Cheng, “Impact of the CALM intervention on breast cancer patients during the COVID-19 pandemic,” Supportive Care in Cancer, vol. 31, no. 2, 2023, doi: 10.1007/s00520-023-07582-0.
[10] G. Rodin and S. Hales, Managing Cancer and Living Meaningfully: An Evidence-Based Intervention for Cancer Patients and Their Caregivers, 2021.
[11] G. Rodin, C. Lo, A. Rydall, J. Shnall, C. Malfitano, A. Chiu, T. Panday, S. Watt, E. An, R. Nissim, M. Li, C. Zimmermann, and S. Hales, “Managing Cancer and Living Meaningfully (CALM): A randomized controlled trial of a psychological intervention for patients with advanced cancer,” Journal of Clinical Oncology, vol. 36, no. 23, pp. 2422–2432, 2018, doi: 10.1200/JCO.2017.77.1097.
[12] M. Wang, C. Gan, J. Zhao, W. Li, S. Yu, S. Yao, L. Tang, J. Xu, and H. Cheng, “Positive influence of managing cancer and living meaningfully (CALM) on fear of cancer recurrence in breast cancer survivors,” Jul. 15, 2023. [Online]. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC10408467/.
[13] S. M. Wulandari, E. Yunitasari, and T. Kusumaningrum, “Managing cancer and living meaningfully for advanced cancer: A systematic review,” Jurnal Ners, vol. 15, no. 1S, p. 1, 2020.
[14] X. Zhang, S. Yao, M. Wang, X. Yin, Z. Bi, Y. Jing, and H. Cheng, “The impact of the VR-CALM intervention on psychological distress and symptom management in breast cancer survivors,” Journal of Oncology, vol. 2022, pp. 1–10, 2022, doi: 10.1155/2022/1012813.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Centre for Research and Innovation
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
