NIH: Reliable evidence for the use of medical hypnosis in the relief of chemotherapy-induced nausea and vomiting
National Institutes of Health Panel (NIH): Definite evidence for hypnosis in alleviating chronic pain in cancer.
Medical Hypnosis Relaxation is the Most Commonly Quoted form of Non Drug Treatment for Cancer Pain
The NIH endorses the use of medical hypnosis for the relief of chemotherapy-induced nausea and vomiting (Kanitz, Camus, & Seifert, 2013).
Medical Hypnosis in Pediatric Oncology
A 1982 study in pediatric oncology examined the impact of medical hypnosis on 33 pediatric oncology patients on pain and anxiety during bone marrow aspiration and lumbar puncture. The researchers described a statistically significant and stronger decrease of pain after medical hypnosis than non-hypnotic techniques (Kanitz et al., 2013).
Three studies by Liossi et al. (2003; 2006; 2009) report a decline in anticipatory anxiety and reduced pain during lumbar punctures after medical hypnosis. These studies show that medical hypnosis combined with a local anesthetic in pediatric cancer patients is more effective than getting local anesthetic alone or empathetic attention.
A randomized study of the efficacy of medical hypnosis in children having chemotherapy found that the children had less anticipatory nausea and vomiting compared to control groups (Kanitz et al., 2013)
Relief of a range of acute and chronic cancer pains, as well as painful interventions in children, seems to be achieved via medical hypnosis. A study published in the Journal of Adolescent Health Care reports significant improvement in anxiety and discomfort in children after medical hypnosis after painful procedures in cancer treatment (Kanitz et al., 2013).
A systematic review by Richardson, Smith, McCall, and Pilkington (2006) critically appraised the evidence on the effectiveness of medical hypnosis for procedure-related pain and distress in pediatric cancer patients. The researchers report that seven randomized controlled clinical trials and one controlled clinical trial met their inclusion criteria. The eight studies showed positive results, including statistically significant reductions in pain and anxiety/distress.
Richardson et al. (2006) however report that the studies were not free of methodological limitations. Despite these limitations, Richardson et al. (2006) conclude that systematic searching and appraisal has demonstrated that medical hypnosis is a clinically valuable intervention for procedure-related pain and distress in pediatric cancer patients.
Medical Hypnosis and Adult Cancer Patients
Medical hypnosis in adult cancer patients has been shown to be effective as well. Montgomery et al. (2007) carried out a clinical trial (randomized) recruiting 200 research participants to examine whether pre-surgery hypnosis in breast cancer patients would decrease intraoperative anesthesia and analgesic use. The researchers tested a hypothesis to see if medical hypnosis could cut side effects such as postsurgical pain, nausea, and fatigue associated with breast cancer surgery. A separate theory was investigated for cost effectiveness of hypnotic intervention.
The patients in the medical hypnosis group required less propofol and lidocaine than participants in the control group. Patients in the medical hypnosis group also reported less pain intensity, pain unpleasantness, nausea, fatigue, discomfort, and emotional upset. The surgical procedure for patients in the hypnosis group cost $772.71 less per patient than those in the control group. The authors report that this decrease in costs was associated with decreased surgical time due to medical hypnosis (Montgomery et al., 2007).
Montgomery et al. (2007) report that medical hypnosis was superior to attention control regarding propofol and lidocaine use.
Medical hypnosis was also able to attenuate pain, nausea, fatigue, discomfort, and emotional upset at discharge while institutional cost decreased as well.
Elvira Lang and colleagues published a paper in 2008 on the effects of medical hypnosis and empathic attention during percutaneous tumor treatments. The outcomes under investigation were effects on
- Pain and anxiety (assessed every 15 min by patient self-report)
- Drug use (50μg fentanyl or 1 mg midazolam = 1 unit)
- Adverse events (defined as occurrences requiring extra medical attention)
Lang et al. (2008) report that medical hypnosis participants had much less pain and anxiety at several time intervals than standard care and empathy patients. Medical hypnosis patients received significantly less median drug units as well. Medical hypnosis participants reported 12% (8 patients out of 66) adverse events. In the emphatic attention group, however, 31 out of 66 patients, or 48%, reported adverse events.
Lang et al. (2008) conclude that medical hypnosis with empathic care reduces pain, anxiety, and medication use. This contrast with empathic care alone, because emphatic care, provides an external focus of attention. It does not enhance patients’ self-coping and thus can result in more adverse events.
Summary
In general, medical hypnosis could be considered one of the most successful mind-body modalities in pediatric oncology to cut pain during procedures and pain management after treatments (Kanitz et al., 2013)
Researchers in these papers as well as the NIH seem to agree that medical hypnosis should be considered as a practical adjunct treatment for adult and pediatric patients in oncology. Medical hypnosis can address many of the side effects associated with cancer and its treatments. However, there is always the warning that larger studies are needed to reach definite recommendations.
How Do I Schedule My Appointment?
Is medical hypnosis as a non drug treatment for cancer pain right for you? Do you want to find out if medical hypnosis can be safely integrated into your “Wellthcare for Survivorship” plans? You can schedule an appointment with Werner by contacting him here or attend one of his drop-in “Medical Hypnosis Assisted Relaxation” sessions.
References:
Kanitz, J. L., Camus, M. E. M., & Seifert, G. (2013). Keeping the balance – an overview of mind–body therapies in pediatric oncology. Complementary Therapies in Medicine, 21, S20–S25. doi:10.1016/j.ctim.2012.02.001
Lang, E. V., Berbaum, K. S., Pauker, S. G., Faintuch, S., Salazar, G. M., Lutgendorf, S., … Spiegel, D. (2008). Beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment: When being nice does not suffice. Journal of Vascular and Interventional Radiology, 19(6), 897–905. doi:10.1016/j.jvir.2008.01.027
Liossi, C., White, P., & Hatira, P. (2009). A randomized clinical trial of a brief hypnosis intervention to control venepuncture-related pain of pediatric cancer patients. Pain, 142(3), 255—263.
Liossi, C., White, P., Hatira, P. (2006) Randomized clinical trial of local anesthetic versus a combination of local anesthetic with self- hypnosis in the management of pediatric procedure-related pain. Health Psychol 25(3), 307—315.
Liossi, C., & Hatira, P. (2003). Clinical hypnosis in the alleviation of procedure-related pain in pediatric oncology patients. Int J Clin Exp Hypn 51(1), 4—28.
Montgomery, G. H., Bovbjerg, D. H., Schnur, J. B., David, D., Goldfarb, A., Weltz, C. R., … Silverstein, J. H. (2007). A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. JNCI Journal of the National Cancer Institute, 99(17), 1304–1312. doi:10.1093/jnci/djm106
Richardson, J., Smith, J. E., McCall, G., & Pilkington, K. (2006). Hypnosis for procedure-related pain and distress in pediatric cancer patients: A systematic review of effectiveness and methodology related to hypnosis interventions. Journal of Pain and Symptom Management, 31(1), 70–84. doi:10.1016/j.jpainsymman.2005.06.010
