Guided imagery is one of the most often used integrative mind-body medicine cancer modalities. Is it right for you?
Guided Imagery in Cancer Patients & Survivorship
Lengacher and colleagues (2003) estimated that 27% of women with breast cancer used guided imagery at least once while 6% of women use guided imagery regularly.
Although researchers have studied the use of guided imagery in cancer patients, few researchers have examined the effects of relaxation and guided imagery in randomized clinical trials. Moreover, only a few studies have examined the effects of relaxation and guided imagery on the immune system in breast cancer patients.
Various stressors act to downregulate the immune system. For example, suppression of natural killer (NK) cell activity leads to a decreased ability to resist illness because NK cells play a role in defense against many disease processes and illnesses. In particular, suppression of NK cell activity can be particularly damaging to cancer patients. For example, NK cells can kill both virally infected cells and tumor cells while sparing normal cells Lengacher et al. (2008).
Lengacher et al. (2008) enrolled breast cancer patients during a clinic visit at which they received their diagnosis, about two to three weeks before surgery. The breast cancer survivors met once for a 30-min guided imagery session with a therapist trained in guided imagery. In the session, the therapist taught participants passive progressive relaxation to prepare them for guided imagery. Participants also received guided imagery recordings. The breast cancer patients were asked to listen to the recordings a minimum of three times per week.
The immune measures used in this study were NK cell function and cytokine IL-2–enhanced NK cells (also known as the lymphokine-activated killer cells or LAK). The results show beneficial effects of guided imagery on the immune system such as NK cell cytotoxicity and LAK activity, after four weeks of participation.
This study supports the hypothesis that a presurgical guided imagery intervention can improve immune function in women undergoing surgical treatment for breast cancer.
Guided Imagery with Theta Music for Patients with Dyspnea Due to Advanced Cancer
A study by Lai, Chao, Yang, and Chen (2010) investigated the effects of guided imagery with theta music for patients with dyspnea due to advanced cancer. In this study guided imagery with theta music produced a significant decrease in the Modified Borg Scale (MBS) for self-reported evaluation of dyspneic symptoms. Furthermore, 90% of the participants (33% of them lung cancer patients) gave positive qualitative reviews of guided imagery with theta music. Clinically, guided imagery with theta music significantly increased end-tidal CO2 (EtCO2), decreased respiratory rate (RR), and decreased heart rate (HR).
Lai et al. (2010) conclude that inexpensive, noninvasive, non-pharmacological, yet powerful guided imagery with theta music can help patients and their families cope in stressful and challenging times. Guided imagery with theta music provides the patient with self-care strategies and a sense of independence, which may help ease anxiety in a very difficult situation.
Lai et al. (2008) further write that guided imagery with theta music is a useful intervention for palliative care of patients with dyspnea. Theta music alone demonstrated to be effective, while soothing non-theta music was not effective in this setting. Guided imagery with theta music was more efficient than theta music alone. Guided imagery with theta music should be considered as an end-of-life palliative care for dyspnea.
Despite these positive results, it must be pointed out that there are consistent methodological problems within the research of mind–body modalities. These themes are low methodological quality, small sample sizes, and a limited amount of research available. Thus future, higher quality research is warranted and needs to be conducted.
For example, a review conducted by King (2010) finds that it is difficult to give concrete recommendations that guided imagery will work for all patients suffering from cancer. However, the two studies written about here, contribute to the growing body of literature that supports the use of guided imagery as an integrative mind-body medicine modality.
King, K. (2010). A review of the effects of guided imagery on cancer patients with pain. Complementary Health Practice Review, 15(2), 98–107. doi:10.1177/1533210110388113
Lai, W.-S., Chao, C.-S. C., Yang, W.-P., & Chen, C.-H. (2010). Efficacy of guided imagery with theta music for advanced cancer patients with dyspnea: A pilot study. Biological Research For Nursing, 12(2), 188–197. doi:10.1177/1099800409347556
Lengacher, C. A., Bennett, M. P., Gonzalez, L., Gilvary, D., Cox, C. E., Cantor, A., … Djeu, J. (2008). Immune responses to guided imagery during breast cancer treatment. Biological Research For Nursing, 9(3), 205–214. doi:10.1177/1099800407309374