In this paper Mravec, Gidron, & Hulin, (2008) discuss some of the known facts about the nervous system and tumorigenesis, but also ask if the brain is capable of monitoring and/or modulating the creation of cancer cells (tumorigenesis). This is crucial especially if we would like to consider the mind-body modality of hypnotherapy to be utilized by cancer patients.
The interactions between the nervous, endocrine and immune systems are studied intensively. The communication between immune and cancer cells, and multilevel and bi-directional interactions between the nervous and immune systems form the basis for a hypothesis assuming that the brain might observe and regulate the processes associated with the development and progression of cancer. The aim of this article is to describe the data supporting this hypothesis.
The Bottom Line:
According to Yapko (2003) the premise of hypnotherapy is “…the client has valuable abilities that are present but hidden, abilities that can be uncovered and used in a deliberate way to overcome symptoms and problems” (p. 18).
Division 30 of the American Psychological Association has this to say about hypnotherapy: “When using hypnosis, one person (the subject) is guided by another (the hypnotist) to respond to suggestions for changes in subjective experience, alterations in perception, sensation, emotion, thought or behavior” (Division 30, APA, n.d.).
As part of an assignment in one of my graduate hypnosis courses, I was asked to come up with my own interpretation of hypnotherapy, given that there seems to be no definitive answer so far. Based on the readings of Hammond (1998), Krippner (2004) and Yapko (2003) my working definition of hypnosis would be:
“Clinical Hypnosis is a COMMUNICATIONS technique between hypnotist and subject to AMPLIFY (to a possible power of a gazillion) the subject’s AWARENESS of his/her innate ability to heal and thus directly impact the subject’s physiology in order to overcome deliberately symptoms and problems.”
A more academically correct term would be to the nth power! I guess I like a gazillion, because it illustrates the scope and impact of hypnosis much better than nth power.
To continue down this path, lets look if hypnotherapy has ever been used successfully to bring about physiological changes in the body. One such physiological change that comes to mind is accelerated healing. Two papers, Ginandes, Brooks, Sando, Jones, & Aker (2003) and Ginandes & Rosenthal (1999) shed more light on the possibility. The lead author of both papers, Dr. Ginandes of Harvard Medical School, showed that subjects hypnotherapy groups experienced accelerated healing for postsurgical wound healing (2003) and the healing of bone fractures (1999). Dr. Dabney Ewin, M.D. (1983) of Tulane University, on the other hand, has extremely compelling cases for the efficacy of hypnosis in burn patients.
This brings me back to the article “Neurobiology of cancer: Interactions between nervous, endocrine and immune systems as a base for monitoring and modulating the tumorigenesis by the brain by Mravec et al. (2008).
The authors start with a brief review of the neuro-endocrine-immune interaction as the base for the neurobiology of peripheral diseases such as cancer. Mravec et al. (2008) cite research that points towards the existence of a “sixth sense” so to speak, that is able to detect signals that otherwise are undetectable by the body’s five senses.
“The role of the immune system in tumorigenesis is of relevance to the CNS [central Nervous system] since the nervous and immune systems can bi-directionally communicate by using a conventional chemical language employing peptide and non-peptide neurotransmitters, hormones, cytokines and common receptors” (p.151).
Then Mravec et al. (2008) go on to elaborate on known clinical and experimental data that substantiate the notion that the brain monitors and modulates the creation of cancer cells.
They cite different animal studies which“…might support the assumption that CNS receives signals related to tumorigenesis” (p. 152), before elaborating on human studies that show differences in the activity of brain regions, such as “… reduced prefrontal activation in cancer patients versus control…” (p. 152).
Mravec et al. (2008) then go on to explain their views on the impact of psychosocial factors and stress on cancer incidence and progression. I will elaborate on these in a future post, as they deserve independent analysis.
This brings us to part three of their paper (my favorite) titled “Nervous system and tumorigenesis: questions, assumptions, and hypotheses” (Mravec et al., 2008, p. 154).
The immune system’s sensory functions to detect and monitor tumor cells and Mravec et al. (2008) hypothesize that the cancer cells release molecules that might serve as messengers to directly “inform” (p. 154) the brain about the state of the creation of cancer cells.
Mravec et al. (2008) explore two indirect pathways, a slow, less informative, non-specific humoral pathway. Cytokines are part of this pathway and the authors go on to say that cytokines stimulate the production of prostaglandins, which in turn might be “…crucial messengers that constitute the links between circulatory cytokines and CNS” (p. 154).
The other indirect pathway mentioned by the authors is the neural pathway, which might be exceedingly location-specific and fast. In other words, the immune system can reach the CNS via peripheral nerves with cytokines playing a significant role, as well. This is illustrated by data that show “…vagal sensory neurons themselves express mRNA for IL-1 receptors, suggesting a direct reaction of afferent vagal fibers to peripheral IL-1” (Mravec et al., 2008, p. 154). This means that cytokines might activate the vagus nerve to disseminate information from the immune system to the CNS.
One last example I’ll list here is a situation in which levels of pro-inflammatory cytokines are low, but nonetheless, somehow these low levels of cytokines are able to contribute to the formation of cancer cells. This involves paraganglia (visceral sensors) that support the transmission of data from the immune system to the brain via the vagus nerve. These structures contain cells that are able to manifest IL-1 receptors, providing a vital link between immune and nervous system (Mravec et al., 2008).
What about direct transmission of information about cancer to the brain?
Mravec et al. (2008) speculate that chemical compounds during tumorigenesis provide enough information to the brain in order for the brain to recognize cancer cells. While uncertain, Mravec et al. (2008) speculate that there might a signaling model specific to tumorigenesis at play, which would allow the brain to “detect” cancers.
Because of this “detection” Mravec et al. (2008) speculate that tumorigenesis could be modulated via neurotransmitters that act on cancer cells.
Then the authors go on into a long explanation (which will be explored in future posts) on how the brain might modulate tumorigenic activities. I am going to jump to the last two points Mravec et al. (2008) make, as it pertains directly to mind-body medicine and hypnosis.
Modulation of tumorigenesis by the brain as a new therapeutic approach.
Mravec et al. (2008) hypothesize and cite research that immunomodulation of the autonomic nervous system could represent a new approach to cancer therapy. This could be achieved by mapping areas of the brain, which regulate various immune functions. For example, natural-killer cell (NK) activity is germane to quash cancer cells, whereas elevated right-hemisphere activity is associated with reduced NK cell activity.
So, if one could then modify the activity of the specific brain regions and structures that are associated with the regulation of specific immune functions, as suggested by Mravec et al. (2008), one then could claim to use immunomodulation effectively as cancer treatment.
And finally, we have come full circle in the role of the CNS, tumor interactions, and mind-body medicine as a therapeutic approach.
Hypnotherapy has been shown to affect brain structures in many different shapes and forms (Halsband, 2006; Halsband, Mueller, Hinterberger, & Strickner, 2009; Rainville, Hofbauer, Bushnell, Duncan, & Price, 2002).
Hypnotherapy has also been used successfully in the cancer patients (Montgomery et al., 2007; Richardson, Smith, McCall, & Pilkington, 2006; Spiegel & Bloom, 1983) just to name a few.
Here, is the website of The Society of Psychological Hypnosis for a bunch of exceptionally reliable information about hypnosis. If you truly desire a front row seat to over one hundred interviews with the world’s greatest hypnosis researchers and clinicians, I encourage you to visit Dr. Eric Willmarth’s site featuring the Willmarth Hypnosis Interviews.
While there are exciting times ahead for hypnotherapy and its role in cancer treatment, please understand that hypnotherapy is used successfully with cancer patients already. As always, please discuss the pros and cons with your primary health care provider, and please, do your homework in finding a reputable hypnotherapist. You might want to start your search by visiting two organizations, which I am a member of The Society of Psychological Hypnosis and SCEH, the Society for Clinical & Experimental Hypnosis.
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Ewin, D. M. (1983). Emergency Room Hypnosis for the Burned Patient. American Journal of Clinical Hypnosis, 26(1), 5–8. doi:10.1080/00029157.1983.10404130
Ginandes, C., Brooks, P., Sando, W., Jones, C., & Aker, J. (2003). Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical trial. The American Journal of Clinical Hypnosis, 45(4), 333–351. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12722936
Ginandes, C., & Rosenthal, D. (1999). Using hypnosis to accelerate the healing of bone fraactures: A randomized controlled pilot study. Alternative Therapies in Health and Medicine, 5(2), 67–75. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=10069091&site=ehost-live&scope=site
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Hammond, D. C. (1998). Hypnotic induction and suggestion. Chicago, IL: American Society of Clinical Hypnosis. Retrieved from http://asch.net/books.htm
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Montgomery, G. H., Bovbjerg, D. H., Schnur, J. B., David, D., Goldfarb, A., Weltz, C. R., Schechter, C., et al. (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
Mravec, B., Gidron, Y., & Hulin, I. (2008). Neurobiology of cancer: Interactions between nervous, endocrine and immune systems as a base for monitoring and modulating the tumorigenesis by the brain. Seminars in Cancer Biology, 18(3), 150–163. doi:10.1016/j.semcancer.2007.12.002
Rainville, P., Hofbauer, R. K., Bushnell, M. C., Duncan, G. H., & Price, D. D. (2002). Hypnosis modulates activity in brain structures involved in the regulation of consciousness. Journal of Cognitive Neuroscience, 14(6), 887–901. doi:10.1162/089892902760191117
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, 70–84. doi:10.1016/j.jpainsymman.2005.06.010
Spiegel, D., & Bloom, J. R. (1983). Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosomatic Medicine, 45(4), 333–339. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/6622622
Yapko, M. (2003). Trancework : an introduction to the practice of clinical hypnosis (3rd ed.). New York: Brunner-Routledge.
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APA: W Absenger. (2012.06.26). Mravec et al. (2008). Neurobiology of cancer and mind-body medicine [Web log post]. Retrieved from The Alternative Medicine Blog at http://amacf.org/2012/06/mravec-et-al-2008-neurobiology-of-cancer-and-mind-body-medicine.html
MLA: Absenger, Werner. ” Mravec et al. (2008). Neurobiology of Cancer and mind-body medicine.” The Alternative Medicine Blog. The Alternative Medicine Blog. 26 June. 2012. Web. Insert your date of access here.