I thought it was time to write an update on the breast cancer research I recently completed right here in West Michigan.
Read the latest Hypnosis research how hypnosis can influence processes that promote healing, behavior, attitudes, perceptions and emotions in cancer patients.
National Institutes of Health Panel (NIH): Definite evidence for hypnosis in alleviating chronic pain in cancer.
Werner Absenger, Saybrook School of MBM PhD Candidate, Examines How Hypnosis Can Impact the Modulation of Cytokines: Report from the Society for Clinical and Experimental Hypnosis (Adapted with permission from Dr. Don Moss and The Saybrook Forum).
Werner Absenger is a PhD Candidate in the Saybrook University School of Mind-Body Medicine, with a specialization in healthcare research. On October 5, 2013, he delivered a presentation to the Society for Clinical and Experimental Hypnosis, based on his current doctoral research utilizing hypnosis to influence immune function and the modulation of cytokines in cancer populations.
Absenger summarized an exhaustive review of 1586 articles in 22 databases to find credible studies where hypnosis was used to modify cytokines. He found only six credible studies, with a total of 133 participants. One of the six studies studied chronic illness. [Read more…]
Last December I posted an announcement that I was going to look for participants for a pilot project, investigating clinical hypnosis and the immune system based on the cytokine Interleukin 1-beta. The aim was to recruit nine pancreatic cancer patients for this project. However time constraints did not allow for this to happen. So I looked to healthy volunteers to do this study.
I finally did write the study up and submitted abstracts for both, the pilot study and the extensive literature review to the Society of Clinical Hypnosis (SCEH) for presentation at the 64th Annual SCEH Scientific Session. I am happy to inform that I will be presenting both papers in October in Berkeley, CA at the 64th SCEH conference.
Announcing the initiation of an exploratory, randomized controlled interventional study to evaluate the effects of Clinical Hypnosis on the immune system of cancer patients suffering from pancreatic cancer (PaCa). This small, exploratory study will enroll up to 21 cancer patients suffering from pancreatic cancer in a 2-week (2 sessions, 1 per week) study starting January 28, 2013 and concluding on February 11, 2013.
Please visit Werner’s Project Page on RocketHub.com for a short video on how you can get involved in this project.
The purpose of this research is to examine clinical hypnosis, a mind-body medicine modality, and its impact on the immune system via quantification of cytokine Interleukin-1beta (IL-1β) as it pertains to cancer patients afflicted with pancreatic cancer. This project is being conducted by Werner Absenger, M.Sc. who is a graduate student of Saybrook University, San Francisco, California, as part of MBM 5551 Doctoral Research I, which serves as a pilot study for dissertation research.
Because of a lack of tests for early cancer screening of the general population, roughly half of pancreatic cancer patients are diagnosed at a late stage. Unfortunately, the median survival rate for advanced pancreatic cancer patients is six months, in comparison to two years for pancreatic cancer patients who were able to undergo surgery (National Cancer Institute, 2010). Clinical hypnosis and guided imagery have been shown to affect a person’s immune function. This project will examine clinical hypnosis(CH) and its impact on the immune system as it pertains to a person afflicted with pancreatic cancer.
Approach: Study participants will be divided into three groups, (1) TAU (Treatment As Usual), (2) TAU plus CH administered face-to-face or (3) TAU plus CH administered
Impact: Evaluation of clinical hypnosis in patients suffering from pancreatic cancer will provide preliminary data, whether or not clinical hypnosis might serve as an adjunct therapy impacting the immune system of patients suffering from pancreatic cancer. This will provide initial, early stage evidence for clinical hypnosis as an integrative cancer treatment.
According to the National Center for Complementary and Alternative Medicine (NCCAM, 2012), as many cancer patients seem to seek refuge in complementary and alternative modalities, evidence-based integrative therapies are sorely needed for adjunct cancer therapies after diagnosis with metastatic cancer.
The study titled “Does Clinical Hypnosis, When Offered in Addition to TAU, Modulate the Expression of IL-1β Compared to TAU in Patients with Pancreatic Cancer?” will add to existing scientific body of Mind-Body Medicine while participants may gain a greater personal awareness, knowledge, and understanding of clinical hypnosis and pancreatic cancer.
An orientation for interested participants will take place:
When: Saturday, January 26, 2013
Time: 11am EDT (will last approximately 1.5 hours)
Where: Spring Lake District Library, 123 E. Exchange Street, Spring Lake, MI, 494546 Please contact Werner to reserve your space.
The study proposal underwent review at the Saybrook University Institutional Review Board, Saybrook University, 747 Front St., 3rd Floor, San Francisco, CA 94111-1920.
Please visit Werner’s Project Page on RocketHub.com for a short video on how you can get involved in this project.
Werner Absenger, M.Sc.
Ph.D. Student at Saybrook University’s School of Mind-Body Medicine, Research Track
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.
Schönpflug, F. (1906). Der Hypnotizeur Fritz Schönpflug. Retrieved from Images from the History of Medicine (NLM) website at http://www.nlm.nih.gov/hmd/ihm/.
Division 30, APA. (n.d.). The official Division 30 definition and description of hypnosis. Retrieved June 26, 2012, from http://psychologicalhypnosis.com/info/the-official-division-30-definition-and-description-of-hypnosis/
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
Halsband, U. (2006). Learning in trance: Functional brain imaging studies and neuropsychology. Journal of Physiology-Paris, 99, 470–482. doi:10.1016/j.jphysparis.2006.03.015
Halsband, Ulrike, Mueller, S., Hinterberger, T., & Strickner, S. (2009). Plasticity changes in the brain in hypnosis and meditation. Contemporary Hypnosis, 26(4), 194–215. doi:10.1002/ch.386
Hammond, D. C. (1998). Hypnotic induction and suggestion. Chicago, IL: American Society of Clinical Hypnosis. Retrieved from http://asch.net/books.htm
Krippner, S. (2004). Hypnotic-like procedures used by indigenous healing practitioners. Presented at the Annual Convention of the American Society of Clinical Hypnosis, Anaheim, CA. Retrieved from http://stanleykrippner.com/papers/asch.2004.htm
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.
Writing an essay, paper, or report? Cite this story:
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.