Seventeen patients treated for acute lymphoblastic leukemia by combination chemotherapy before their reaching 10 years of age were studied for altered dental root development of their premolar teeth. Five of the 17 patients showed subjective radiographic evidence of marked shortening of the premolar dental roots; 13 had thinning of the roots. A quantitative analysis was developed and verified, which disclosed a 63.33% to 84.38% reduction of premolar root length when compared with the mean of the historical controls. With recent significant increases in long-term survival rates of children with malignancies, altered dental development becomes an important factor to follow years after chemotherapy is discontinued. The findings of these chemotherapy-associated dental development changes impacts on the patient's quality of life and also can serve as a research tool to assess permanent effects of chemotherapy on normal tissue growth and development.

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The use of surgery, radiation, and chemotherapy has resulted in increased control of malignancy and prolonged survival for cancer patients. These modalities also carry significant morbidity. Normal physiological homeostasis is often altered by both the neoplasm and its treatment. The diagnosis, treatment, and social stigma of cancer exact profound psychological impact. Hypnosis effectively can control the range of both physiological and psychological "side-effects" of cancer and its therapy.This paper will delineate those effects of hypnosis of proven value to the cancer patient. Incorporation of images into each phase of a hypnosis session will be demonstrated with an actual case history and annotated transcript. Imagery as a therapeutic modality will be discussed in general, and specific suggestions and images will be given.Modern medical hypnosis traditionally utilizes a pre-hypnotic interview, an induction and so-called trance deepening techniques as a start for "therapeutic intervention." As an almost intrinsic part of this process, we usually see relaxation with concomitant anxiety control, time distortion, dissociation and selective amnesia. All of these hypnotic effects are of direct benefit to the oncology patient, who needs compression of the unpleasant and expansion of comfort.The selection of a variety of imagery I The opinions expressed in this paper are those of the author and do not imply approval of Memorial Sloan-Kettering Cancer Center.The author wishes to thank Ms. Linda Lynn for her assistance in the preparation of this paper. t i I For reprints, write the author at 430 East 67

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