Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: a controlled clinical trial

Abstract

Few controlled clinical trials have tested the efficacy of psychological techniques for reducing cancer pain or post-chemotherapy nausea and emesis. In this study, 67 bone marrow transplant patients with hematological malignancies were randomly assigned to one of four groups prior to beginning transplantation conditioning: (1) hypnosis training (HYP); (2) cognitive behavioral coping skills training (CB); (3) therapist contact control (TC); or (4) treatment as usual (TAU; no treatment control). Patients completed measures of physical functioning (Sickness Impact Profile; SIP) and psychological functioning (Brief Symptom Inventory; BSI), which were used as covariates in the analyses. Biodemographic variables included gender, age and a risk variable based on diagnosis and number of remissions or relapses. Patients in the HYP, CB and TC groups met with a clinical psychologist for two pre-transplant training sessions and ten in-hospital "booster" sessions during the course of transplantation. Forty-five patients completed the study and provided all covariate data, and 80% of the time series outcome data. Analyses of the principal study variables indicated that hypnosis was effective in reducing reported oral pain for patients undergoing marrow transplantation. Risk, SIP, and BSI pre-transplant were found to be effective predictors of inpatient physical symptoms. Nausea, emesis and opioid use did not differ significantly between the treatment groups. The cognitive behavioral intervention, as applied in this study, was not effective in reducing the symptoms measured.

Hypnosis in Cancer Patients: Can We Do Better?

“…A same strategy with breast cancer patients was tested over a four month period (Butler, 2009): it significantly reduced chronic pain intensity over the period but not the frequency of pain episodes or the amount of constant pain. Syrjala (1992) confirmed some of these outcomes in a trial including 94 male or female adult patients diagnosed with leukemia, myelodysplasia or lymphoma, and suffering from persistent oral mucositis pain following bone marrow transplantation. Before hospitalization, training material (information on relaxation, deep breathing and audio-tapes) was presented through one-to-one interaction in two sessions.…”

“…Complementary approaches are therefore interesting, especially for anticipatory symptoms. Three trials tested this question using self-hypnosis (Syrjala, 1992;Jacknow, 1994;Hawkins, 1995) that patients were supposed to use before and during treatments, while the other one proposed tailored individual hypnosis (Zelter, 1991) including imaginative fantasy with suggestions (for example, holding or cuddling a pet). All these trials concerned pediatric cancer patients except for Syrjala (1992).…”

“…Three trials tested this question using self-hypnosis (Syrjala, 1992;Jacknow, 1994;Hawkins, 1995) that patients were supposed to use before and during treatments, while the other one proposed tailored individual hypnosis (Zelter, 1991) including imaginative fantasy with suggestions (for example, holding or cuddling a pet). All these trials concerned pediatric cancer patients except for Syrjala (1992). Because of the small sample size of the four trials, a meta-analysis was conducted by Richardson (2007) who concluded that hypnotherapy significantly lessened symptoms.…”

La intervención psicológica en pacientes oncológicos: una revisión de la literatura (2000-2014)

“…Diferentes estudios han mostrado resultados favorables, especialmente en relación con las náuseas-vómitos, el dolor y el cansancio. Para el manejo del dolor, más concretamente, técnicas como la reestructuración cognitiva (38) o la relajación (39) mostraron resultados positivos al igual que la hipnosis (40) . Los estudios que mediante relajación e hipnosis (41,42) se focalizaron en náu-seas y vómitos anticipatorios en pacientes en quimioterapia o mediante la desensibilización sistemática o distracción cognitivoconductual (43) , lograron evitar su aparición.…”

Hypnosis for Chronic Pain Management

“…Some authors [37][38][39] published controlled clinical trials in cancer patients successfully treated with hypnosis.…”