Cancer and Palliative – End of Life Care

Hypnosis has been specifically used in the palliative care of cancer patients to reduce symptoms associated with radiation and chemotherapy, such as pain, nausea, fatigue, hot flashes, and sleep dysfunction.

Length of hypnotic treatment varies depending on the nature and severity of the problem.

All end-of-life choices and medical decisions have complex psychological components, ramifications, and consequences that have a significant impact on suffering and the quality of living and dying.

The medical end-of-life decisions are often the most challenging for terminally ill people and those who care about them.

Each of these decisions should ideally be considered in terms of the relief of suffering and the values and beliefs of the dying individual and his or her family. People facing the end of life due to end stage cancer or any other fatal disease generally feel depressed and anxious. It is normal to feel this way however those feelings only add to the already overwhelming burdens the patient is carrying.

Using hypnotherapy to decrease stress and anxiety can be a wonderful tool for end of life care and palliative hypnotherapy care.

In research, cancer patients undergoing clinical hypnotherapy typically receive approximately five sessions or more of hypnosis, each involving a hypnotic induction and instruction in self-hypnosis. The practice of self-hypnosis helps patients achieve a relaxed, therapeutic, hypnotic state.

Professionals serve as facilitators of self-hypnosis, often providing hypnosis audio recordings for patients to use between sessions.

Hypnosis is frequently offered in conjunction with other therapies such as cognitive behavioral therapy (CBT). Research suggests that using a combination of hypnosis and CBT improved outcomes more than those achieved for at least 70% of patients who used CBT alone.

Sleep

Hypnosis can also be an effective treatment option for cancer patients suffering from sleep problems. Cancer patients experience sleeping difficulties for a number of reasons, including anxiety related to diagnosis, depression, pain, fatigue, and other treatment-related side effects. Cancer patients have been reported to be nearly three times more likely than members of the general population to meet diagnostic criteria for insomnia.

While sleep disorders can be treated with medication, this treatment modality carries with it the inherent risks of dependence and potentially dangerous drug interactions. Furthermore, pharmacotherapy does not treat the underlying source of the sleep disturbance. Hypnosis provides cancer patients with a safe alternative treatment option that not only improves the ability to obtain restful sleep, but can also lead to improvements in other symptom areas.

A study conducted by Elkins (et al) supports the efficacy of clinical hypnosis in improving the quality of sleep for cancer patients. At the conclusion of the 5-week treatment period, not only did cancer patients report fewer hot flashes, but they also reported significant improvements in sleep quality, as well as fewer symptoms of anxiety and depression. This study provides an example of how hypnosis may be effective at treating a target symptom and improving the patient’s overall quality of life.

Pain

Hypnosis is the most frequently cited form of non-pharmacologic cognitive pain control.

Hypnotherapy for the management of chronic pain has been demonstrated to provide relief for the symptoms of pain in cancer, arthritis, sickle cell disease, temporomandibular disorder (TMJ), and fibromyalgia. Hypnosis has demonstrated positive outcomes for the reduction of chronic and procedural-related pain in oncology/cancer treatment.

A study of breast cancer patients found that those assigned to treatment that included clinical hypnosis demonstrated significantly less pain. In addition, patients who underwent hypnosis reported significantly less of an increase in pain over time. Another study of advanced-stage cancer patients with malignant bone disease was conducted with results showing that the hypnosis intervention group had a significant overall decrease in pain.

Nausea

It has been reported that 70% to 80% of all cancer patients who receive chemotherapy experience nausea and vomiting. Hypnosis has been studied for relief of nausea and vomiting secondary to chemotherapy and has been shown to reduce symptoms in some patients. Studies have shown that some cancer patients who underwent a pre-surgical hypnosis intervention to improve post-surgical side effects had reduced postsurgical nausea, as well as a decrease in pain.

Fatigue

Cancer-related fatigue has long been recognized as one of the most difficult symptoms to manage during cancer treatment, and it remains the most common unrelieved symptom of cancer. Research suggests that fatigue is a multidimensional syndrome which results from both cancer and cancer therapies, such as chemotherapy and radiation.

Estimates of the prevalence of fatigue in cancer patients undergoing radiation are diverse. Literature suggests that fatigue can affect 60% to 90% of patients receiving chemotherapy or radiation therapy. Hypnotherapy has been shown for some patients to provide some relief from symptoms of fatigue due to the illness or treatment of the illness.