Hypnosis therapy shown to decrease fatigue levels in breast cancer patients
Breast cancer patients receiving radiotherapy showed decreased fatigue as a result of cognitive behavioral therapy plus hypnosis (CBTH), according to a study recently published in the Journal of Clinical Oncology.
The study, titled, “Randomized Controlled Trial of a Cognitive-Behavioral Therapy Plus Hypnosis Intervention to Control Fatigue in Patients Undergoing Radiotherapy for Breast Cancer,” was led by Guy Montgomery, PhD, Associate Professor and Director of the Integrative Behavioral Medicine Program in the Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai. The results of a randomized controlled trial of 200 patients showed that the treatment group had significantly less fatigue than a control group both during treatment and for up to six months afterwards.
The average patient in a treatment group had less fatigue than 79 percent of patients in a control group at the end of radiotherapy. Six months after the end of radiotherapy, the average patient in a treatment group had less fatigue than 95 percent of patients in a control group. “These results support CBTH as an evidence-based complementary intervention to control fatigue in patients undergoing radiotherapy for breast cancer,” said Dr. Montgomery. “CBTH works to reduce fatigue for patients who have few other treatment options. It is also noninvasive, has no adverse side-effects, and its beneficial effects persist long after the last intervention.”
Additionally, patients also reported that participating in CBTH was relaxing and helpful.
“This study is important because it shows a new intervention that helps to improve patients’ quality of life during taxing course of breast cancer radiotherapy and for long after,” said Montgomery.
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The study was partially funded by grants from the National Cancer Institute and the American Cancer Society.
Cognitive-Behavioral Therapy Plus Hypnosis Controls Fatigue in Breast Cancer Patients Receiving Radiotherapy
In the study, 200 consecutive patients with breast cancer at Mount Sinai Medical Center, New York, who were scheduled for a 6-week course of external-beam radiotherapy were randomly assigned to receive cognitive-behavioral therapy/hypnosis with trained clinical psychologist interventionists (n = 100) or interventionist attention without cognitive-behavioral therapy/hypnosis (n = 100) during the period of radiotherapy.
In both groups, the initial intervention session, scheduled for the patients’ radiotherapy verification day, lasted for 30 minutes. Patients met with an interventionist twice weekly during the course of radiotherapy, with each session lasting 15 minutes. The final intervention session, scheduled for the penultimate day of radiotherapy, lasted for 30 minutes.
For control group patients, the interventionist did not lead the patient in cognitive-behavioral techniques of imagery, relaxation, or evaluation of thought processes or in discussion; the interventionist allowed the patient to direct the flow of the conversation and provided supportive/empathic comments.
Fatigue was measured using the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue subscale, the primary outcome measure, and visual analog scales for fatigue and muscle weakness at baseline, end of radiotherapy, and at 4 weeks and 6 months after radiotherapy. Comparisons were made in the intent-to-treat population and were adjusted for multiple comparisons.
The cognitive-behavioral therapy/hypnosis group and the control group were balanced for age (mean, 56 years in both), education (college degree or higher for 66% in both), marital status (53% and 51% currently married), race (69% and 66% white), receipt of chemotherapy before radiotherapy (43% and 38%), Karnofsky performance score (mean, 94 in both), adjuvant hormone treatment (tamoxifen in 30% and 31%, aromatase inhibitor in 44% and 42%), disease stage (0 in 29% and 32%, I in 39% and 38%, II in 21% and 19%, and III in 11% in both), and total radiation dose (mean, 62 Gy in both).
By Matthew Stenger
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The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven member hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services - from community-based facilities to tertiary and quaternary care.
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