Can Hypnosis Reduce Hot Flashes in Breast Cancer Survivors? A Literature Review

American Journal of Clinical Hypnosis,  Jul 2004  by Elkins, Gary,  Marcus, Joel,  Palamara, Lynne,  Stearns, Vered

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Suggestions to Control Stress

Hot flashes can occur spontaneously without any identifiable trigger. However some women do report specific precipitating factors such as hot weather, being in a confined space, spicy foods, alcohol, and caffeine (Voda, 1981; Gannon, et al., 1987; Kronenberg, 1990). Psychological stress is also often cited as a precipitant for the onset of hot flashes (Swartzman, Edelberg, & Kemmann, 1990). Research has suggested that hypnosis may be of benefit in reducing the distress in breast cancer survivors. For example, Bridge, Benson, Pietroni, and Priest (1988) completed a study to determine whether relaxation and mental imagery could reduce the levels of distress in breast cancer patients. At the end of treatment there was significantly lower total mood disturbance in the intervention groups (with the relaxation and mental imagery group reporting less disturbance than the relaxation only group) in comparison with a control group.

Suggestions for Reduced Insomnia

Hypnotic techniques also may be of significant benefit in treatment of insomnia (National Institute of Health, 1995). Hypnosis involves the use of imagery and suggestive methods to induce relaxation and imagery with features that are similar to other relaxation techniques used to improve sleep. For example, Borkovec and Fowles (1973) compared progressive muscle relaxation, hypnotic relaxation, and no treatment. Results indicated that both hypnotic relaxation and progressive muscle relaxation resulted in significant decreases in the latency of sleep onset in comparison to the no-treatment condition. More recently, Elkins (1997) described a brief hypnotic intervention for insomnia. The results indicated a high degree of compliance with practice of self-hypnosis, improved sleep, and a high degree of satisfaction with the treatment. Given that many breast cancer survivors with hot flashes experience disturbed sleep and "night sweats," the potential use of hypnosis to reduce hot flashes through improved sleep is also rational.

Preliminary Case Studies

The following preliminary case studies illustrate the potential use of hypnosis for hot flashes.

Case One

History. Ms. D. was a 49-year-old divorced woman who was postmenopausal with invasive ductal carcinoma of the right breast. She completed a course of chemotherapy and her cancer was in remission. She was experiencing significant distress due to hot flashes and was referred by her oncologist for hypnotherapy.

At the time of consultation the patient was experiencing an average of 4 to 6 hot flashes per day. She reported the hot flashes as frequently waking her in the middle of the night "drenched in sweat." She also reported significant interference in her activities of daily living. These disruptions included blocking of thoughts, insomnia, having to stop what she was doing, and embarrassment. Ms. D. was experiencing a great deal of distress when the hot flashes would disrupt her concentration during a work or other administrative duty.