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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The patient was asked to record the frequency of hot flashes on a daily basis. Also, the patient was asked to rate the severity of hot flashes on a 0-10 scale anchored as "very mild" on one end and "very severe" at the other end. The baseline period was for one week and the patient also recorded the daily frequency and severity of her hot flashes for the five weeks of hypnotherapy.

The patient was seen for five hypnotherapy sessions. At each session a hypnotic induction was completed using a transcript that included suggestions for relaxation and coolness. In addition, the patient was asked to practice self-hypnosis on a daily basis.

As shown in Figure 1, during the baseline period the patient recorded 30 hot flashes at baseline. She experienced a steady decline in the frequency of hot flashes during treatment. At the end of treatment the frequency of hot flashes was reduced to 7 hot flashes in her final recording period. Thus, the mean number of daily hot flashes was reduced from 4.3 to 1 (77% reduction).

The severity of hot flashes was also recorded daily. The patient was asked to rate the severity of her hot flashes with four descriptive adjectives (mild, moderate, severe, or very severe). As shown in Figure 2, during the baseline period she recorded 29 hot flashes as "moderate" and 1 as mild. At the end of treatment the number hot flashes were recorded as 0 moderate hot flashes 7 mild hot flashes.

Also, at the end of treatment the patient reported that she was much less bothered by hot flashes. She stated that her sleep and mood had improved as well. She found that she was less bothered by hot flashes and the attendant anticipatory anxiety about when the next hot flash would occur. She reported that her feeling of well being and confidence had generalized to other areas of her life such as work and social interactions.

Case Two

History. Mrs. H. was a 62-year-old married woman who was postmenopausal with invasive ductal carcinoma. She had undergone a modified radical mastectomy and had completed her course of chemotherapy one month prior to meeting with the therapist. 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 12 hot flashes per day. She reported the hot flashes as frequently waking her in the middle of the night "drenched in sweat," causing her to get out of bed, change bed clothes, and experience significant problems getting back to sleep. She also reported dramatic interference in her activities of daily living. These disruptions included blocking of thoughts, insomnia, having to stop what she was doing, and embarrassment. Ms. H. was experiencing a great deal of distress when the hot flashes would disrupt her concentration, frequently having to stop what she was doing to regroup and gain her equilibrium after a hot flash.

The patient was asked to record the frequency of hot flashes on a daily basis. Also, the patient was asked to rate the severity of hot flashes on a 0-10 scale anchored as "very mild" on one end and "very severe" at the other end. The baseline period was for one week and the patient also recorded the daily frequency and severity of her hot flashes for the five weeks of hypnotherapy.