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 seen for four 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. Mrs. H. felt that she had done so well that she discontinued treatment prior to the suggested five sessions.

As shown in Figure 3, during the baseline period the patient recorded 86 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 21 hot flashes in her final recording period. This woman had a reduction from 12.3 daily mean hot flashes to 3 (76% reduction).

The severity of hot flashes was also recorded daily. The patient was asked to rate the seventy of her hot flashes with four descriptive adjectives (mild, moderate, severe, or very severe). As shown in Figure 4, during the baseline period she recorded 51 hot flashes as "moderate" and 20 as mild. She also recorded a total of 15 severe hot flashes during the same baseline week. At the end of treatment the number of her mild hot flashes were recorded as 21. She did not report any hot flashes in either the moderate or severe range.

By 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 also reported that her feeling of well being and confidence had generalized to other areas of her life such as work and social interactions. In fact, she reported such a feeling of confidence and control over her internal and external environments that she had decided to change careers.

Although these are anecdotal reports, the present research provides important preliminary data regarding this intervention. The two women had a substantial reduction in their hot flashes within a short time interval, which was more substantial than the average placebo effect. The results of these cases are encouraging and this intervention warrants further study.

Discussion and Future Research

This review reveals that hot flashes remain a very significant problem for many breast cancer survivors and that there is a need to develop new and effective interventions. Hormonal approaches are generally avoided with breast cancer survivors and non-hormonal pharmacological agents are not very effective or are associated with many side effects. A well-tolerated, non-hormonal treatment such as hypnosis for hot flashes would be of great value. Hypnosis is a mind-body intervention that is generally well tolerated and is a non-hormonal treatment that may be of significant benefit in reducing frequency and intensity of hot flashes in breast cancer survivors. Further, hypnosis may result in improved sleep and decreased interference of hot flashes on daily activities. However, the use of hypnosis for hot flashes has not been adequately explored and the efficacy of hypnosis is, as yet, unknown. The mechanisms by which hypnosis may operate to reduce hot flashes have also not been determined.