Hypnosis eases post-breast cancer hot flashes

NEW YORK (Reuters Health) - Hypnosis can help reduce hot flashes among breast cancer survivors, new research published in the Journal of Clinical Oncology shows.

The authors of the report note that “hot flashes are a significant problem for many breast cancer survivors.” The new findings are particularly important because the current best treatment for hot flashes, estrogen therapy, is off limits for most women who have had breast cancer.

Furthermore, many women must take estrogen-blocking drugs like tamoxifen for years after breast cancer treatment, but “hot flashes can be so severe that some women make a decision to not continue those medications,” Dr. Gary Elkins told Reuters Health.

Based on some small studies that found hypnosis benefited women suffering from hot flashes, Elkins of Baylor University in Waco, Texas, and his team randomly assigned 60 breast cancer survivors to hypnosis once a week for five weeks or no treatment.

The hypnosis sessions, which lasted about 50 minutes, involved helping the patient to reach a deeply relaxed state, and then offering suggestions for mental imagery to help her relax and feel cool. This could mean having a woman imagine herself walking down a cool mountain path, for example. Women also received instructions on how to practice hypnosis on their own.

Among the 51 women who completed the study, those who had hypnosis reported a 68% reduction in the severity and frequency of their hot flashes. This translated to 4.39 fewer hot flashes a day, on average, for women in the hypnosis group, while there was little change in the control group.

In an editorial accompanying the study, Dr. Nancy E. Avis of the Wake Forest University School of Medicine in Winston-Salem, North Carolina, calls the reduction in hot flashes seen by Elkins and his team “impressive,” but points to the need to compare hypnosis to some type of placebo, rather than no treatment at all.

In fact, Elkins said, he and his colleagues are now launching a National Institutes of Health-funded study to address this issue, which will enroll 180 postmenopausal women and will compare hypnosis to another type of mind-body intervention.

The mechanism behind hot flashes is still poorly understood, Elkins noted. “We know that they are related to decreases in estrogen, however that relationship is not direct in the sense that hot flashes lessen over time even though estrogen levels remain low,” he explained.

Hot weather, spicy food and stress can also trigger hot flashes, he added, so it’s possible that women undergoing menopause may have a more difficult time regulating their body temperature in response to these triggers. Hypnosis treatment can reduce stress by helping women to relax, Elkins explained, and may also give them a sense of control that allows them to keep their body temperature more stable.

SOURCE: Journal of Clinical Oncology, online September 22, 2008.