clinical hypnotherapy in cancer care white paper · if we are to improve cancer outcomes, boost...

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� | P a g e 1Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707

Email: [email protected] | www.AvinoamLerner.com

Clinical HYPNOTHERAPY

in Cancer Care

http://www.AvinoamLerner.com

Table of Contents Introduction……………………………………………………………………………………………..3

Clinical Hypnotherapy & PNI……………………………………………………………………………4

How Hypnosis is Used in Cancer Treatment……………………………………………………..……4

Hypnosis as an Immunotherapeutic Approach………………………………………………………..5

Evidence to Support This Treatment…………………………………………………………………..6

Clinical Hypnotherapy Uses

Chemotherapy…………………………………………………………………………………..7

Radiation…………………………………………………………………………………………8

Surgery…………………………………………………………………………………………..8

Quality of Life……………………………………………………………………………………………9

What To Expect………………………………………………………………………………………….10

Qualified Professional……………………………………………………………………………………11

Is This Intervention Right for Me?……………………………………………………………………….11

About Avinoam Lerner…………………………………………………………………………………..12

References………………………………………………………………………………………………13

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Cancer is all around us. We have all

been affected by it in one way or another. We

have seen the upsides, downsides and

struggles of cancer and know it is an ailment

that medicine has yet to conquer. We try our

best to believe in the strong minds and

research of modern medicine, but the truth is

that modern medicine despite its advances

continues to disappoint. Its paradigm separates

the person from the illness thus treating only the

symptom, failing to treat its root cause. It is time

to transcend the mechanistic-reductionist-

Newtonian view of disease

and recognize that illness is a

whole person event. As such,

if we are to improve cancer

outcomes, boost quality of life

a n d p r o v i d e i m p r o v e d

prognoses we must seek

interventions that are more

ho l i s t i c to comp lement

medical care.

It is time to explore clinical

h y p n o t h e r a p y a s a n

integrative intervention that

improves treatment efficacy

and recovery outcome by

increasing patient’s engagement. We can no

longer leave recovery up to fate or even in the

hands of trusted medical professionals. It is

essential that we leave no stone unturned and

explore every viable option.

Whether you are looking for answers for

a loved one or yourself, clinical hypnotherapy

has scientific evidence and years

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Clinical Hypnotherapy as an Effective Intervention for Cancer Recovery


of patient testimonials to support its use in

cancer management and rehabilitation.

C l i n i c a l h y p n o t h e r a p y &

psychoneuroimmunology (PNI)?

Psychoneuroimmunology (PNI) is the

study of the interactions between psychological

processes and the nervous and immune

systems of the human body. PNI describes how

psychological factors such trauma, attitude and

outlook can impact the functioning of the

immune system and therefore physical

resiliency. Research shows that psychological

state plays a role in many common diseases

and conditions, including heart disease,

diabetes, autoimmune disorders and cancer.

Mediated by the endocrine and nervous

systems, a person’s mental state and behavior

has an effect on his or her immune system

capacity fight and protect against disease. The

brain influences the functioning of the immune

system by controlling the autonomic nervous

system. In addition, the endocrine hormones

regulate body function and have an effect on

sleep, body temperature and activity. The

immune and nervous systems work together.

Our bodies have evolved to sense and respond

to danger and create an appropriate, adaptive

response. Research shows that the

interactions of the central nervous system and

immune systems are highly modulated by

behavior and psychological states (Ziemssen

2007). Our psychological status influences

immunity and disease.

Clinical hypnotherapy utilizes a technique

called induction to help patient enter the

hypnotic state. The hypnotic state is a state of

focused attention, absorption and heightened

suggestibility. Recent research suggests that

hypnos is can effect i ve l y change ou r

physiological and neurological state and

functions.

Clinical hypnotherapy utilizes practices

that are respectful of an individuals will.

Hypnosis can range in depth and experience

from light trance to a more complex and deep

trance. In addition, self-hypnosis can be utilized

for self-management. Light trance can help take

away the anticipatory anxiety associated with

cancer and restore confidence and autonomy in

treatment. Deeper trance can help support and

boost immune response and improve the

efficacy of medicine.

How is hypnosis used in cancer treatment?

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Hypnosis is used in cancer treatment for

a variety of reasons. Goals will be specific to

patient needs. They may need assistance with

resolving hopelessness, managing pain, and

lessening anxiety, preparing for surgery,

reducing nausea or any other multitude of

issues.

The skilled clinician promotes the

treatment of the whole person. He or she will

help patients engage and harness the creativity

and intelligence of their mind to revive and

strengthen the immune response, increase

resiliency and quality of life.

Providing patients a safe and effective

way to play a more active role in their care and

recovery, they can recognize their own drive

and purpose for continuing and overcoming the

adversity of disease. Clinical hypnotherapy

helps to identify, substantiate and verbalize a

reason to continue and to overcome. Clinical

hypnotherapy works in conjunction with

conventional medicinal treatment and is

appropriate to begin at any point during the

cancer treatment.

Hypnosis as an immunotherapeut ic approach to recovery:

The human immune system is comprised of

specialized cells, hormones, organs and

psychological factors, including behavior. The

immune system is capable of responding to

foreign cells, objects and bacteria and creating

an appropriate response to destroy it. In

addition, the immune system is able to adapt to

small changes in foreign cells and address

them. Evidence shows that there is a high level

of interaction between the biological response

of the body and the psychological function of

the central nervous system (Kiecolt-Glaser

1999).

Immmunotherapy utilizes the body’s own

immune system to help recognize cancer cells

and strengthen the immunologic response.

Immunotherapy is also known as biological

therapy. In traditional medicine, doctors use

drugs and proteins called antibodies to target

cancer cells. This form of treatment is used

with the goal of increasing the body’s

immunologic efficacy and destroying invading

cancer cells. Most of these drugs are man

made.

Research shows that behavior changes

can be used to improve immunity. Immunity is

very dependent on sleep cycles and outside

substances. Research also shows that chronic

depression doubles the risk of cancer in the

elderly (Penninx 1998). The behavioral property

of depression weakens the immune system,

making the individual more susceptible to

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cancer cell spread. Mood and emotional state

are more correlated to immune changes than

coping attitudes. For this

Immmunotherapy utilizes the body’s own

immune system to help recognize cancer cells

and strengthen the immunologic response.

Immunotherapy is also known as biological

therapy. In traditional medicine, doctors use

drugs and proteins called antibodies to target

cancer cells. This form of treatment is used

with the goal of increasing the body’s

immunologic efficacy and destroying invading

cancer cells. Most of these drugs are man

made.

Research shows that behavior changes

can be used to improve immunity. Immunity is

very dependent on sleep cycles and outside

substances. Research also shows that chronic

depression doubles the risk of cancer in the

elderly (Penninx 1998). The behavioral property

of depression weakens the immune system,

making the individual more susceptible to

cancer cell spread. Mood and emotional state

are more correlated to immune changes than

coping attitudes. For this reason, addressing

emotion and mood is essential for proper

hypnotic treatment. Hypnosis has been shown

to naturally increase the production and power

of immune cells, particularly lymphoid natural

killer cells. In an exciting research study,

changes to the psychiatric mood, thought

processes and emotions were correlated with

improved lymphoid natural killer cells (Fawzy

1990). By improving psychiatric outlook,

immunity is improved. Hence, hypnosis is a

valid immunotherapeutic approach to cancer

treatment.

What evidence supports this treatment?

For the las t th i r ty years, many

researchers have investigated hypnosis as a

treatment intervention to determine the impact

of hypnosis on cancer. Research has

investigated many endpoints, from pain to

depression, to survivorship and quality of life. In

investigating length of survival, a randomized

controlled trial of patients with breast cancer

found a positive impact on survival when

utilizing hypnosis (Spiegel 1989). The test

groups participated in intervention of group

sessions for one year in congruence to their

standard medical treatment. The study found

that the median survival time was over a year

and a half longer in the hypnosis intervention

group. The researcher repeated this study many

years later with a larger sample size and found

similar outcomes (Spiegel 2007).

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Clinical hypnotherapy use for-

Chemotherapy:

One of the main treatment options for

individuals dealing with cancer is chemotherapy.

Chemotherapy utilizes pharmaceutical drugs to

treat cancer cells throughout the body.

Chemotherapy is not targeted to one area of the

body, but instead the medication reaches the

whole body. For this reason, chemotherapy can

attack cancer cells that have metastasized

(spread) to other parts of the body, away from

the original tumor. The goals of chemotherapy

are to cure the cancer, kill cancer cells that may

have spread, slow the cancer’s growth and

keep the cancer from spreading. Because the

medication is meant to kill cancer cells and the

chemo circulates throughout your entire body,

chemotherapy can cause some ver y

unpleasant and adverse side effects. Chemo

targets fast growing cancer cells, but has an

affect on normal, healthy cells as well. The

normal cells that are most often damaged are

blood-forming cells in the bone marrow, hair

follicles, and cells in the mouth, gastrointestinal

tract and reproductive system. Common side

effects include fatigue, hair loss, increased

bruising, reduced immunity, nausea and

vomiting.

Research has found that cl inical

hypnotherapy is effective in reducing side

effects associated with chemotherapy. In a

systematic review of evidence (Richardson

2007), six randomized controlled trials were

reviewed to determine the effect of clinical

hypnotherapy on chemotherapy outcomes for

adults and children. The researchers found that

hypnosis is a clinically valuable treatment for

reducing chemotherapy related nausea and

vomiting. As nausea and vomiting are typically

some of the most unpleasant side effects

experienced by patients, hypnotherapy should

be incorporated to treatment in conjunction with

chemotherapy. Not only does c l in ica l

hypnotherapy reduce s ide effects o f

chemotherapy, but it has been linked to

improved survivorship. An individual’s response

to chemotherapy correlates with overall

prognosis and survival. The better the patient is

compliant with chemotherapy and the better the

outcomes of chemotherapy, the greater the

tumor regression and patient survival. Hypnosis

improves an indiv idual ’s to lerance for

chemotherapy, which increases compliance

with treatment and overall outcomes.

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Radiation:

Radiation therapy uses high-energy

particles or waves to destroy cancer cells. It is

one of the most common treatments for many

types of cancers. Radiation kills cancer cells by

breaking up the DNA inside the cancer cells. By

disrupting the DNA, the cancer calls are not

able to grow and divide, which causes cell

death. Side effects include fatigue, skin

changes, and long-term damage to otherwise

healthy body parts.

Utilizing clinical hypnosis during radiation

treatment has been shown to reduce fatigue. A

research study done in 2009 examined the

effectiveness of cognitive-behavioral therapy

and hypnosis to treat radiation related fatigue in

individuals undergoing radiation for breast

cancer (Montgomery 2009). The researchers

examined two groups of women: one group

received standard medical care while the other

group received standard medical care in

addition to cognitive-behavioral therapy and

hypnosis. Fatigue was measured weekly using

a standardized outcome measurement tool. The

researchers found that there was a significant

effect on the intervention group, as the

participants’ fatigue did not increase over the

course of the treatment. The group of women

receiving standard medical care had a linear

increase in fatigue during their treatment. This

study suggests the effectiveness of clinical

hypnotherapy for controlling and preventing

radiation related fatigue.

Surgery:

Surgery offers the greatest chance for a

cure for many cancer patients. Surgery

removes all or part of a tumor, while trying to

avoid damage to healthy tissues. Surgery can

be performed for many reasons, including:

diagnostic, palliative, staging, reconstructive

and curative. As with any type of medical

procedure, surgery has risks and side effects.

Risks include bleeding, anesthesia drug

reactions, damage to other tissues, blood clots,

infection and pain.

Again, research has shown the benefits

of hypnotherapy while undergoing cancer

surgery. In 2007, researchers investigated

whether a br ief pre-surgical hypnosis

intervention would decrease anesthesia and

analgesic use during surgery and side effects

after surgery (Montgomery 2007). The

researchers assigned women scheduled to

undergo excision breast biopsy or lumpectomy

to a 15 minutes pre-surgical hypnosis session

or to a control group that participated in

nondirective listening. They found that patients

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in the hypnosis group required less pain

medication during surgery than patient sin the

control group. Because of this, the overall cost

was significantly lower ($772.71 less per

patient) in the control group for the hospital. In

addition, the hypnosis group patients reported

less pain intensity, nausea, fatigue, discomfort

and emotional upset.

Another study investigated the use of

hypnosis and guided imagery in a sample of 36

head and neck cancer surgery patients (Rapkin

1991). The experimental group received

hypnotic intervention in addition to their usual

medical care. Postoperative hospitalizations for

the group that received hypnosis were

significantly shorter than for the control group.

This study suggests that hypnosis can act

prophylactic-ally, by reducing postoperative

complications and reducing hospital stays.

Quality of life:

Quality of life is generally assessed with

standardized outcome measurement tools and

can include a great many parameters including

physical and psychological health, sexual

function, pain, independence, financial status

and more. Individuals should not underestimate

the importance of quality of life in cancer

treatment and journey. A research study (Liossi

2001) examined the impact of individualized

hypnosis on quality of life in 50 terminally ill

cancer patients. Hypnosis showed significant

outcomes over general support. Those that

received hypnosis treatment had less

depression and anxiety overall.

Depression affects nearly half all of all

patients during their cancer treatment.

Research shows that episodic depression

increases an individual’s risk of cancer by nearly

20% (Dalton 2002). Depression has been

shown to shorten survival rates and significantly

increases suicidal rates. In addition, depression

decreases patient compliance. As research

shows the efficacy of hypnosis in reducing

depression, hypnosis should be incorporated

into cancer treatment.

Several clinical trials have shown the

benefit of hypnosis to reduce pain in both

ch i l d ren and adu l t s . When u t i l i z i n g

hypnosisduring a procedure or immediately

preceding an operation, the self-report of pain is

less than those not utilizing hypnosis. In

addition, hypnosis is shown to be effective in

reducing chronic pain associated with cancer

(Kwiatkowski 2012).

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What to Expect


In a clinical hypnotherapy session, you

can expect to be assisted into a state of

focused attention and comfort. Once in this

state, you wi l l work wi th the c l in ica l

h y p n o t h e ra p i s t t o e n g a g e w i t h t h e

Subconscious Mind. When immersed in the

hypnotic experience, you are more receptive to

healthy new suggestions and thoughts, which

allows you to act on these positive thoughts in

your day-to-day life. Clinical hypnotherapy is

safe, non-invasive and holistic intervention with

no undesired side effect.

Hypnosis is much more than what is

portrayed in the movies or even by stage

hypnotists. A professional hypnotherapist will

ensure your safety, confidentiality and moral

integrity. He or she will help you address issues

and life aspects necessary for attaining your

goal in a meaningful and respectful way.

Hypnosis is not a state of deep sleep

but one of focused attention and relaxation,

which may explain why someone’s eyes may

be closed. The hypnotic state produces a

feeling of well-being where you can more readily

embrace new ideas that are not in conflict with

personal values. While physically very relaxed,

you are utilizing a great deal of thinking and

mental activity, focusing on specific topics,

memories and ideas. Your brain utilizes a

significant amount of neurologic activity. You

can expect to leave the session feeling relaxed,

motivated and hopeful.

Qualified professional:

A Clinical Hypnotherapist is a specialist

in hypnosis. This professional utilizes the healing

power of hypnosis to allow proper functioning of

the immune system and improve the efficacy of

other medicinal interventions.

Is this intervention approach right for me?

If you feel that there more to cancer than

just what takes place in your body; and that

there must be more that you can do to improve

your cancer treatment and outcomes, you must

consider clinical hypnotherapy. If you are ready

to take control of your cancer recovery, explore

viable innovative options to better health, then

you will benefit from clinical hypnotherapy. I

encourage you to be your own advocate along

your cancer journey. I encourage you to explore

all plausible, research-based treatments to

holistically address your cancer diagnosis. Tap

in to and harness the power o f your

subconscious mind. Take control of your cancer

journey.

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A v i n o a m L e r n e r i s a c l i n i c a l

hypnotherapist specializing in Cancer care and

the author of The New Cancer Paradigm.

His innovative approach to cancer

recovery highlights the multidimensional nature

of our being and the need to treat illness not

only on the level of the body but also on the

level of Mind. He offer patients seeking to play a

more active role in their care, a practical,

meaningful and effective path to engage the

creative power of their Mind to revive their

body’s innate immune response and strengthen

its capacity to defend and fight cancer.

Avinoam guiding belief is that for true

and lasting recovery we must transcend the

mechanistic-reductionist-Newtonian view of

disease and recognize that illness is a whole

person event. As such he works with patients in

all stages at his Watertown MA office to

strengthen their body’s innate immune

response, increase physical and psychological

resiliency and enhance their outlook and

attitude toward a favorable outcome.

After earning his degree in Holistic

Hea l th f rom the R idman Co l lege fo r

Complementary Alternative Medicine in Israel in

2000, Avinoam was certified by the National

Guild of Hypnotists (NGH) as well as the

National Federation of Neuro-Linguistic

Programming (NLP) in the USA.

Much of Avinoam’s work is founded on

the work of Dr. Ernest Rossi as described in his

breakthrough book The Psychobiology of Mind

Body Healing and Dr. Al Barrios, a clinical

psychologist and a pioneer in the field of

immunotherapy.

Avinoam is also inspired by the work of

Stephen C.Parkhill, a noted hypnotherapist and

the author of Answer Cancer – The Healing of A

Nation.

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References:

American Cancer Society (n.d) Retrieved November 14, 2014 from http://www.cancer.org.

Dalton SO, Boesen EH, Ross L, Schapiro IR, Johansen C (2002) Mind and Cancer: do Psychological factors cause cancer? Eur J cancer; 38: 1313-1323. Fawzy Fl, Kemeny ME, Fawzy NW, Elashoff R, Morton D, Cousins N, Fahey JL (1990) A structured psychiatric intervention for cancer patients. II. Changes over Time in immunological measures. Arch Gen Psychiatry 47(8): 729-35. Kiecolt-Glaser JK, Glaser R (1999) Psychoneuroimmunology and Cancers: fact or fiction? Eur J Cancer 35(11): 1603-7. Kwiatkowski Fabrice (2012) Hypnosis in cancer patients: can we do better?; Psychology – Selected Papers. Dr. Gina Rossi (Ed.), ISBN: 978-953-51-0587-9. Liossi C (2001). Efficacy of clinical hypnosis in the enhancement of quality of life of Terminally ill cancer patients. Contemporary hypnosis; 15(1): 34-8. Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH (2007) A randomized Clinical trial of a brief hypnosis intervention to control side effects in breast Surgery patients. J Natl Cancer Inst Sept 5; 99(17): 1304-12. Montgomery GH, Kangas M, David D, Hallquist MN, Green S, Bovbjerg DH, Schnur JB (2009). Fatigue during breast cancer radiotherapy: an intitial randomized study of cognitive-behavioral therapy plus hypnosis. Health Psychol 28(3): 317-22. Penninx BW, Guralnik JM, Pahor M, Ferrucci L, Cerhan JR, Wallace RB, Havlik RJ (1998) Chronically depressed mood and cancer in older persons. J Natl Cancer Inst; 90(24): 1888-93. Rapkin DA, Straubing M, Holroyd JC (1991). Guided imagery, hypnosis and recovery From head and neck cancer surgery: an exploratory study Int J Clin Hypn 39 (4): 215-26. Richardson J, Smith JE, McCall G, et. Al (2007). Hypnosis for nausea and vomiting in Cancer chemotherapy: a systematic review of the research evidence. Eur J Cancer Care. 16: 402-412. Spiegel D, Bloom JR, Kraemer HC, Gottheil E (1989). Effect of psychosocial Treatment on survival of patients with metastatic breast cancer. Lancet; 2: 211-22. Spiegel D, Butler L, Giese-Davis J, Koopman C, Miller E, DiMiceli S, Classen C, Fobair P, Carlson R, Kraemer H (2007). Effects of supportive-expression therapy on Survival of patients with metastatic breast cancer. Cancer; 11(5): 1130-8. Ziemssen T, Kern S (2007) Psychoneuroimmunology= cross-talk between the

immune and nervous systems. J Neurol. May: 254 Suppl 2:II8-11.

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22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707 Email: [email protected] | www.AvinoamLerner.com




clinical hypnotherapy in cancer care white paper · if we are to improve cancer outcomes, boost...

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