Public release date 27-Mar, 2005

Self-hypnosis helps breast cancer patients cope with aftereffects

By Greg Okuhara - Eagle Staff Writer www.theeagle.com

Liz Hirschler wasn't sure why, late in 2004, she began waking up several times a night feeling hot and unable to get back to bed.

She would throw the covers off, walk around and drink a glass of cold water or milk. It would take about 20 minutes for her to finally feel comfortable enough to get back in bed.

The next day, she would come home from work exhausted, without the energy to play with her daughter, and facing another potential night of restlessness.

Hirschler, 42, later found out that the chemotherapy treatments she went through after her breast cancer had hit the fast-forward button on her body's path to menopause.

The result of the sudden change in her body's chemistry were intense hot flashes that were having a severe effect on her quality of life.

But Hirschler began using a self-hypnosis technique that has helped her reduce the severity of the hot flashes and regain some measure of control over her body.

"I believe it's something just about anyone can do without any problems," Hirschler said.

Gary Elkins, director of Scott & White's Mind-Body Cancer Research Program in Temple, helped create the hypnosis therapy techniques that Hirschler uses.

For about 20 minutes before going to bed, she listens to tapes that help with her mental imagery. Along with other techniques, she imagines herself sitting on a dock with her feet dangling in the cold water of a lake.

Before starting the hypnosis therapy, Hirschler said she would wake up once every 1 1/2 hours each night; it would take nearly a half-hour for her to feel comfortable enough to get back into bed.

"It took about two weeks to notice an appreciable difference," she said.

Hirschler said she finds a comfortable place to relax and concentrate. She listens to the tapes while her husband watches television.

She used to have about three or four hot flashes a night, but since beginning Elkins' hypnosis therapy, Hirschler said she wakes up only about once a night.

"Not only has it cut down on the frequency, but the severity as well," she said. "Now, if I wake up, I'll throw the covers off, and five or six minutes later I'm back to sleep."

Techniques

Elkins said hypnosis techniques have been used in the past as a tool for pain, anxiety and stress management.

During a staff meeting, an oncologist working with breast cancer patients suggested Elkins look into using similar techniques to treat hot flashes as an alternative to drug- or hormone-based treatments.

Elkins' program teaches women to use mental imagery in which they visualize themselves in a cool, soothing place.

Through the use of tapes with various prompts and other exercises, Elkins said women can help quell the severity and number of hot flashes.

"When women experience hot flashes, it's seen as a loss of control," he said. "What we are doing is giving them a greater sense of control over their symptoms and body."

Regaining some measure of control is important, Elkins said, because the hot flashes negatively affect a woman's quality of life.

In a 1998 study, the Journal of Clinical Oncology reported that 89 of 102 breast cancer survivors experiencing hot flashes described the episodes as "severe," and 37 percent of the respondents said the episodes interrupted their daily activities and disrupted sleep.

Hot flashes also create additional stress and anxiety for women because of their embarrassing effects such as sweating, itching sensations, weakness, feeling faint and a rapid heartbeat, Elkins said.

Hirschler takes Tamoxifen, a drug that helps decrease the recurrence of breast cancer. But side effects include intense hot flashes.

Elkins said when menopause naturally occurs, it's a gradual process that women's bodies can adjust to, unlike the chemically induced hot flashes that disrupt their lives.

"When a patient begins to have severe hot flashes, they can interfere with everything from their personal life, work and sexual and marital relationships," he said.

A good alternative

Another important characteristic of the hypnosis therapy, Elkins said, is the lack of menopausal treatments for some breast cancer survivors.

Researchers also have looked at nonhormonal therapies such as soy and vitamin E supplements, but neither was very effective in suppressing the number or severity of hot flashes.

Anti-depression medication also is used, but some women and doctors don't want to use them because of potential side effects.

Because of the nature of Hirschler's tumor, which tested positive for progesterone and estrogen, she could not use hormone replacement drugs. The risk of the cancer returning was too significant since it possibly would feed on the two hormones.

Her oncologist gave her two other options: antidepressant medication or Elkins' program.

More medication was not an option for Hirschler.

"With all my liver and kidneys had gone through with all the drugs I had already taken, I didn't want to expose my body to that anymore," she said.

Although there is a common misconception of what hypnosis involves, Hirschler said she approached Elkins' therapy with an open mind.

During their initial meeting, she found out it wasn't that much different from the mental imagery she uses when practicing archery.

"There are a lot of myths and misperceptions about hypnosis that are perpetuated by movies and magicians," Elkins said.

Patients are given suggestions to concentrate on getting to a relaxed state.

"We ask the patients to think of images, and they're able to experience more coolness and comfort physically," Elkins said. "Patients who do the best are those who practice the hypnosis on a daily basis."

There are about 30 openings to participate in the Scott & White study, which is funded by the National Institutes of Health.

Elkins said to be eligible, women must not be taking any kind of hormone-replacement therapy.

Patients who are accepted and assigned to the treatment group will receive information on hypnosis, learn the process of hypnosis, a tape recording to practice hypnosis at home and individual consultation to come up with images to use during hypnosis.

For more information, call Amanda Wilder at 254-724-3123.

Hirschler encourages any women going through the same situation she did to give the hypnosis therapy a shot because it's been so helpful to her.

"It's so much nicer to wake up in the morning and not be grouchy," she said.

. Greg Okuhara's e-mail address is greg.okuhara@theeagle.com .