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IMMUNE SYSTEMS OF BREAST CANCER PATIENTS
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One experiment that provides an excellent template for future inves-
tigations is a randomized-control study by Spiegel, Bloom, Kraemer, &
Gottheil (1989) that related the effects of psychosocial intervention to
the survival of breast cancer patients. In this prospective study, 86
patients with metastatic breast cancer were followed for 10 years. Par-
ticipants in the treatment group learned self-hypnosis for pain and
attended weekly group-therapy sessions that emphasized coping
mechanisms and social support for 1 year. At the end of the study, the
mean survival time from the start of the intervention to the date of
death was 36.6 months for patients in the treatment group and 18.9
months for the control group, even when initial staging was taken into
account (Spiegel et al.). A similar but less rigorous study performed by
Simonton and Matthews-Simonton (1981) found that individual- and
group-counseling sessions involving relaxation and mental imagery
given to 71 patients with advanced breast cancer resulted in an overall
median survival time of 38.5 months, compared to the contemporary
national average of 18 months.
It is unclear how such psychosocial interventions biologically
altered survival times since neither the Spiegel et al. (1989) nor the
Simonton & Matthews-Simonton (1981) trials recorded immunological
mediators. However, it is likely that the impact of psychological treat-
ment on the immune system affected survival times. A recent study
investigated the relationship between lymphocyte counts and survival
in women with metastatic breast cancer and found that higher cyto-
toxic T cell levels correlated with longer survival times (Blake-
Mortimer, Sephton, Carlson, Stites, & Spiegel, 2004). Interestingly,
immune markers predicted survival time regardless of concurrent medi-
cal or psychotherapeutic treatments. Finally, psychiatric group therapy
has been associated with enhanced immune function and survival time
in the same patient population in a trial of Stages I and II malignant mel-
anoma patients exposed to 6 weeks of treatment. Compared to controls,
subjects in the intervention group showed significant immune-mediated
effects, including an increase in NK cells 6 months posttreatment (Fawzy
et al., 1990), and improved survival at 5- to 6-year (Fawzy et al., 1993)
and 10-year follow-ups (Fawzy, Canada, & Fawzy, 2003). However, the
study was not intended to investigate survival rates at its inception,
which may limit its generalizability (Fawzy et al., 2003). It is therefore
worthwhile to examine the association between hypnosis, immune func-
tioning, and clinical outcomes simultaneously in breast cancer patients
since many questions remain unanswered.
Because hypnosis can alter the immune system of patients with dis-
ease, it is natural to wonder if psychological intervention can prevent
cancer in healthy or at-risk individuals. According to Kiecolt-Glaser
and Glaser (1992), the answer to this question is “No,” because a nor-
mal immune system has homeostatic mechanisms that prevent it from
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