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IMMUNE SYSTEMS OF BREAST CANCER PATIENTS
415
a decade ago, Smith, Barabasz, Barabasz, and Warner reported that
high hypnotizable participants who underwent hypnosis showed sig-
nificant increases in CD4
+
T cells and B cells in a short-term study that
exposed 65 healthy subjects to alert-based hypnosis, relaxation in the
form of Restricted Environmental Stimulation Therapy (REST), or con-
trol conditions (1995). Conversely, in a study of 24 healthy, high hyp-
notizable individuals exposed to varicella-zoster (VZ) antigen,
hypnosis did not change the delayed-type hypersensitivity (DTH)
immune response as measured by the mean diameter of induration
(Locke et al., 1994).
In the context of cancer, the potential for hypnosis to enhance the
immune system is clinically relevant because immunosurveillance plays
a role in cancer progression, though the extent of which is unknown. In
particular, NK cells, B cells, T cells, and macrophages have been impli-
cated in antitumor immune defenses (Turner-Cobb, Sephton, & Spiegel,
2001). Moreover, transplant patients on immunosuppressive agents
have an increased incidence of tumors compared to the general popula-
tion, suggesting that a well-functioning immune system reduces the
occurrence of carcinomas (Nossal, 1993). Hypnosis may also benefit can-
cer patients by down-regulating the hypothalamic-pituitary-adrenal
axis and subsequent release of glucocorticoids and cortisol, which have
been associated with tumor proliferation (Turner-Cobb et al.). Psycho-
logical interventions utilizing imagery have shown statistically signifi-
cant immunological improvements in treated breast cancer patients
compared to controls in some studies (Gruber et al., 1993) but not others
(Richardson et al., 1997). The results of the two hypnotic studies in
breast cancer patients will shed more light on the relationship between
hypnosis and the immune system in the setting of cancer.
A
N
E
VALUATION OF
T
WO
S
TUDIES
A
SSESSING
THE
E
FFECTS
OF
H
YPNOSIS ON
THE
I
MMUNE
S
YSTEM
IN
B
REAST
C
ANCER
P
ATIENTS
The effects of hypnotic intervention on the psychological and
immunological well-being of breast cancer patients was appraised in
the Bakke et al. (2002) and Hidderley and Holt (2004) experiments.
Table 1 lists the design parameters of each study. Both investigations
enrolled approximately 30 women with early stage breast cancer rang-
ing in age from those in their reproductive years to postmenopausal
women. Participants were at least 6 months beyond invasive treat-
ments, such as radiotherapy, and received weekly instructor-guided
hypnotic treatment for 2 months. At the end of the trial, both studies
concluded that the psychological intervention improved mood and
elevated certain immune-cell levels in the breast cancer patients.
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