Outcomes of Guided Imagery (GI) in Patients Receiving Radiation Therapy for Breast Cancer.

Abstract

Abstract Background: There is an emerging recognition of the importance of Integrative Medicine in cancer care. We initiated a study evaluating the impact of GI on patients undergoing radiation therapy for breast cancer.Materials and Methods: A prospective, IRB-approved study evaluating the efficacy of GI among patients receiving radiation therapy for breast cancer was completed. Eligible patients had GI sessions with an Integrative Oncology Nurse (ION) and were given the tools and were trained techniques for self practice. The study endpoints include evaluating relaxation response to GI sessions using clinical variables that represent the level of an individuals stress and anxiety. These biofeedback measures included blood pressure (BP), respiration rate (RR), pulse rate (PR), and skin temperature (temp.) before and after the GI exercise. Further, the EQ-5D questionnaire, an established and validated tool for measuring health outcomes, was used for the subjective assessment. Patients completed the EQ-5D questionnaire prior to their first GI session (baseline data) and again at completion of radiation treatment. Patient feedback on their overall experience was collected at the end of the planned RT treatment through a satisfaction survey.Results: In all, 68 breast cancer patients have completed the protocol. The median age is 57 years. Median number of GI sessions with the ION was 4 (range: 1-6). In all cases, the parameters measured statistically significant improvement from baseline; median RR decreased from 19.6 per minute to 17.5 per minute; the mean drop of 4 beats/ minute in the pulse rate was observed. The mean drop in the systolic BP was 8.6mmHg, and the mean drop in the diastolic BP was 3.6 mmHg, and the mean skin temperature increased from 84.70F to 89.40F indicating increase in peripheral capillary flow secondary to a decrease in the sympathetic response. Results are summarized in Table 1. Overall 86% described the GI sessions as helpful, and 100% would recommend this intervention to others.Clinical VariablePrior to GI session (mean values)After GI session (mean values)p-valueRespiration rate19.617.5<0.001Pulse rate77.073.00.002Diastolic BP71.668.00.02Systolic BP124.3115.7<0.001Skin temp.84.7°F89.4°F0.007 Conclusion: The results of this study illustrate the positive impact of GI as measured through subjective and objective parameters. In improving the overall care of breast cancer patients there may be value to incorporating practices of Integrative Medicine. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5039.