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Clinical Note
Hypnosis for Postradiation Xerostomia in Head and Neck Cancer Patients: A Pilot Study
Elad Schiff MD, a, , Jorge G. Mogilner MDa, Eyal Sella MDa, Ilana Doweck MDa, Oded Hershko MDa, Eran Ben-Arye MDa and Noam Yarom MDa
aDepartment of Internal Medicine (E.S.), Bnai-Zion Hospital, Haifa; Department for Complementary/Integrative Medicine, Law and Ethics (E.S.), and The International Center for Health, Law and Ethics (E.S.), Haifa University, Haifa; Department of Pediatric Surgery (J.G.M.), The Ruth & Bruce Rappaport Faculty of Medicine, and the Complementary and Traditional Medicine Unit (E.B.-A.), Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa; Department of Otolaryngology-Head and Neck Surgery (E.S., I.D.), Carmel Medical Center, Haifa, Israel; Faculty of Medicine (O.H.), Semmelweis University, Budapest, Hungary; Clalit Health Services (E.B.-A.), Haifa and Western Galilee District; and Oral Medicine Clinic (N.Y.), Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Israel
Abstract
Xerostomia, the sensation of dry mouth, affects almost all patients who undergo radiotherapy for cancer in the head and neck area. Current therapies for xerostomia are inadequate, and the condition negatively impacts the quality of life.
This prospective observational pilot aimed to evaluate whether hypnosis could improve salivation and decrease xerostomia. Twelve patients with xerostomia after radiotherapy for head and neck cancer were assessed for severity of xerostomia symptoms and sialometry. They then received a single hypnosis session with specific suggestions to increase salivation.
The session was recorded on a compact disk (CD), and the participants were instructed to listen to it twice a day for one month. Sialometry was repeated immediately after hypnosis. Validated xerostomia questionnaires were completed at one, four, and 12 weeks after hypnosis.
A substantial overall improvement was reported by eight patients at 12 weeks (66%). The saliva flow rate increased on sialometry in nine patients following hypnosis (75%). There was no correlation between the magnitude of changes in the measured saliva flow rate and changes in subjective measures (Spearman's correlation coefficient r = 0.134). Symptomatic improvement significantly correlated with the number of times the patients listened to the hypnosis CD (r = 0.714, P = 0.009).
No adverse events were reported. The data from this small observational trial suggest that hypnosis may be an effective treatment for xerostomia. Confirmation in a larger randomized and controlled investigation is warranted.
Journal of Pain and Symptom Management (article in press February 09)
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