THE EFFECTS OF MENTAL IMAGERY ON EMOTIONS, IMMUNE FUNCTION AND CANCER OUTCOME.

Description

The purpose of this longitudinal, experimental study was to test in a sample of patients with cancer the effects of mental imagery on hope, sense of coherence, cellular immune function, disease state, and quality of life and to test a conceptual model of the relationships among these variables. Thirty-eight outpatients with solid tumors who were receiving chemotherapy were randomly assigned to an experimental or control group. Experimental group patients (N = 22) met monthly for four months as a support group and were taught mental imagery techniques. Control group patients (N = 16) were a time-matched control. All patients completed questionnaires on hope, sense of coherence (SOC), and quality of life (QOL) before the study and once a month for four months. At the same time, peripheral blood was drawn to assess circulating $\beta$-endorphins, natural killer (NK) and lymphokine activated killer (LAK) cell function, and monocyte cytotoxicity. Disease state was quantified on a 6-point scale ranging from absence of disease to death and assessed before and immediately after the experimental intervention, and again 6 and 12 months afterwards. The quality of imagery for experimental group subjects was measured with the Image CA, and frequency of practice was documented in a journal. The experimental group had significantly better LAK function and monocyte cytotoxicity over time. NK function was reduced in both groups over time. Although disease state improved in the experimental group, this difference was not significantly different from the control group. Within six months after the intervention ended, disease state increased significantly in both groups. Analysis of the conceptual model indicates that a higher quality imagery is a better predictor of quality of life, disease state, and emotional state than the frequency of imagery practice. Time lapse from the last chemotherapy correlated positively with $\beta$-endorphin levels, monocyte cytotoxicity, and LAK function, suggesting that chemotherapy suppressed these parameters. The findings suggest that mental imagery taught in a support group setting contributes to improved immune function in patients with cancer, and that effective imagery can improve quality of life, emotional state, and disease state, while the intervention is being employed.

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