A randomized trial of the effect of training in progressive muscle relaxation and guided imagery techniques in improving psychological and quality-of-life for breast and prostate cancer patients receiving chemotherapy

Abstract

The randomized study aimed to determine the efficacy of psychological intervention consisting of relaxation and guided imagery to reduce anxiety, depression, and pain intensity and improve Quality of Life in prostate and breast cancer patients undergoing chemotherapy. Material and Method: Two-hundred patients with breast and prostate cancer were included in this study. The patients were randomly allocated to either the study group (n = 100) or the control group (n = 100). Patients in both groups received chemotherapy, but only the study group patients received training in relaxation and guided imagery. Each participant received 4 sessions of progressive muscle relaxation and guided imagery and saliva was collected before and after the sessions. Two primary systems are particularly involved in setting on the stress response, hypothalamus–pituitary– adrenocortical axis (HPA) and sympatho-adrenomedullary (SAM) system. The activation of HPA causes an increase in cortisol secretion in adrenal cortex. Alpha-amylase is one of the major salivary enzymes in humans, and is secreted from the salivary glands in response to sympathetic stimuli. Salivary cortisol and amylase were assayed as indexes of the HPA and SAM system, respectively. Other measurements included assessment of Quality of Life using the EORTC QLQ-C30 (Breast Module-BR23 and Prostate Module- PR25), pain intensity (numeric-pain intensity- rating scale – NRS), depression (Beck Depression Inventory) and anxiety (Self-Rating Anxiety Scale (SAS). Results and Discussion: Even though the study has not yet been completed initial results show that the amylase level was significantly decreased after the progressive muscle relaxation and guided imagery sessions to the study group compared to the control group. Quality of life, anxiety, depression ratings also show a positive response to the interventions. Conclusion: Salivary amylase level was more significantly reduced and reacted more rapidly than cortisol to the relaxation and guided imagery interventions, suggesting that it is a better soothing or relaxation index. The use of relaxation techniques and guided imagery is effective in reducing the levels of anxiety, depression and body discomfort (i.e. pain) in patients who have breast or prostate cancer. These simple and inexpensive interventions enhanced the psychological and physical wellness in these patients.