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Biological Research For Nursing, Vol. 9, No. 3, 205-214 (2008)
DOI: 10.1177/1099800407309374
© 2008 SAGE Publications

Immune Responses to Guided Imagery During Breast Cancer Treatment

Cecile A. Lengacher, RN, PhD

University of South Florida College of Nursing, clengach{at}health.usf.edu

Mary P. Bennett, PhD, RN, ARNP

Western Kentucky University School of Nursing

Lois Gonzalez, PhD, ARNP

University of South Florida College of Nursing

Danielle Gilvary, BS

H. Lee Moffitt Cancer Center, University of South Florida

Charles E. Cox, MD

H. Lee Moffitt Cancer Center, University of South Florida

Alan Cantor, PhD

H. Lee Moffitt Cancer Center, University of South Florida

Paul B. Jacobsen, PhD

H. Lee Moffitt Cancer Center, University of South Florida

Chiu Yang, RN, MSN

National Taiwan University

Julie Djeu, PhD

H. Lee Moffitt Cancer Center, University of South Florida

Background: The use of relaxation and guided imagery to reduce stress and improve immune function has great potential benefits for patients with breast cancer. Methods: This pilot study used a pretest—posttest experimental design with 28 breast cancer patients, aged 25 to 75 years, with the diagnosis of stage 0, 1, or 2 breast cancer. The experimental group received a relaxation and guided imagery intervention and the control group received standard care. The effects of the intervention on immune function were measured by natural killer (NK) cell cytotoxicity and IL-2—activated NK cell activity prior to surgery and 4 weeks postsurgery. NK cell activity was measured using a 15-hr incubation chromium release assay. Cytotoxicity of NK cells was measured against chromium-labeled K-562 target cells. IL-2 was used to enhance reactivity of NK cells against tumor cells. After incubation for 15 hr, cytotoxicity was measured through the release of radioactive chromium. Results: Significant differences between groups were found at 4 weeks postsurgery. T-tests showed increased NK cell cytotoxicity for the intervention group at 100:1, 50:1, and 25:1 effector cell: target cell ratios (E:T) (p < .01 to p < .05) and increased activation for IL-2 at 100:1, 50:1, 25:1, and 12.5:1 (E:T) (p < .01 to p < .05) for the intervention group as compared to the control group. Discussion: These findings suggest that a relaxation intervention such as guided imagery could have an effect on NK cell cytotoxicity and NK cell cytotoxicity after activation with IL-2 in patients undergoing surgery for breast cancer.

Key Words: guided imagery • immune response • breast cancer • natural killer cells


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