Hypnosis for the Side Effects of Chemotherapy and Radiotherapy
The appointment is on Monday. It is Thursday, and you are already thinking about it.
It is not just the infusion. It is the journey, the car park, the smell of the corridor on the second floor. Some people say their chest tightens at the sight of the building, others that the nausea starts in the car, before anything has been injected.
And then there is everything else. The fatigue that is like no other, the kind a night's sleep does not touch. Food that no longer tastes the same. A body you do not recognise in the mirror. The nights you wake at three with questions nobody can answer.
Around you, people mean well. You are told you are brave, that you have to stay positive, that a friend of a friend came through it. You smile, and you keep what you really think to yourself.
This page will not ask you to be positive. It explains what complementary support can do, what it cannot, and what must always go through your care team.
Always report your symptoms to your oncology team.
Fever is an emergency during chemotherapy. The threshold that means calling is in your treatment record, and that is what counts, because it is not the same everywhere. In Quebec, the Fondation québécoise du cancer asks people to go to the emergency department at 38.3 °C, or 38 °C for one hour. In France, the Institut national du cancer uses a fever of 38.5 °C or more, or 38 °C for 24 hours, or conversely a temperature below 36.5 °C. Take your temperature by mouth, and do not take paracetamol or an anti-inflammatory before you have called: it masks the fever.
Call without delay too in case of chills, vomiting or diarrhoea you cannot control, if you can no longer drink, in case of bleeding, breathlessness, unusual pain, or if there is redness, discharge or pain around your catheter.
Report tingling and numbness in your hands or feet, even mild. Your team uses this to decide whether to adjust your treatment, and it can only do so if it is informed.
If you are having radiotherapy, show any skin reaction to the team. On the treated area, apply no greasy cream and no perfumed or alcohol-based product before a session: moisturisers go on between sessions, and only those your team has指 indicated.
Never change your anti-sickness medicines on your own. Hypnosis does not replace them.
Finally, tell your team you are seeing a hypnotherapist, and ask what your hospital offers.
The side effects of chemotherapy
Chemotherapy acts on rapidly dividing cells, which is why its effects also reach healthy tissue. These effects vary enormously between protocols and between people, and your team is the only one who can tell you what applies to you.
The most frequently reported are fatigue, nausea and vomiting, changes in taste and appetite, digestive trouble, mouth and mucous membrane problems, hair loss, tingling in the hands and feet, sleep disturbance, difficulty concentrating and remembering, and considerable emotional distress.
Three kinds of nausea, and only one really concerns hypnosis
Medicine distinguishes several forms of nausea under chemotherapy. Three of them bear directly on what you live with day to day, and the distinction changes everything, because they are not treated the same way.
- Acute nausea comes in the hours following the infusion. It is caused by the treatment and is a matter for the prescribed anti-sickness medicines, whose protocols have improved a great deal in recent years.
- Delayed nausea appears over the following days. Same logic: it is prevented and treated medically.
- Anticipatory nausea comes before the infusion, sometimes on the journey, at the sight of the building or the smell of a product. It is not caused by the medicine, since none has been given yet: these are learned reactions, an association between a context and the sickness experienced during previous cycles. It is the same mechanism that makes you salivate at a cooking smell.
The prescribed anti-sickness medicines target the first two forms, the ones the drug causes. They do not prevent anticipatory nausea, which has no pharmacological origin. That does not mean no treatment exists for it: international guidelines propose, for this form specifically, both a prescribed medicine and behavioural approaches, among them progressive muscle relaxation, systematic desensitisation and hypnosis. So it is a conversation to have with your team, not something to sort out alone.
And there is one point on which the guidelines are unanimous: the best way to stop anticipatory nausea taking hold is for the previous cycles to have been well covered medically. Which is one more reason never to lighten your anti-sickness medicines on your own initiative.
If the fear of vomiting is long-standing and goes beyond the treatment setting, see also Hypnosis for Emetophobia.
Radiotherapy raises different difficulties
The two treatments often go together, and pages that conflate them do a disservice. Radiotherapy has its own effects, and they are not worked on in the same way.
Its side effects are first of all local, meaning limited to the treated area: skin reactions, irritation of the mucous membranes, difficulty swallowing for head and neck treatment, digestive or urinary trouble depending on the region. Nausea only concerns certain sites. Your team has told you what applies to you.
Fatigue, on the other hand, is general and cumulative. It sets in over the weeks, often peaking at the end of treatment, and it sometimes continues long after the last session. It is the most reported effect, and the one those around you most underestimate, since a session of a few minutes surely cannot be tiring.
The rhythm is very particular. The session lasts a few minutes, but it repeats every day, five days a week, for several weeks. It is not the intensity that wears you down, it is the repetition, the daily journeys and the organisation of a whole life around one time slot.
And there is the session itself. You are alone in the room, still, with the noise of the machine and the requirement not to move. It is short, and it can feel very long. Many people find this moment harder than they had expected, and few dare say so.
Any new or worsening symptom must be reported to your team, including those you judge minor or embarrassing, and including mouth ulcers that stop you drinking.
Any decision about your treatment, including your anti-sickness or pain medicines, belongs solely to the team looking after you.
How the treatments affect daily life
Fatigue is the most reported effect, and the one those around you understand least. It is not a tiredness that rest repairs: it settles in, it makes every action costly, and it is often what weighs longest, well after the last cycle. Many people describe the gap between what they feel and what others imagine, and the energy it takes to explain it over and over to people who mean well. See Hypnosis for Sleep and Insomnia.
The rhythm of life falls in behind the treatments. With chemotherapy, you learn to know the good days and the bad ones, to place what matters inside a window, to cancel without warning. With radiotherapy it is the reverse: the daily slot becomes the fixed point around which everything else is organised, for weeks, work and childcare included.
The body changes and how you see yourself with it: hair, weight, scars, skin. This dimension is rarely raised with the medical team, although it takes up a great deal of room.
Those close to you worry, and that takes energy too. Many people in treatment describe the invisible work of reassuring everyone else.
Pain and unfamiliar sensations punctuate the journey. See Hypnosis for Pain Management, remembering that any new pain is reported first.
And there is the fear. Of the next scan result, of recurrence, sometimes of dying. It is not a failure of morale, it is a response fitted to the situation. See Hypnosis for Stress and Anxiety.
The resources that already exist around you
Start with what your hospital already offers. It is the most underused part of the pathway.
- Supportive care, built into the care pathway: pain management, dietetics, psychological support, social support, adapted physical activity, appearance care. In France, nine of these make up a nationally validated "basket" of supportive care, reimbursed in full or in part by the health insurance system. In Quebec, these services exist within the public oncology team and cost you nothing at the point of care.
- Hypnosis within the hospital exists in some centres, practised by trained clinicians, but the offer varies a great deal between hospitals and between countries. Ask your team: if they offer it, that is the first door to push, and it is already inside your pathway.
- Your coordinating or pivot nurse, who is the fastest person to reach for anything to do with symptoms.
- Psychological support, and in particular psycho-oncology, the field devoted to the psychological experience of cancer. That is the reference professional when distress is in the foreground.
- Patient associations, whose contribution on isolation is considerable, and the national information lines, listed at the foot of this page.
- Grief support if the illness affects someone close to you, or for the losses the illness itself brings. See Hypnosis for Grief and Sadness.
Hypnosis in private practice comes on top of that provision, never in its place. One point of transparency, since nobody says it: it is not reimbursed by any public scheme, in Quebec, in France or in Morocco.
Hypnosis during treatment: aims and benefits
Let us start with what hypnosis does not do, and this list is the most important on the page.
It has no effect on the disease. It slows nothing, strengthens no defences, and does not influence the outcome of your treatment. It replaces neither chemotherapy, nor anti-sickness medicines, nor painkillers. It must never delay a call to your team or mask a symptom. And it will not ask you to be positive.
What a session aims for
- Apprehension about procedures, in particular putting in the line, the port, imaging and blood tests. This is the best supported indication: the joint guidelines of the Society for Integrative Oncology and the American Society of Clinical Oncology name hypnosis specifically for procedural pain.
- Anticipatory nausea, by undoing the learned association between the care setting and feeling sick. Hypnosis is among the behavioural approaches international guidelines cite for this specific form, alongside relaxation and desensitisation, with none placed above the others.
- Radiotherapy sessions, in particular the stillness and being alone in the room.
- The experience of pain, alongside the prescribed treatments and once the symptom has been reported.
- Sleep, often the first change noticed.
- Anxiety and rumination, particularly in the days before a follow-up scan.
- Your relationship with your body, during and after.
- Hot flushes, common after breast cancer and on hormone therapy. We set out the evidence on Hypnosis for Menopause.
Preparing for radiotherapy sessions
This is the most specific request we receive on this subject, and the one where short support makes the most sense: the situation is known, brief, and repeats identically.
The first move is to talk to the radiotherapy team. Radiographers know this apprehension well and have solutions: speaking through the intercom, announcing the duration and the stages, putting on music, adjusting how you are positioned. It is not a favour, it is part of their job.
Preparation is our part. It means walking through the session mentally, from the corridor to the table, until it becomes familiar; working on your relationship with duration, since time seems to stretch when you cannot move; and learning a self-hypnosis exercise usable lying down, still and with your eyes closed, which is exactly the treatment position. A recording listened to before going in helps many people.
If the fear of enclosed spaces is long-standing and not limited to medical care, see Hypnosis for Claustrophobia.
You do not have to be positive
This needs saying plainly, because it is what people in treatment hear most and bear least.
The idea that morale, fighting spirit or positive thinking would influence how a cancer develops is widespread. It is not supported by the data. The most complete review on the question, published in the *British Medical Journal*, brought together twenty-six studies on survival and eleven on recurrence: the great majority of those examining fighting spirit or helplessness found no association. Its authors conclude that people with cancer should not feel pressured into adopting particular coping styles to improve survival or reduce the risk of recurrence.
This is not bad news, it is a relief. It means you do not have to add, on top of treatment, the exhausting job of being permanently combative. You are allowed to be frightened, to be angry, to be discouraged on some days. None of that makes your illness worse, and nobody should let you believe otherwise.
One clarification, because the two questions often get confused. Saying that your attitude does not influence the illness does not mean support is useless. Distress and depression can be identified, they can be treated, and they deserve attention in their own right. That is simply a different question from prognosis, and it is there, and only there, that support makes sense.
What the research says
This is one of the areas where hypnosis has been most studied, and the results are real while remaining narrow.
On procedural pain, the joint guidelines of the Society for Integrative Oncology and the American Society of Clinical Oncology, published in 2022, cite hypnosis among the approaches to consider, with a level of evidence described as intermediate. That recommendation targets the pain of punctures, line placements and examinations, not cancer pain in general.
On surgery, a randomised trial published in 2007 in the *Journal of the National Cancer Institute* evaluated a fifteen-minute hypnosis session before the procedure, in two hundred women due to undergo an excisional breast biopsy or lumpectomy. The supported group reported less pain, less nausea, less fatigue, less discomfort and less emotional upset at discharge, and received less propofol and lidocaine during the procedure. The cost per person to the institution was 773 dollars lower. Participants knew which group they were in, which is the usual limitation of this kind of trial.
On anticipatory nausea, a systematic review gathered the available trials: five of the six concerned children, and it is in children that the conclusion is favourable. Its authors asked for the question to be studied in adults. It should be added that many of these studies predate current anti-sickness protocols, which makes their present-day relevance hard to assess.
On fatigue in radiotherapy, a randomised trial published in 2014 in the *Journal of Clinical Oncology*, covering two hundred women treated for breast cancer, evaluated an intervention combining cognitive behavioural therapy and hypnosis. The supported group reported less fatigue at the end of treatment and up to six months afterwards. An important detail: it is the combination that was evaluated, and the trial does not allow the effect to be attributed to hypnosis alone.
On the course of the disease, nothing. No data allows anyone to claim that psychological support, hypnosis included, changes the prognosis. Any page that suggests it, even by implication, is misleading you.
An example of a session
*Illustrative example. The first name has been changed and the path described commits only the person who lived it.*
Martine was on her third cycle when she got in touch. Her anti-sickness medicines worked well enough after the infusion, but since the second cycle the nausea had been starting on the journey, as soon as she caught sight of the building. She had stopped eating lunch on treatment days, and had told nobody, convinced this was a detail you do not trouble an oncology team with. She arrived almost apologising, saying she knew other people had worse problems than hers.
We first asked her to raise it with her coordinating nurse, because this kind of nausea should be reported and a medical adjustment is sometimes possible. She did, and the work began alongside her care.
It covered two things. First the journey itself, walked through mentally in session, as far as the chair. Then a short exercise she could use in the car, and later in the waiting room.
> "The nausea has not gone. But it no longer starts as I leave the house, and I manage to eat in the morning." > Martine, name changed
She finished her protocol as planned. It was her team who got her there, and that was the only aim that mattered. Every situation is different, and Martine's path tells you nothing about what yours will be.
How a Hypnosis session works on this subject
The conversation. Where you are in your protocol, what troubles you most, what your team has already put in place, and your current treatments. We will always ask whether your symptoms have been reported. If they have not, that comes before anything else.
The goal. Set together, modest and dated. For instance: getting to Tuesday's cycle without the nausea starting in the car, or sleeping the night before the scan.
The induction. A natural state of focused attention that you already know without naming it. You stay aware, you hear everything, you can speak and stop whenever you wish. Sessions are shortened if fatigue calls for it.
The work. Most often it focuses on the learned association between the care setting and feeling sick, on preparing for an upcoming procedure, on comfort and on sleep.
The debrief and the exercise. A conversation, and a self-hypnosis exercise to take away, often recorded so you can listen to it at the hospital, with headphones, during the infusion.
In practice. Sessions are held by video as readily as in the practice, and that is often preferable during a protocol: no journey, no waiting room, and the possibility of cancelling easily on a tired day.
The number of sessions is agreed at the first meeting, according to your treatment calendar, which comes before ours.
Booking an appointment
Before booking, check what your hospital offers. If it provides hypnosis as supportive care, that is the first door to push: it is inside your pathway, it is delivered by clinicians who know your protocol, and it will cost you nothing. We will tell you so anyway at the first meeting, because it is the advice that serves you best, even if it does not serve us. It is only afterwards, if that door does not exist where you are or if the waiting times are long, that support in private practice makes sense.
In the practice, our practitioners see clients in Montreal, Sherbrooke, Gatineau, Paris and Lille. By video call, wherever you are in the world, and that is often the format that suits best during a protocol. The how-to is here.
A question before you decide? Write to us describing your situation.
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Frequently asked questions about Hypnosis for the Side Effects of Chemotherapy and Radiotherapy
No. It has no effect on the disease, on cells or on prognosis, and no data allows anyone to claim otherwise. What it can support is how you get through the treatments. If somebody offers you anything else, walk away.
No, never on your own. These medicines prevent nausea of pharmacological origin, which hypnosis does not cover, and they work better when taken as prescribed. International guidelines are emphatic on this point: the best way to stop anticipatory nausea taking hold is for the previous cycles to have been well covered. If you think your regimen could be lightened, that is a conversation to have with your oncologist.
The first answer is not hypnosis: report it to your team, now, even if it seems mild. These symptoms are closely monitored, and international guidelines provide for them to lead to a dose or protocol being adjusted. Your team can only take them into account if it is informed. Once that report is made and your care is in place, support can address how you live with these sensations day to day, never about noticing them less.
No. The hypnotic state is one of focused attention, not sleep and not being placed under anyone's influence. You stay aware, you hear everything, and you keep the ability to refuse a suggestion, to speak, or to stop the session.
A hypnosis session is not a medicine: it is not administered, it is not dosed, and it does not get added to your prescription. That said, whether any approach fits with your protocol is for your team to say, and for them alone. Tell them you are seeing a hypnotherapist, as you would for any complementary approach. And tell them too about any food supplement or natural product you may be taking: those can genuinely interact with cancer treatment.
Psychotherapy is regulated by law, reserved to authorised professionals whose title is protected. In oncology there is a field devoted to it, psycho-oncology, available within your care pathway. That is the reference professional when psychological distress is in the foreground. Hypnosis as we practise it is a narrower form of support, alongside and never instead.
This is common and rarely voiced. Raise it with the team before your next session: they have concrete solutions, and in some cases your doctor can prescribe something for the sessions. Preparation in hypnosis can be added to that, focused on stillness and on duration. The one thing not to do is miss sessions without saying so.
Fatigue is the most reported effect, it builds up over the weeks and often continues after the last session. The people around you will struggle to understand, since a session lasts only a few minutes. It is not in your head, it is documented.
Sessions are held by video, from your bed if need be, and they can be shortened. On this subject, adapting to how you are on the day is part of the work.
This is often the most disorienting moment: the protocol stops, everyone around you considers it finished, and you are left with the fatigue, the after-effects and the fear of recurrence, which peaks before every follow-up scan. This period responds well to support, and it is too often left without any.
The number of sessions is agreed at the first meeting, according to your treatment calendar. It is often deliberately small: your energy is limited.
Where to find help.
In Quebec: your oncology pivot nurse first · Info-Santé 811, option 1, day and night, for a physical symptom · Info-Social 811, option 2, for psychosocial support · Canadian Cancer Society, 1 888 939-3333, toll free, with live chat.
In France: your coordinating nurse and your hospital's supportive care team · Cancer info, Institut national du cancer, 0 805 123 124, free and confidential, in French · Ligue contre le cancer, 0 800 940 939.
In Morocco: the oncology centre following you remains the way in; the Fondation Lalla Salma keeps the directory of centres in the country.
In distress or having suicidal thoughts: in Quebec, 1 866 277-3553 or text 535353, day and night; in France, 3114, free, day and night.
Sources and references
Institutional resources
- Chemotherapy: what side effects are possible? and the effects on the blood. Institut national du cancer, in French. The second page carries the French fever thresholds.
- Possible side effects of radiotherapy. Institut national du cancer, in French. Source of the guidance on creams.
- What is supportive care in oncology? Institut national du cancer, in French.
- Febrile neutropenia. Fondation québécoise du cancer, in French. Source of the Quebec threshold.
- Side effects of chemotherapy. Canadian Cancer Society.
Scientific references
- Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. Mao, J. J. et al. (2022). Journal of Clinical Oncology, 40(34), 3998-4024. The guideline that names hypnosis for procedural pain.
- 2016 updated MASCC/ESMO consensus recommendations: Anticipatory nausea and vomiting. Dupuis, L. L. et al. (2017). Supportive Care in Cancer, 25(1), 317-321.
- A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. Montgomery, G. H. et al. (2007). Journal of the National Cancer Institute, 99(17), 1304-1312.
- Randomized controlled trial of a cognitive-behavioral therapy plus hypnosis intervention to control fatigue in patients undergoing radiotherapy for breast cancer. Montgomery, G. H. et al. (2014). Journal of Clinical Oncology, 32(6), 557-563.
- Hypnosis for nausea and vomiting in cancer chemotherapy: a systematic review. Richardson, J. et al. (2007). European Journal of Cancer Care, 16(5), 402-412.
- Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy: ASCO Guideline Update. Loprinzi, C. L. et al. (2020). Journal of Clinical Oncology, 38(28), 3325-3348. The guideline providing for treatment to be adjusted according to neuropathy.
- Influence of psychological coping on survival and recurrence in people with cancer: systematic review. Petticrew, M., Bell, R., & Hunter, D. (2002). BMJ, 325(7372), 1066. Open access. The source of the section "You do not have to be positive".
And the neighbouring articles
- If the fear of vomiting is long-standing and goes beyond the treatment setting, see Hypnosis for Emetophobia.
- If stillness and enclosure are the hard part, see Hypnosis for Claustrophobia.
- For pain, see Hypnosis for Pain Management, and for fatigue and sleep, Hypnosis for Sleep and Insomnia.
- For the anxiety of follow-up scans, see Hypnosis for Stress and Anxiety.
Hypnosis as practised by the members of Solutions Hypnose is a complementary support approach. It is neither a medical act, nor a diagnosis, nor psychotherapy in the regulatory sense, and it in no way replaces a consultation, follow-up or treatment prescribed by a health professional.
Our practitioners do not assess and do not treat mental disorders or illnesses. They never ask for an ongoing treatment to be stopped or changed: that decision rests exclusively with your doctor.
No result can be guaranteed. The testimonials and examples presented on this page describe individual experiences and do not predict what you will experience.
In case of significant distress, unexplained physical symptoms or suicidal thoughts, contact a doctor, emergency services or a helpline without delay.
Page written by Patricia Jouannet
hypnotherapist and NLP coach
partner at Solutions Hypnose.
English version reviewed by David Veilleux