This mind-body therapy uses your imagination to help you relax, relieve symptoms, stimulate your body’s healing responses, access inner strengths and resources, and tolerate procedures and treatments better.

How can guided imagery help you? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

To see more details, click the plus sign to the right of any section.

Much of the evidence regarding guided imagery involves studies that used other mind-body therapies along with guided imagery. We report the effects of guided imagery alone and also combined with other therapies.

Improving treatment outcomes

Is guided imagery linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.

Imagery combined with relaxation training

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on response to chemotherapy among people with breast cancer treated with relaxation training and imagery in preliminary studies

Optimizing your body terrain

Does guided imagery promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

See Optimizing Your Body Terrain ›

Find medical professionals who specialize in managing body terrain factors: Finding Integrative Oncologists and Other Practitioners ›

Hormone imbalance

Changes in hormone levels seen in the studies here may not be beneficial in every situation. Your oncology team needs to determine whether any changes would be favorable for your condition.

Preliminary (conflicting) evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower cortisol levels—a marker of stress—around the time of surgery among people treated with guided imagery

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lower cortisol 6 weeks to 1 year after completing cancer treatment among people with breast cancer participating in an 8-week imagery stress-reduction program

Immune function

Increased immune system activation is not always beneficial, so your oncology team needs to determine whether immune activation would be favorable in your situation.

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of higher immune system activation among people receiving guided imagery with other mind-body therapies

Guided imagery combined with other therapies

Guided imagery is often combined with other therapies.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of higher markers of immune activation among women receiving chemotherapy followed by surgery, radiotherapy, and hormone therapy for large or locally advanced breast cancers and treated with relaxation training and guided imagery

Preliminary evidence of lower cortisol levels 1 day after cholecystectomy among people treated with relaxation and guided imagery

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on stress hormones during radiotherapy among people with breast cancer treated with relaxation and visualization therapy in a preliminary study

Preliminary evidence of higher markers of immune activation among men undergoing surgery for prostate cancer participating in a stress-management intervention including discussing concerns about the surgery, diaphragmatic breathing, guided imagery, and adaptive coping skills

Preliminary evidence of higher markers of immune activation among women with stage 1 breast cancer participating in relaxation, guided imagery, and biofeedback training

Managing side effects and promoting wellness

Is guided imagery linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Side effects and symptoms as a whole

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of better global symptom scores after completing cancer treatment among people with breast cancer participating in an imagery stress-reduction program

Anxiety

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety during chemotherapy among people treated with guided imagery

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on anxiety among people with cancer undergoing surgery treated with guided imagery in a preliminary trial

Breathlessness and other lung side effects

No evidence of an effect on lung (pulmonary) function after colorectal cancer surgery among elderly people treated with guided imagery in a small study

Changes in appetite

Preliminary evidence of better appetite during chemotherapy among people with cancer treated with guided imagery

Depression or mood

Weak evidence of less depression among people with breast cancer treated with guided imagery

Preliminary evidence of less depression, better mood, or less negative emotions during chemotherapy among people with cancer treated with guided imagery

Fatigue

No evidence of an effect on fatigue after surgery among elderly people treated with guided imagery in a preliminary study

Gastrointestinal symptoms

Insufficientpreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) (conflicting) evidence of an effect on nausea during chemotherapy among people with cancer treated with guided imagery in preliminary studies

No evidence of an effect on nausea, vomiting, or ileus from surgery among people with colorectal cancer treated with guided imagery in preliminary studies

Pain

Preliminary evidence of less pain during chemotherapy among people treated with guided imagery

No evidence of an effect on pain from surgery among people with cancer treated with guided imagery in several trials

Preliminary evidence of less pain and related distress, and more perceived control over pain during hospitalization among people with cancer treated with analgesic imagery

Quality of life and function

Preliminary evidence of better quality of life and related measures during chemotherapy among people treated with guided imagery, sometimes with other mind-body therapies

Preliminary evidence of more comfort during radiation therapy among women with early stage breast cancer treated with guided imagery

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better quality of life and function after completing cancer treatment among people treated with guided imagery

Stress, tension, or distress

Preliminary evidence of less pain-related distress among hospitalized people with cancer pain treated with analgesic imagery

Preliminary evidence of less stress after cancer treatment among people treated with imagery

Weak evidence of less distress among caregivers participating in a guided imagery intervention

Symptoms and side effects not specific to cancer

Preliminary evidence of less anxiety among hospitalized children or their parents receiving guided imagery

Preliminary evidence of less anxiety among hospitalized children or their parents receiving guided imagery

Modest evidence of less pain and use of pain medications after surgery among people treated with guided imagery

Guided imagery combined with other therapies

Guided imagery is often combined with other therapies.

Keep reading about guided imagery

Authors

Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Martin L. Rossman, MD

Co-founder of the Academy for Guided Imagery, physician, acupuncturist, and author
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Martin L. Rossman is a physician and acupuncturist who has practiced holistic medicine for over 30 years. He is co-founder of the Academy for Guided Imagery and the author of the award-winning Guided Imagery for Self-Healing and Fighting Cancer from Within.

Martin L. Rossman, MD Co-founder of the Academy for Guided Imagery, physician, acupuncturist, and author

Reviewer

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Last update: December 12, 2023

Last full literature review: October 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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