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 me? 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).

Learn more about how we research and rate therapies.

Much of the evidence regarding guided imagery involves studies that used other mind-body therapiesapproaches that enhance your mind’s capacity to positively affect your body’s function and symptoms. Some interventions focus on calming your mind, improving focus, enhancing decision-making capacity, managing stress, or resolving conflict. Other interventions have a goal of relaxing both your mind and your body. along with guided imagery. We are often not able to assess the effects of guided imagery alone.

Treating cancer

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.

Breast cancer

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 proliferation or response to radiotherapy or chemotherapy among people with breast cancer participating in relaxation and visualization therapy in small trials

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.

Hormone imbalance

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, either with or without a relaxation intervention

Immune function

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 immune system function among people receiving guided imagery with other mind-body therapies

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

Weak evidence of less anxiety without regard to treatment phase among people with breast cancer treated with guided imagery and other mind-body therapiesapproaches that enhance your mind’s capacity to positively affect your body’s function and symptoms. Some interventions focus on calming your mind, improving focus, enhancing decision-making capacity, managing stress, or resolving conflict. Other interventions have a goal of relaxing both your mind and your body.

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 and perhaps other mind-body therapies

Preliminary evidence of less anxiety during radiotherapy 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 anxiety among people with cancer undergoing surgery treated with guided imagery in a preliminary trial

Preliminary evidence of less anxiety among people with terminal cancer receiving interactive guided imagery and progressive muscle relaxation

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

Changes in appetite

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

Cognitive difficulties

Preliminary evidence of less cognitive dysfunction after completing cancer treatment among people with breast cancer participating in an imagery-based group intervention

Depression or mood

No evidence of an effect on mood among people with metastatic breast cancer in pain treated with relaxation and visualization training in a preliminary study

Weak evidence of less depression among people with breast cancer treated with guided imagery and other mind-body therapies

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 less depression, better mood, or less negative emotions during chemotherapy among people with cancer treated with guided imagery, often with other mind-body therapies

Modest evidence of less depression during radiotherapy among people treated with guided imagery and relaxation

Preliminary evidence of better mood among men undergoing surgery for prostate cancer treated with guided imagery and other mind-body therapies

Weak evidence of less depression among people with terminal cancer treated with interactive guided imagery and progressive muscle relaxation

Preliminary evidence of less sadness among parents of hospitalized children with cancer participating in progressive muscle relaxation and guided imagery

Fatigue

Preliminary evidence of less fatigue among people participating in guided imagery and progressive muscle relaxation

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

Preliminary evidence of less fatigue more than 6 weeks after completing treatment among people participating in imagery-based group interventions

Gastrointestinal symptoms, including nausea and vomiting

Modest evidence of less nausea and vomiting during chemotherapy among people treated with guided imagery, often with relaxation

No evidence of an effect of guided imagery on nausea, vomiting, or ileusa painful obstruction of the ileum or other part of the intestine from surgery among people treated with guided imagery in preliminary studies

Preliminary evidence of less nausea after transplantation among people with breast cancer undergoing autologous bone marrow/peripheral blood stem cell transplantation treated with mind-body therapies including guided imagery

Oral symptoms

Preliminary evidence of lower oral mucositisinflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer pain levels among people undergoing bone marrow transplants treated with relaxation and imagery

Pain

Preliminary evidence of better ability to decrease pain, but no difference in pain intensity, without regard to treatment phase among people participating in relaxation and visualization training

Modest evidence of less pain during chemotherapy among people treated with guided imagery, sometimes with progressive muscle relaxation

Preliminary evidence of less discomfort during hospitalization among people undergoing brachytherapy participating in relaxation and guided imagery

No evidence of an effect on pain from surgery among people with cancer treated with guided imagery, sometimes with other mind-body therapies, in several studies

Preliminary evidence of less pain and related distress, and more perceived control over pain during hospitalization, among people treated with analgesic imagery, and comparable to effects with progressive muscle relaxation

Preliminary evidence of less pain intensity among people with terminal cancer in hospice treated with interactive guided imagery and progressive muscle relaxation

Preliminary evidence of less pain among hospitalized children treated with imagery

Quality of life and function

Preliminary evidence of better quality of life and indicators of satisfaction without regard to treatment phase among people treated with meditation, affirmation, imagery, and ritual

Modest 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

Preliminary evidence of better quality of life during cancer treatment after mastectomy among women participating in mind-body therapies including mental images

Modest evidence of better quality of life and function after completing cancer treatment among people treated with guided imagery, sometimes with other mind-body therapies

Sleep disruption

Preliminary evidence of less sleep disturbance among people with cancer treated with imagery, sometimes with other mind-body therapies

Stress, tension, or distress

Preliminary evidence of less distressemotional, social, spiritual, or physical pain or suffering that may cause a person to feel sad, afraid, depressed, anxious, or lonely; people in distress may also feel that they are not able to manage or cope with changes caused by normal life activities or by having a disease, such as cancer among people recently diagnosed participating in progressive muscle relaxation with guided imagery

No evidence of an effect on distress among people with cancer and with pain participating in relaxation and visualization training in a preliminary study

Modest evidence of less stress or tension during radiotherapy among people treated with relaxation training and imagery

Preliminary evidence of better levels of stress hormones after surgery among people treated with guided imagery and relaxation

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

Preliminary evidence of less tension among parents of hospitalized children with cancer participating in progressive muscle relaxation and guided imagery

Other side effects and symptoms

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

Guided therapy in combination with complementary therapies beyond mind-body therapies

Preliminary evidence of less anxiety, fatigue, and pain among women with breast cancer undergoing initial surgery receiving a self-care toolkit of audio-files of guided mind-body techniques (breathing, progressive muscle relaxation, meditation, guided imagery, and self-hypnosis) and acupressure antinausea wristbands

Symptoms and side effects not specific to cancer

Modest evidence of less anxiety at the time of surgery among people treated with guided imagery

Modest evidence of less pain related to surgery among people treated with guided imagery, sometimes with music

Preliminary evidence of better quality of sleep scores at the time of surgery among people treated with a guided imagery tape with music and relaxing text

Preliminary evidence of shorter time to first bowel movement after colorectal surgery, but no evidence of an effect on complications or itching (pruritus) among people treated with guided imagery and music

Preliminary evidence of less surgical wound redness among people participating in relaxation with guided imagery

Keep reading about guided imagery

Authors

Nancy Hepp, MS

Lead Researcher and Program Manager
View profile

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
View profile

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
View profile

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: May 26, 2022

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.

References[+]