A study exploring the practicality and effectiveness of relaxation therapy plus autohypnotherapy for patients with breast and lung cancer undergoing radiotherapy

INTERVENTION: Patients will be randomised to radiotherapy treatment as usual or HYPREL. HYPREL will consist of a standard, protocolised intervention consisting of: 1. Training in progressive muscular relaxation and cue controlled relaxation by means of audio recordings. Commencing on Day 1, patients will be asked to practice at least once daily until the completion of radiotherapy. They will keep a diary record as in previous studies. 2. Four sessions of protocolised live training in hypnotherapy consisting of training in autohypnosis (Spiegel eye roll technique, anchoring); rehearsal in imaguo, and ego strengthening. The timing of sessions will be: Sessions 1 and 2: between days 8 and 14 (in the OHC) Session 3: day 15 (in the CT planning suite (rehearsal in vivo) Session 4 (booster): day 42 (mid point of radiotherapy) CONDITION: Lung cancer, oesophageal cancer or breast cancer ; Cancer ; Malignant neoplasm of the lung PRIMARY OUTCOME: During radiotherapy, the frequency and amplitude of chest wall movement will be measured during RT1, RT10, and RT15 (last fraction of treatment for breast cancer) or RT20 (last fraction of treatment for thoracic cancer) using the Varian RPM system. This is an established system with an integrated software package for data retrieval and processing. It involves no direct patient contact. An infra‐red camera is used to track a pair of reflective markers that are mounted on the front face of a small box which is placed on the patient?s chest. Apart from the placement of this box, the use of this equipment has no impact on the standard treatment. The motion of these markers acts as a surrogate for that of the chest itself and is used to measure its amplitude and frequency. The regularity of the breathing cycle of each patient will be characterised by the mean and standard deviation established over 40 breathing cycles. SECONDARY OUTCOME: 1. Differences between groups in the frequency and amplitude of chest wall movement at other time points; 2. Between‐group differences in Mood Rating Scale (MRS), Brief State Anxiety Inventory (BSAI), Patient Satisfaction Questionnaire (PSQ) and Functional Assessment of Cancer Therapy (FACT) scores at all time points following randomisation INCLUSION CRITERIA: 1. Treatment to include at least 15 ‐ 20 fractions of radical radiotherapy to the thorax or breast 2. Lung cancer, oesophageal cancer or breast cancer 3. Male or female 4. Age at least 18 years 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 ‐ 1 6. Able to complete questionnaires 7. Able and willing to give written informed consent