Applying hypnosis, in its different forms, can be extremely useful to terminal patients in central aspects of their existence such as effective, long term management of impairing symptoms and pain, better coping with existential aspects of the disease in order to obtain better quality of life, variable that is related to survival rate.
The World Health Organization (WHO) defines “palliative” a branch of medicine that takes global and proactive care of patients who are affected by diseases that no longer respond to treatments and that lead to death. Being a discipline that considers patients as a “whole” that expresses many different kinds of needs (on the biomedical, psychological and existential levels), it spontaneously included, among its therapeutical instruments, integrative approaches that consider mind-body connections. 
Most of the patients who need palliative care are oncologic ones. 84% of them report of suffering from intense pain, 49% from respiratory difficulties and 33% from nausea[1]. Furthermore treating these symptoms can cause side effects such as insomnia or states of excessive sedation. Many of these problems are common to other kinds of terminal patients.
Difficulties in facing, accepting and adapting to the idea of imminent death can arise during treatment. All these factors taken together, along with the modification of daily routine, often cause depression and anxious states.
From this standpoint hypnosis represents a useful instrument because it can be applied in many ways to the management of terminal patients [2,3]. Results of a study by Liossi [1], consistently with findings of previous research [4,5,6,7], demonstrate that patients treated with hypnosis have a greater reduction of anxiety, depression and a better quality of life, especially because of the improvements of psychological aspects, such as the way of coping with the disease, which are different if compared to patients who followed standard care protocols which, however, included other psychological interventions. This result becomes more relevant if we consider that variables such as psychological stress and depressive disorders in terminal patients correlate with life expectancy and with the functionality of the immune system [4,5,7,8,9,10]; it is therefore crucial for the care of patient to consider these aspects during treatment. Remarkable improvements have been reported in physical symptoms.
Similar results have been replicated in other studies [2,3] and they provide, especially in early hypnotic intervention cases, useful data about the management of typical problematic aspects of terminal patients, such as changes in body image, impairment in daily activities and the inevitable loss of independence.
Patients can benefit from self-hypnosis trainings too: a recent research [11] showed that patients who suffer from multiple sclerosis with chronic pain obtain better anaesthesia compared to patients who have been trained in progressive muscular relaxation.
In conclusion we report an interesting article [12] that investigates integrative approaches for the treatment of neuropathic cancer-related pain. Neuropathic pain is caused by a direct consequence of a lesion or of a disease that targets the somatosensory system. Cancer patients often suffer from this specific kind of pain because of nerve compression or because of chemotherapy’s neurotoxicity. Researchers actually report that there are no specific substances to manage neuropathic pain and that the commonly used agents tend to have low success rates [13,14]. By using self-hypnotic techniques, patients can relax and anesthetize pain, restructuring it in a less negative frame. One study in particular (Jensen et al. 2009) demonstrates that patients with persistent pain who are trained in self-hypnosis obtain a quick and remarkable decrease in pain that remains stable in time.

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3. Rajasekaran M, Edmonds PM, Higginson IL. Systematic review of hypnotherapy for treating symptoms in terminally ill adult cancer patients. Palliative medicine. 2005;19:418-426.
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10. Gruzelier J. A review of guided imagery and relaxation interventions on the immune system, well-being, health and individual differences. Stress. 2001.
11. Jensen MP, Barber J, Romano JM, Molton IR, Raichle KA, Osborne TL, Engel JM, Stoelb BL, Kraft GH, Patterson DR. A Comparison of Self-Hypnosis Versus Progressive Muscle Relaxation in Patients with Multiple Sclerosis and Chronic Pain. International Journal of Clinical and Experimental Hypnosis. 2009 April;2(57):198-221.
12. Cassileth BR, Keefe FJ. Integrative and behavioral approaches to the treatment of cancer-related neuropathic pain. The Oncologist. 2010;15(suppl 2):19-23.
13. Santiago-Figueroa J, Kuffler DP. Reducing and eliminating neuropathic pain. Puerto Rico health science journal. 2009;28:289-300.
14. U.S. Food and Drug Administration. available at http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm. 2009 September 18 (accessed).
15. Jensen MP, Barber J, Romano JM. Effects of self-hypnosis training and EMG biofeedback relaxation training on chronic pain in persons with spinal-cord injury. International Journal of Clinical Hypnosis. 2009;57:239-268.