Cancer treatment moves quickly. And when a patient cannot tolerate radiotherapy — particularly the tight immobilisation mask used for head and neck cancers — everything stops. Sessions are cut short, panic escalates and carefully planned treatment schedules risk being disrupted at the most critical time.

For some patients, the distress is so intense that they consider refusing radiotherapy altogether. Others opt for more invasive treatment options simply because they cannot face the mask.

At present, the only immediate support available in the Healthcare system is diazepam — and when patients are already prescribed it, there is nowhere else for clinicians to refer them. Counselling services, though valuable, have long waiting lists and are not equipped to respond within the urgent timelines of cancer care.

This is the gap a pilot in Northern Ireland aims to fill.

A Critical Window for Support

Fear often emerges before treatment even begins.

During the mask fitting — a rigid moulding process required for precision — many patients experience panic, claustrophobia, or a sudden sense of being trapped. For some, this mirrors older experiences of feeling restricted; for others, it comes as a complete shock.

From that moment, there is usually a three-week gap before radiotherapy starts. Without rapid emotional support, anxiety can build quickly — making it more likely that patients panic, refuse treatment, or struggle through their first session.

This is exactly where Solution Focused Hypnotherapy (SFH) offers something uniquely powerful. SFH is brief, future-focused, and avoids retraumatising history-taking. Instead, it teaches patients practical tools to regulate the nervous system in real time, while using a clear brain-based model that helps them understand why they feel as they do.

Its speed, structure, and safety make it ideally suited to the demands of cancer care.

The Pilot Programme

Over the past few months, I’ve been working with the Macmillan Information & Support Centre and the Radiotherapy Department at Belfast City Hospital to deliver a three-session SFH programme for patients who are struggling with radiotherapy-related anxiety.

Early Outcomes

So far, the pilot has supported seven patients — all men — all completing the full three-session programme. The sample is small, but the outcomes are compelling:

• 100% of patients successfully completed treatment after just one hypnotherapy session.
• All had previously managed only seconds or minutes in the mask.
• All reported increased calm, confidence, and control during treatment.
• All experienced improvements beyond the treatment room — better sleep, improved mood, fewer worry loops, and greater resilience.

For people who had considered refusing treatment entirely, being able to calmly complete a full radiotherapy session is genuinely life-changing.

The Tools That Change Everything

One of the most transformative aspects of this work has been teaching patients the internal tools that help them regulate their own nervous system during treatment. Solution Focused Hypnotherapy uniquely combines brief, neuroscience-informed techniques with a clear explanation of how the brain works,making the approach both practical and psychologically liberating.

Many of the patients describe themselves as calm, capable, and steady — engineers, ex-military personnel, and men who “don’t get anxious.” When they panic in the mask, it feels bewildering and sometimes shameful. Several have had earlier experiences of restriction — caving, army tunnel exercises, getting stuck in drains — long forgotten consciously but stored in the body.

In SFH, we explain how the brain creates and triggers “fear templates,” and how the limbic system reacts long before logic or willpower can step in. Understanding that their reaction is a normal, protective response — not a personal failure — creates visible relief. Their shoulders drop. Their breathing softens. They finally understand why they feel the way they do.

Alongside this psychoeducation, SFH uses several brief, complementary techniques:

• A self-hypnosis tool that guides patients into their own Safe Place — a location they choose themselves where they naturally feel calm, confident, and in control. For some it’s been kayaking, for others a favourite family spot or meaningful memory. This personalised inner sanctuary becomes an immediate source of steadiness, helping them keep their “stress bucket” manageable even in the most challenging moments.
• TheAnchor, consistently described as the most powerful technique, providing a discreet physical cue that can “empty the bucket in seconds” and prevent panic.
• Breath regulation, settling the autonomic nervous system.
• Positive visualisation, rehearsing safety and successful treatment.
• And when appropriate, theRewind technique to resolve older memories of fear or confinement that spill into the radiotherapy experience.

What makes SFH unique is not just the tools themselves, but the way they are combined — brief, future-focused, strength-based, easy to learn, and immediately usable in high-pressure medical environments.

Together, they give patients something they often feel they have lost:
a way to influence their own experience — to find Calm, Confidence, and Control, even when much is outside their control.

Integration With Healthcare Teams

A defining strength of this pilot has been its integration with the radiotherapy team. I have toured the radiotherapy department, spent time understanding the process from the clinicians’ perspective, and provided sessions for staff so they can experience the same tools their patients learn.

This shared framework means radiographers now prompt patients using the same language — “breathe… anchor… visualise…” — reinforcing calm in the moments patients need it most.

Macmillan’s role has been equally important. They provide the environment for hypnotherapy, facilitate rapid referral, and work with radiotherapy staff to coordinate transport and scheduling so patients can access support without long waits. This reduces anticipatory anxiety and allows tools to be applied immediately — sometimes within hours.

Impact Beyond the Individual

Early indicators show this integrated approach is already reducing:

• interrupted sessions
• mask removals
• treatment delays
• patient refusals
• and the need for replanning

for those who now tolerate the mask consistently.

Clinicians also report feeling less stressed — because when a patient panics or refuses treatment, the emotional impact on staff is significant.

There are early signs that this approach may support better treatment completion rates, as patients feel more equipped to manage both anxiety and side effects such as pain, fatigue, or loss of appetite.

I will be meeting with the radiotherapy team soon to gather structured data from their perspective. But even at this early stage, it is clear that integrating SFH into cancer care offers something powerful: rapid emotional relief, practical tools patients can use instantly, and a sense of psychological safety during one of the most challenging phases of treatment.

As the pilot progresses, I hope this work contributes to wider recognition of SFH within healthcare — showing that simple, evidence-informed, solution-focused approaches can profoundly support patients at the moments when they need it most.