M.Tech. / Photodynamic therapy is a treatment that is used for the destruction of certain types of tumours and is emerging as a promising treatment modality in the field of dermatology (Davids et al., 2008). The photochemical interactions of the photosensitizer, light and molecular oxygen producing reactive oxygen species known as ROS, results in damage to organelles within malignant cells and so can lead to tumour destruction (Plaetzer et al., 2008). Melanoma is one of the most common forms of malignancies (Oliveria et al., 2007). Unfortunately, there are limited treatment options available for this disease because chemotherapy and radiation therapy are largely ineffective. Metastatic disease frequently develops even after potentially curative surgery (MacCormack, 2008). Since this metastatic disease is an understudied cancer, and the incidence and mortality is increasing, describing the long term burden of this cancer and identifying factors that contribute to it will facilitate efforts to develop responsive prevention strategies, so that novel therapies such as PDT can be proposed (Oliveria et al., 2007; Pan et al., 2008; Schuitmaker et al., 1996). Numerous worldwide clinical trials have shown that PDT represents an effective and safe modality for various skin disorders, but little research has been done in terms of its effect on malignant melanomas (De Rosa and Bentley, 2000; Kolarova et al., 2008). In order for PDT to be an effective treatment modality it depends on many factors such as the type of photosensitizer utilized its ability to selectively penetrate tumour cells and the duration of the treatment (Robertson et al., 2009). Other important factors include the type of activating light source, its ability to penetrate the desired target and the duration of exposure (Plaetzer et al., 2008). Lastly, the type of target cells and their oxygen status also play an important role in the efficacy iv of PDT (Kolarova et al., 2008). In order for PDT to be completely effective, the resulting damage from the treatment must surpass cellular repair mechanisms and cause direct destruction of cellular pathways through vascular compromise and increase immune response to overcome disease (Pazos and Nader, 2007). Porphyrins are the most studied photosensitizers and their disadvantage is the inability to specifically localize in tumour cells and so they are retained in normal cells for prolonged periods, causing patients to be photosensitive (Braathen et al., 2007). This factor stimulated the development of second generation photosensitizers with improved physical, chemical and spectral properties (Davids et al., 2008). Phthalocyanine compounds are second generation photosensitizers which have shown potential in the PDT treatment of many cancers (Kolarova et al., 2007).

Prostate cancer (PCa) is one of the most common cancer in men and affecting hundreds of thousands of men worldwide. The early detection of PCa have been proven to be advantageous for more efficient treatment against PCa. However, the conventional screening methods towards PCa are lack of selectivity and sensitivity, which leading to high false positive rate and overdiagnosis of PCa. The objective of this study is to (1) identify more sensitive and accurate diagnostic biomarkers towards PCa; (2) followed by developing new chemosensor towards the newly found biomarkers. In the first part of this study, based on the previously findings on urinary spermine as useful biomarker for PCa, a more comprehensive study on urinary polyamine levels was carried out and the important role of urinary spermine as biomarker for PCa detection was consolidated. In the second part of this work, molecularly imprinted polymer (MIP) towards the target analyte of urinary spermine was prepared for the capturing and extraction of spermine. The specific adsorption and selectivity towards spermine of the MIP were discussed and reported. In the third part of this study, a rapid detection method of spermine was developed via the use of aggregation-induced emission (AIE) active molecules. The presence of spermine would cause aggregation of this chemosensor for a "turn-on" detection of spermine under ultra-violet (UV) excitation, which would be useful in PCa diagnosis in the future.

目的：結直腸癌是世界上第三常見惡性腫瘤，結腸鏡檢查是診斷的金標准。但其創傷性、昂貴的設備以及人力的需求阻礙了廣泛應用。本研究評估了糞便miRNA作為非損傷性分子生物標記物篩查結直腸腺瘤和腫瘤的可行性，並深入探究了致癌miRNA的基因靶點。 / 方法：我們評估了糞便miRNAs的穩定性以及檢測的可重復性。糞便樣本收集自88例結腸直腸癌患者，57例結直腸息肉患者和101名健康對照，用實時定量逆轉錄PCR檢測miRNA水平。所有候選miRNA標記物在配對的癌及癌旁組織中進行驗証。我們共測試了糞便中7種miRNAs，包括前期報道在結直腸癌中上調的miR-21和miR-92a(第一部分)，以及在667個miRNA中在結直腸癌上調最高的5個miRNA(第二部分)。我們研究了它們的水平與腫瘤分期及位置的關系。並隨訪了病人經腫瘤或腺瘤切除術后其糞便miRNA水平，從而証實它們是否與腫瘤相關。我們應用了彗星試驗、細胞活力試驗、集落形成試驗，以及細胞凋亡分析試驗研究了miR-18a在腫瘤的發展過程中的作用(第三部分)。 / 結果：第一部分，我們確定糞便miRNA的穩定性，能被實時定量逆轉錄PCR檢測並顯示高重復性。糞便miR-92a標記物的靈敏度和特異性分別為71.6%和73.3%，miR-21分別為55.7%和73.3%。MiR-92a水平顯示遠端結直腸癌比近端結直腸癌的檢測具有更高靈敏度，晚期腺瘤比小息肉更具靈敏度。腫瘤切除后，miR-21和miR-92a水平顯著下降。 / 第二部分，基於結直腸腫瘤miRNA的表型，我們發現糞便miR-18a, miR-20a, miR-135b和miR-221能作為標記物鑒別結直腸癌，miR-18a (敏感度: 51.1%, 特異性: 90.1%); miR-20a (72.7%, 81.2%) ; miR-135b (81.8%, 68.3%); miR-221 (69.3%, 77.2%)。腫瘤切除后，這四種標記物會顯著下降。MiR-135b和miR-221也能鑒別腺瘤。四種標記物對遠近端結腸癌的檢測無顯著差異。 / 第三部分，通過程序和熒光素酶報告基因活性預測和驗証，我們發現一種重要的DNA修復蛋白---共濟失調毛細血管擴張突變(ATM)是miR-18a的靶蛋白。MiR-18a的異位表達減弱細胞DNA雙鏈損傷修復機制，導致腫瘤發生的易感性。 / 結論：我們發現糞便中miR-21, miR-92a, miR-18a, miR-20a, miR-135b 和miR-221標記物能夠鑒別結直腸癌。MiR-92a, miR-135b 和miR-221能鑒別結直腸腺瘤。MiR-18a抑制共濟失調毛細血管擴張突變基因表達並減弱細胞DNA雙鏈損傷修復機制。糞便miRNA是結直腸癌篩查的有效生物標記物。 / Objective: Colorectal cancer (CRC) is the third most common cancer worldwide. Colonoscopy is the current gold standard for diagnosing CRC. However, its invasive nature, the cost of equipment and the demand for manpower have hampered the wide application of this procedure. This study evaluated the feasibility of using stool-based miRNA as non-invasive biomarkers for the screening of colorectal adenoma and cancer, and investigated the gene target of a candidate oncogenic miRNA. / Methods: The reproducibility of detection and stability of stool-based miRNAs were first evaluated. Stool samples were collected from 88 CRC patients, 57 patients with colorectal polyp and 101 healthy controls MiRNA levels were detected by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). AII candidate miRNA markers were validated in a cohort of paired tumor and adjacent normal tissues. In total, we tested 7 miRNAs in the stool, including miR-21 and miR-92a which were reported to be up-regulated in CRC in previous studies (part one), and 5 miRNAs which were found to be the most up-regulated in colorectal tumor based on the profiling of 667 miRNAs (part two). Their levels with tumor stage and location were evaluated. Their change in level was followed up in a subset of patients after the removal of tumor or adenoma. We investigated miR-18a for its function in cancer development using comet assay, cell viability assay, colony formation assay, and analysis on apoptosis (part three). / Results: In part one, we found stool miRNAs stable and detectable with high reproducibility by qRT-PCR. In detecting CRC, stool miR-92a had a sensitivity of 71.6% and a specificity of 73.3%, stool miR-21 had a sensitivity of 55.7% and a specificity of 73.3%. Stool miR-92a level had higher sensitivity for distal CRC than proximal CRC, and a higher sensitivity for advanced adenoma than minor polyps. The removal of tumor resulted in reduced stool miR-21 and miR-92a levels. / In part two, based on miRNA profiling of CRC tumors, we found that stool-based miR-18a, miR-20a, miR-135b, and miR-221 can discriminate colorectal cancer patients from healthy individuals: miR-18a (sensitivity: 51.1%, specificitiy: 90.1%); miR-20a (72.7%, 81.2%); miR-135b (8 1.8%, 68.3%); miR-221 (69.3%, 77.2%). Levels of these 4 stool-based markers dropped after removal of tumors. Stool-based miR-135b and miR-221 also discriminated patients with adenoma from healthy individuals. MiR-18a, miR-20a, miR-135b and miR-221 showed no desparity in detecting proximal or distal colon cancer. / In part three, based on in silico prediction and validation with luciferase reporter activity, we identified Ataxia Telangiectasia Mutated (ATM ), a protein crucial to DNA repair, as a target of miR-18a. Ectopic expression miR-18a attenuates DNA double strand break repair mechanism, creating a genetic predisposition to the development of cancer. / Conclusion: Stool-based miR-21, miR-92a, miR-18a, miR-20a, miR-135b and miR-221 can discriminate patients with CRC from healthy individuals. Notably, a subset of these miRNAs (miR-92a, miR-135b, and miR-221) can discriminate patients with colorectal adenoma from healthy individuals MiR-18a suppressed ATM gene expression and attenuated cellular repair mechanism to DNA double strand breaks. Stool-based miRNAs are useful CRC screening biomarkers. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Wu, Chung Wah. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 80-92). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese. / Chapter CHAPTER ONE --- INTRODUCTION --- p.1 / Chapter 1.1 --- Colorectal cancer --- p.1 / Chapter 1.2 --- Current screening methods --- p.3 / Chapter 1.2.1 --- Colonoscopy --- p.3 / Chapter 1.2.2 --- Sigmoidoscopy --- p.4 / Chapter 1.2.3 --- Stool-based tests --- p.4 / Chapter 1.2.3.1 --- Fecal occult blood test --- p.5 / Chapter 1.2.3.2 --- Stool-based DNA test --- p.6 / Chapter 1.2.3.3 --- Stool-based RNA and protein test --- p.7 / Chapter 1.3 --- MiRNA and its role in cancer --- p.8 / Chapter 1.4 --- Aims of study --- p.9 / Chapter CHAPTER TWO --- METHODOLOGY --- p.10 / Chapter 2.1 --- Subjects and sample collection --- p.10 / Chapter 2.2 --- MiRNA extraction in tissue and stool samples --- p.13 / Chapter 2.3 --- MiRNA quantitation by quantitative reverse transcription quantitative reverse transcription polymerase chain reaction --- p.14 / Chapter 2.4 --- Determining the stability of miRNA in stool samples --- p.15 / Chapter 2.5 --- Determining the reproducibility of miRNA quantitation in stool samples --- p.16 / Chapter 2.6 --- Reverse transcription for miRNA array --- p.16 / Chapter 2.7 --- Quantitative polymerase chain reaction for miRNA array --- p.16 / Chapter 2.8 --- Cell culture, miRNA precursors and transfection --- p.17 / Chapter 2.9 --- Dual-luciferase reporter assay --- p.17 / Chapter 2.10 --- Quantitative reverse transcription polymerase chain reaction for mRNA --- p.19 / Chapter 2.11 --- Western blot analysis --- p.19 / Chapter 2.12 --- Comet assay --- p.19 / Chapter 2.13 --- Colony formation and cell viability assay --- p.20 / Chapter 2.14 --- Annexin V apoptosis assay --- p.21 / Chapter 2.15 --- Statistics --- p.21 / Chapter CHAPTER THREE --- RESULTS --- p.23 / Chapter 3.1 --- PART 1 --- p.23 / Chapter 3.1.1 --- Stability of miRNA detection in stool samples --- p.23 / Chapter 3.1.2 --- Reproducibility of miRNA quantitation in stool samples --- p.23 / Chapter 3.1.3 --- Detection and normalization of miRNA levels --- p.25 / Chapter 3.1.4 --- Expression of miR-21 and miR-92a in CRC tissue samples --- p.28 / Chapter 3.1.5 --- Levels of stool-based miR-21 and miR-92a in CRC and polyp patients --- p.30 / Chapter 3.1.6 --- Sensitivity of stool-based miR-21 and miR-92a towards colorectal cancer and polyps --- p.32 / Chapter 3.1.7 --- Association of stool-based miR-21 and miR-92a with clinicopathological features --- p.34 / Chapter 3.1.8 --- Follow-up on stool miR-21 and miR-92a levels after removal of lesion --- p.37 / Chapter 3.2 --- Part 2 --- p.39 / Chapter 3.2.1 --- MiRNA profiling in colorectal tumors --- p.39 / Chapter 3.2.2 --- Validation of miRNA profiling results --- p.41 / Chapter 3.2.3 --- Candidate miRNA levels in stool samples of CRC and adenoma patients --- p.44 / Chapter 3.2.4 --- Sensitivities and specificities of miRNA candidates for adenoma and CRC --- p.47 / Chapter 3.2.5 --- Sensitivties of miRNA candidates based on tumor location --- p.49 / Chapter 3.2.6 --- Follow-up on stool miRNA levels after removal of lesion --- p.51 / Chapter 3.2.7 --- Association of stool-based miRNAs with nodal involvement in CRC --- p.53 / Chapter 3.2.8 --- Establishing the miRNA marker panel --- p.55 / Chapter 3.3 --- Part 3 --- p.57 / Chapter 3.3.1 --- In Silico prediction of miR-18a target and validation by luciferase assay --- p.57 / Chapter 3.3.2 --- Expression and correlation between miR-18a and ATM in paired colorectal tumor tissue, cell lines and normal colon biopsies --- p.60 / Chapter 3.3.3 --- Regulation of double strand DNA damaga recovery by miR-18a --- p.62 / Chapter 3.3.4 --- Cell sensitization to genotoxin by miR-18a --- p.64 / Chapter 3.3.5 --- Effect of miR-18a on genotoxin induced apoptosis --- p.66 / Chapter CHAPTER FOUR --- DISCUSSION --- p.68 / Chapter 4.1 --- Stability and detection reproducibility of stool-based miRNA --- p.68 / Chapter 4.2 --- Stool-based miRNAs for screening colorectal cancer and polyps/adenomas --- p.69 / Chapter 4.2.1 --- MiR-21 --- p.69 / Chapter 4.2.2 --- MiR-18a, miR-20a and miR-92a --- p.70 / Chapter 4.2.3 --- MiR -135b and miR -221 --- p.71 / Chapter 4.2.4 --- MiR -31 --- p.72 / Chapter 4.3 --- Discriminating proximal and distal CRC --- p.73 / Chapter 4.4 --- Evaluation of stool-based miRNA level after removal of lesions --- p.74 / Chapter 4.5 --- MiRNA marker panel --- p.74 / Chapter 4.6 --- Advantages of stool-based miRNA tests --- p.75 / Chapter 4.7 --- Ataxia telangiectasia mutated as the direct target of miR -18a --- p.75 / Chapter 4.8 --- Future directions for study --- p.78 / Chapter 4.9 --- Conclusion --- p.78 / REFERENCES --- p.80 / PUBLICATIONS --- p.93

published_or_final_version / Obstetrics and Gynaecology / Doctoral / Doctor of Philosophy

Nanoscience and nanotechnology have advanced rapidly in recent years and have made a profound impact in the medical field. Nanoparticles have attracted great attention for their potential as diagnostic and/or therapeutic tools in oncology owing to their unique properties. Theranostics are nanodevices with diagnostic, therapeutic and possibly treatment-monitoring functions for treating cancers. Different noble metal nanoparticles can provide the basic unit for theranostics. Suitably designed and developed noble metal nanoparticle-based theranostics will have multiple functions. In this project, the design, fabrication and performance of novel multifunctional nanodevices for cancer detection and treatment were investigated. The foundation of this project was laid by investigating different types of hybrid nanoparticles for novel theranostics. Different approaches were developed for fabricating core-shell structured hybrid nanoparticles. Highly branched gold and gold-silver bimetallic nanoparticles were firstly made. pH-sensitive folic acid-chitosan (CS-FA) conjugate was then introduced on these nanoparticles to form hybrid nanoparticles with a metal core (Au@CS-FA and Au-Ag@CS-FA). Poly(lactide-co-glycolide) (PLGA) and chitosan (CS) micro- or nanoparticles were also produced to serve as the polymer core for forming hybrid particles with a gold or gold-silver nanoshell (PLGA@Au, CS@Au and PLGA@Ag-Au). Furthermore, Fe3O4@Au nanoparticles having both magnetic and plasmonic properties were investigated. Thermo-sensitive poly(N-isopropylacrylamide) (pNIPAm) polymer or pH-sensitive CS-FA was then coated on Fe3O4@Au nanoparticles, forming new hybrid nanoparticles. The formation mechanisms of nanoparticles and hybrid nanoparticles were studied. Raman reporters (Rhodamine B or 4-mercaptobenzoic acid) and anti-cancer drugs (paclitaxel or 5-fluorouracil) were loaded into the polymer core or shell of hybrid nanoparticles to form multifunctional nanodevices. While the noble metal unit in the nanodevices provided high light-scattering enhancement for achieving photothermal effect, the polymer component encapsulated Raman reporter molecules and put them close to the metal nanoparticles for generating high surface enhanced Raman scattering (SERS) signals. These nanodevices could also serve as excellent drug carriers, and the stimulus-triggered release of incorporated drug was studied. It was shown in this project that the conjugation of targeting ligand (e.g. folic acid) or antibody (e.g. anti-HER2 monoclonal antibody) on hybrid nanoparticles had formed novel theranostics which allowed selective detection, continuous imaging of intracellular behavior and killing of targeted cancer cells. These theranostics could be taken up by specific cancer cells through receptor-mediated endocytosis and internalized into cytoplasma of the cell. These theranostics as stable SERS-active tags and imaging agents for HeLa cells, SK-BR-3 cancer cells or MCF-7 cancer cells were demonstrated. The targeting ability and intracellular uptake of these theranostics were studied. The photothermal effect of the theranostics was investigated using different laser irradiation powers. The anti-cancer treatment could be significantly improved by the synergistic effects of chemo- and photothermal therapy when these theranostics were also tasked as the carrier of anti-cancer drugs. Therefore, combining plasmonic metal nanoparticles with targeting ligand or antibody, magnetic nanoparticles, polymer shell or core, and anti-cancer drug has created advanced theranostics for the early detection and effective treatment of cancers. These novel theranostics have greatly improved capability for cancer detection and can provide multifunctions for cancer cell targeting, sensing/imaging and combined therapy. / published_or_final_version / Mechanical Engineering / Doctoral / Doctor of Philosophy

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Nanomedicine utilises biocompatible nanomaterials for therapeutic as well as imaging purposes, for the treatment of various diseases including cancer, neurological disorders and wound infections. Graphene, a material composed of a single layer of carbon atoms, has recently shown great potential to improve diagnostics and therapeutics, owing to its small size, large surface-area-to-volume ratio and unique physicochemical properties. However, the limited fabrication, in vitro and in vivo functionalities published in the literature indicate inconsistencies regarding the factors affecting metabolic fate, biodistribution as well as toxicity patterns of graphene. This thesis focuses on the biological effects of graphene-based materials, including graphene oxide (GO), reduced graphene oxide (rGO), graphene nanopores (GNPs), graphene quantum dots (GQDs) and three-dimensional graphene foam (GF). These can be used to closely mimic therapeutic functions and thereby open up new pathways to anticancer nanomedicine. In this work, a biocompatible GO-based anti-metastatic enzyme cancer therapy approach has been introduced for the first time to target the extracellular pro-metastatic and pro- tumourigenic enzymes of cathepsin D and cathepsin L, which are typically overexpressed in ovarian and breast cancers. Definitive binding and modulation of cathepsin- D and -L with GO has revealed that both of the enzymes were adsorbed onto the surface of GO through its cationic and hydrophilic residues under the biologically relevant condition of acidic pH. It has been demonstrated that low concentrations of rGO were shown to significantly produce late apoptosis and necrosis rather than early apoptotic events in lung cancer cells (A549 and SKMES-1), suggesting that it was able to disintegrate the cellular membranes in a dose-dependent manner. GNPs at lower concentrations (250μg/ml) induce upregulation of phosphatidylserine on cell surface membrane (i.e. early apoptotic event), which does not significantly disintegrate the cell membrane in the aforementioned lung cancer cells, while higher concentrations of GNPs (5 and 15 mg/kg) in rats (when intraperitoneally injected) exhibited sub-chronic toxicity in a period of 27 days. The interaction of GQDs and trypsin has revealed the strong bonding capacity of GQDs with trypsin, owing to their surface charge and surface functionalities evidencing the high bioavailability of GQDs in enzyme engineering. Finally, 3D GF was developed to probe the role of graphene-based scaffold cues in the field of regenerative medicine revealing their cell attachment to in vitro cell cultures. Furthermore, GF was shown to maintain remarkable biocompatibility with in vitro and in vivo toxicity screening models when exposed for 7 days at doses of 5, 10 and 15 mg/l. Taken together, graphene and its modified structures developed in this thesis promise to revolutionise clinical settings across the board in nanomedicine which include, but are not limited to, ultra-high sensitive enzyme adsorbents, high throughput biosensors, enzyme modulators and smart scaffolds for tissue regeneration.

published_or_final_version / Medicine / Master / Doctor of Medicine

External nuclear medicine diagnostic imaging of early primary and metastatic lung cancer tumors is difficult due to the poor sensitivity and resolution of existing gamma cameras. Nonimaging counting detectors used for internal tumor detection give ambiguous results because distant background variations are difficult to discriminate from neighboring tumor sites. This suggests that an internal imaging nuclear medicine probe, particularly an esophageal probe, may be advantageously used to detect small tumors because of the ability to discriminate against background variations and the capability to get close to sites neighboring the esophagus. The design, theory of operation, preliminary bench tests, characterization of noise behavior and optimization of such an imaging probe is the central theme of this work. The central concept lies in the representation of the aperture shell by a sequence of binary digits. This, coupled with the mode of operation which is data encoding within an axial slice of space, leads to the fundamental imaging equation in which the coding operation is conveniently described by a circulant matrix operator. The coding/decoding process is a classic coded-aperture problem, and various estimators to achieve decoding are discussed. Some estimators require a priori information about the object (or object class) being imaged; the only unbiased estimator that does not impose this requirement is the simple inverse-matrix operator. The effects of noise on the estimate (or reconstruction) is discussed for general noise models and various codes/decoding operators. The choice of an optimal aperture for detector count times of clinical relevance is examined using a statistical class-separability formalism.

D. Litt et Phil. / It is well known that high levels of anxiety and/or depression often accompany the diagnosis and treatment of cancer. Literature from various sources, but in particular from the fairly new field of research, Psychoneuroimmunology, also provides ample evidence that excessive anxiety and/or depression can be immunosuppressive. It makes sense, therefore, that any intervention restoring balance to the immuno-regulatory system, thereby allowing the body’s innate healing processes to focus on eliminating cancer, is highly desirable. In line with current thinking based on the mind-body connection as well as cognitive behavioural techniques utilised in many therapeutic settings, various psychological interventions have been found to help the patient gain a better sense of control over distressing symptoms and side-effects of cancer. Some of these include: basic cognitive restructuring, hypnotherapy, relaxation-meditation techniques, art and music therapy, and guided imagery. Substantial international research illustrates the beneficial effect that relaxation and/or guided imagery provides in such diverse settings including work, sport and health. In this regard, it was decided to run a pilot study to ascertain whether a customised tape recording with a relaxation and guided imagery dialogue aimed at helping patients manage and cope with negative symptoms of cancer, could significantly reduce anxiety levels in patients with cancer receiving radiotherapy. To operationalise the above, 30 men and women, aged between 20 and 80, with Stages 1, 2 or 3 breast, prostrate, gynaecological cancers, and head and neck cancers, who were about to commence radical (minimum 25 fractions) radiotherapy, were randomly selected to an experimental and a control group. A consecutive sample, pre-test post-test experimental design was applied to this study in which the experimental and control groups were subjected to pre- and post radiotherapy Hospital Anxiety & Depression (HAD) Scale, Institute for Personality Assessment and Training (IPAT) Anxiety Scale and blood pressure measurements during their 1st, 3rd, 6th week cycle of treatments, as well as a final measurement 12 weeks after commencement of therapy. The main hypothesis of this pilot study was that there would be statistically significant decreases in levels of anxiety as a result of the intervention of guided imagery tape recording in patients with non-metastatic cancer undergoing curative radiotherapy. For the intervention, each experimental participant was taught a relaxation technique and then following an interview a customised guided imagery dialogue developed for the participant’s sole use. The participant was requested to listen to this tape at least once a day. The control group had the same pre- and post tests as the experimental group, but did not receive any intervention. Statistical analysis of the data revealed that the experimental group showed a tendency towards decreased blood pressure and anxiety over the course of radiotherapy. The most significant change, however, was noted in terms of diastolic blood pressure, suggesting that the intervention corresponded to a physiological decrease in anxiety. There was not a statistically significant difference in terms of the measured psychological variables. A general conclusion to this pilot study suggests that whilst guided imagery may contribute to a lowering of anxiety, additional cognitive intervention would probably affect a more substantial and sustained change in the patient. Although this pilot study revealed some methodological weaknesses the results are sufficiently encouraging to warrant further in-depth research regarding the use of guided imagery as a cost-effective, easy method for individuals to learn and utilise as part of their integrative cancer treatment programme.