Mind and matter

Hypnosis reduces pain and costs in breast cancer surgery

August 29, 2007 - The use of hypnosis prior to breast cancer surgery reduced the amount of anesthesia administered during the operation, the level of pain reported afterwards, and the time and cost of the procedure, according to a study published online August 28 in the Journal of the National Cancer Institute.

Breast cancer surgery patients often suffer side effects such as pain, nausea, and fatigue during and after their operation. These complications can lengthen their hospital stay, lead to hospital readmission, or require additional medications-all of which increase medical costs. Several previous studies have suggested that hypnosis may reduce pain, recovery time, and the need for medications after surgery.

Guy Montgomery, Ph.D., of Mount Sinai School of Medicine in New York and colleagues conducted a clinical trial to examine the effects of hypnosis when it is given within one hour before surgery. Two hundred women were randomly assigned to either 15 minutes of hypnosis by a psychologist or a control session in which they spoke with a psychologist. The researchers then compared the use of pain medications and sedatives during surgery, as well as the levels of pain and other side effects reported afterwards.

The hypnosis session began with suggestions for relaxation and pleasant visual imagery. The patients were also given suggestions on how to reduce pain, nausea, and fatigue, and instructions on how to use hypnosis on their own.

Patients in the hypnosis group required less anesthesia than patients in the control group. They also reported less pain, nausea, fatigue, discomfort, and emotional upset after surgery. They spent less time in surgery (almost 11 minutes less), and their surgical costs were reduced by about $773 per patient, mainly due to the time savings.

"Together, the combination of potential improvements in symptom burden for the hundreds of thousands of women facing breast cancer surgery each year and the economic benefit for institutions argues persuasively for the more widespread application of brief presurgical hypnosis," the authors write.

In an accompanying editorial, David Spiegel, M.D., of the Stanford University School of Medicine in Palo Alto, Calif., describes the history of hypnosis in medicine and the evidence for why hypnosis could reduce pain.

"It has taken us a century and a half to rediscover the fact that the mind has something to do with pain and can be a powerful tool in controlling it - It is now abundantly clear that we can retrain the brain to reduce pain: 'float rather than fight,'" Spiegel writes.

Journal of the National Cancer Institute