Breast Cancer Surgery and Treatments

Breast CancerFacing breast cancer and surgery is difficult on all levels. So many emotions come into play. Dealing with the diagnosis of cancer and the fear it provokes is heart wrenching. Having to undergo surgery and the anxious feelings this elicits adds yet another layer of difficulty.

I accompanied a friend yesterday to her chemo treatment. A woman sitting next to her started talking to me and telling me her story. She spoke of her day to day struggle with her illness and the treatments. She spoke of how the surgery was really just the beginning of the long road to recovery. She explained how she feels that her life is now depleted of joy.

She is tired, sad, and feeling weak and discouraged.

My friend who has been greatly helped by hypnosis and meditation asked me to tell her about it and I did. We downloaded a little hypnosis tape onto her iPhone. This little act of being proactive and doing something for herself already lifted her spirit and when we left she was smiling and animated. Using clinical hypnosis is wonderful as a tool to promote positive outlook and relaxation. Hypnosis helps engage the body’s healing powers and as the study shows patients that received hypnosis reported less pain, discomfort, fatigue and emotional upset. Hypnosis helps. http://jnci.oxfordjournals.org/content/99/17/1304.short

A Randomized Clinical Trial of a Brief Hypnosis Intervention to Control Side Effects in Breast Surgery Patients

  1. Guy H. Montgomery,
  2. Dana H. Bovbjerg,
  3. Julie B. Schnur,
  4. Daniel David,
  5. Alisan Goldfarb,
  6. Christina R. Weltz,
  7. Clyde Schechter,
  8. Joshua Graff-Zivin,
  9. Kristin Tatrow,
  10. Donald D. Price and
  11. Jeffrey H. Silverstein

+Author Affiliations


  1. Affiliations of authors: Department of Oncological Sciences (GHM, DHB, JBS), Department of Surgery (AG, CRW), and Department of Anesthesiology Sciences (JHS), Mount Sinai School of Medicine, New York, NY; Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania (DD); Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY (CS); Department of Health Policy and Management, Columbia University, New York, NY (JGZ); Department of Psychology, Good Shepherd Rehabilitation Hospital, Allentown, PA (KT); Departments of Oral and Maxillofacial Surgery and Neuroscience, University of Florida, Gainesville, FL (DDP)
  1. Correspondence to: Guy H. Montgomery, PhD, Department of Oncological Sciences, Mount Sinai School of Medicine, Box 1130, 1 Gustave L. Levy Place, New York, NY 10029-6574 (e-mail:guy.montgomery@mssm.edu).
  • Received January 5, 2007.
  • Revision received June 25, 2007.
  • Accepted July 11, 2007.

Abstract

Background Breast cancer surgery is associated with side effects, including postsurgical pain, nausea, and fatigue. We carried out a randomized clinical trial to test the hypotheses that a brief presurgery hypnosis intervention would decrease intraoperative anesthesia and analgesic use and side effects associated with breast cancer surgery and that it would be cost effective.

Methods We randomly assigned 200 patients who were scheduled to undergo excisional breast biopsy or lumpectomy (mean age 48.5 years) to a 15-minute presurgery hypnosis session conducted by a psychologist or nondirective empathic listening (attention control). Patients were not blinded to group assignment. Intraoperative anesthesia use (i.e., of the analgesics lidocaine and fentanyl and the sedatives propofol and midazolam) was assessed. Patient-reported pain and other side effects as measured on a visual analog scale (0–100) were assessed at discharge, as was use of analgesics in the recovery room. Institutional costs and time in the operating room were assessed via chart review.

Results Patients in the hypnosis group required less propofol (means = 64.01 versus 96.64 μg; difference = 32.63; 95% confidence interval [CI] = 3.95 to 61.30) and lidocaine (means = 24.23 versus 31.09 mL; difference = 6.86; 95% CI = 3.05 to 10.68) than patients in the control group. Patients in the hypnosis group also reported less pain intensity (means = 22.43 versus 47.83; difference = 25.40; 95% CI = 17.56 to 33.25), pain unpleasantness (means = 21.19 versus 39.05; difference = 17.86; 95% CI = 9.92 to 25.80), nausea (means = 6.57 versus 25.49; difference = 18.92; 95% CI = 12.98 to 24.87), fatigue (means = 29.47 versus 54.20; difference = 24.73; 95% CI = 16.64 to 32.83), discomfort (means = 23.01 versus 43.20; difference = 20.19; 95% CI = 12.36 to 28.02), and emotional upset (means = 8.67 versus 33.46; difference = 24.79; 95% CI = 18.56 to 31.03). No statistically significant differences were seen in the use of fentanyl, midazolam, or recovery room analgesics. Institutional costs for surgical breast cancer procedures were $8561 per patient at Mount Sinai School of Medicine. Patients in the hypnosis group cost the institution $772.71 less per patient than those in the control group (95% CI = 75.10 to 1469.89), mainly due to reduced surgical time.

Conclusions Hypnosis was superior to attention control regarding propofol and lidocaine use; pain, nausea, fatigue, discomfort, and emotional upset at discharge; and institutional cost. Overall, the present data support the use of hypnosis with breast cancer surgery patients.

  The researchers concluded that: “Hypnosis was superior to attention control regarding propofol and lidocaine use; pain, nausea, fatigue, discomfort, and emotional upset at discharge; and institutional cost. Overall, the present data support the use of hypnosis with breast cancer surgery patients. (highlighting not in original article).

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Shirly Gilad
Certified Clinical Hypnotherapist at Integrative Hypnotherapy Boca Raton
Shirly Gilad is an accomplished and experienced practitioner. She has knowledge in both traditional medicine and complementary practices. She is a certified clinical hypnotherapist. She holds graduate degrees in nursing, clinical nutrition and homeopathic medicine. Shirly is also a behavioral analyst and an expert in assessing behaviors and changing dysfunctional behavior patterns. Shirly studied in the United States and worked at a large clinic in New York that provided comprehensive treatment for cancer patients. She now caters to local community from her Boca Raton office as she helps national and international clients over Skype.
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