Women who undergo hypnosis just before breast cancer surgery need less anesthetic, and experience lower levels of pain and other side-effects following the surgery, a study suggests.

Patients who had a hypnosis session with a psychologist an hour before surgery spent less time in the operating room – about 11 minutes, on average – resulting in significant cost savings, mainly due to reduced operating time, the research shows.

"Breast cancer patients are a population in need," lead author Guy Montgomery, a clinical psychologist at the Mount Sinai School of Medicine, said Tuesday from New York. "They're going through a lot both from a psychological perspective as well as a physical perspective from the surgery itself."

Patients who underwent hypnosis at discharge had less pain intensity, nausea, fatigue and discomfort, and were less emotionally upset about the whole experience, Montgomery said of those who were hypnotized.

Pre-surgery hypnosis focuses attention

To conduct the study, published online Tuesday in the Journal of the National Cancer Institute, 200 women scheduled for surgical breast biopsy or lumpectomy were randomly assigned to have either a 15-minute session of hypnosis or a short period of empathetic listening with a psychologist.

Those assigned to hypnosis were first reassured about the so-called mesmerizing technique, with psychologists debunking myths about hypnosis popularized in movies and television, said Montgomery, director of the Integrative Behavioural Medicine Program at Mount Sinai.

"We explain that hypnosis is not mind control; you're not going to be asked to do anything embarrassing," said Montgomery. "It's not like taking a powerful drug that leaves you zonked out. It's more like focused attention, focused concentration, where you're able to let yourself relax and you're the person in charge."
  
Once hypnotized, suggestions were made specifically related to recovery from surgery.
     
The patients experienced reduced side-effects, spent less time in hospital recovering, while less time in the operating room resulted in an average saving to a hospital of $773 US per patient, the study found.

"The most important point is this is an easy thing we can do for patients; it saves institutions money, so basically it's a win-win," said Montgomery. "We can reduce side-effects of surgery without using basically any health-care dollar resources. It pays for itself."

Dr. May Lynn Quan, a breast surgical oncologist at Sunnybrook Health Sciences Centre in Toronto, called pre-op hypnosis a "very novel idea.

"We're always looking for ways to improve the patient experience, and if we can do it without using drugs and without the purchase of an expensive piece of equipment or whatever, that's really exciting."

But Quan noted that the study relied on highly trained clinical psychologists to perform the hypnosis, a type of health provider she does not believe is abundantly available at most Canadian hospitals.

Furthermore, she said, the type of anesthetic used by the U.S. doctors — a drug called propofol that produces heavy sedation rather than the unconsciousness of general anesthetic — is not widely used by breast cancer surgeons in Canada. It's unclear whether the study results would still apply.