Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients

Abstract

Each year, hundreds of thousands of women undergo excisional breast biopsies for definitive diagnosis. Not only do these patients experience pain associated with the procedure, but they also endure distress associated with the threat of cancer. Hypnosis has been demonstrated as effective for controlling patients' pain in other surgical settings, but breast surgery patients have received little attention. To determine the impact of brief presurgical hypnosis on these patients' postsurgery pain and distress and to explore possible mediating mechanisms of these effects, 20 excisional breast biopsy patients were randomly assigned to a hypnosis or control group (standard care). Hypnosis reduced postsurgery pain and distress. Initial evidence suggested that the effects of hypnosis were mediated by presurgery expectations.

Predictors of expectancies for post-surgical pain and fatigue in breast cancer surgical patients

“…The use of VAS questions has been well supported in previous studies related to breast cancer (e.g., DiLorenzo et al, 1995;Montgomery et al, 2002).…”

“…According to Response Expectancy Theory (Kirsch, 1990), response expectancies are sufficient to cause nonvolitional outcomes. A growing body of research has supported this concept among various surgery patients (Logan & Rose, 2005;Salmon & Hall, 1997;Wallace, 1985), including breast cancer surgery patients (Montgomery & Bovbjerg, 2004;Montgomery et al, 2002), as well as in experimental contexts (e.g., Montgomery & Kirsch, 1997;Price et al, 1999). Although the relationship between expectancies and post-surgical side effects has been well established in the literature, little research has been conducted to determine the sources of these expectancies.…”

“…For example, women scheduled to undergo breast cancer surgery have specific pre-surgical expectancies about how much post-surgical pain and fatigue they will experience (Montgomery & Bovbjerg, 2004;Montgomery, Weltz, Seltz, & Bovbjerg, 2002). A recent study found that such treatment-related expectancies are common among cancer patients (Hofman et al, 2004).…”

Relations between coping responses and optimism–pessimism in predicting anticipatory psychological distress in surgical breast cancer patients

“…This position is consistent with the present findings indicating that specific coping mechanisms influence optimism and pessimism. Recent research has supported the view that response expectancies can directly influence distress in breast cancer surgical patients (Montgomery et al, 2002), however, more empirical research in this area is needed.…”

“…In the United States of America, more than 150,000 women undergo lumpectomy and mastectomy for breast cancer each year, and hundreds of thousands more undergo similar surgical procedures (i.e., excisional biopsy) for definitive diagnosis. Research with patients awaiting breast surgery for treatment or diagnosis of breast cancer consistently support the time before surgery as a period of heightened distress (Carver, Pozo, & Harris, 1993;Montgomery, Weltz, & Seltz, 2002;Northhouse, Tocco, & West, 1997). Generally, higher levels of distress have been associated with poorer postoperative outcomes in various surgical patient samples (Scott, Clum, & Peoples, 1983;Urrutia, 1975).…”