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Hypnosis Improves Fatigue, Anxiety After Lumpectomy, but Not Pain

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A short hypnosis session before surgery didn’t ease pain after lumpectomy, but did ease fatigue and anxiety after the procedure, according to a study.

The research was published in the Aug. 17, 2018, issue of the journal JAMA Network Open. Read “Effects of a Hypnosis Session Before General Anesthesia on Postoperative Outcomes in Patients Who Underwent Minor Breast Cancer Surgery: The HYPNOSEIN Randomized Clinical Trial.”

What is hypnosis?

Hypnosis, also called hypnotherapy or hypnotic suggestion, puts you in a trance-like state of consciousness. During hypnosis, you are more focused, and the process brings you to a state of deep relaxation. Hypnosis is usually done with the help of a therapist who uses verbal repetition and mental imagery. When you’re under hypnosis, you usually feel calm and relaxed and are more open to suggestions. Research suggests that hypnosis can help ease pain, nausea, vomiting, stress, and anxiety.

Up to 20% of women have moderate to severe pain within the first few days after breast cancer surgery. About 10% to 15% have nausea and vomiting.

This study, called the HYPNOSEIN study, was done between Oct. 7, 2014, and April 5, 2016, in France. The study included 150 women diagnosed with breast cancer who were scheduled to have lumpectomy and be discharged on the same day or the day after surgery.

The women ranged in age from 20 to 84 years old. Most of the women had had surgery before, but none of the women had had surgery with hypnosis before.

The women were randomly assigned to receive either:

  • a 15-minute or shorter personalized hypnosis session before receiving general anesthesia; the hypnosis was done by a trained anesthesiologist who had been practicing hypnosis for more than 1 year (77 women)
  • standard general anesthesia with no specific language used to talk to the women and no nonverbal communication (73 women)

The women’s levels of:

  • pain
  • nausea/vomiting
  • fatigue
  • comfort/well-being
  • anxiety

were recorded at several times during the study:

  • before surgery
  • immediately before leaving the post-anesthesia care unit (this assessment was done by a nurse who didn’t know if the women had hypnosis or not)
  • when the women were discharged from the hospital or clinic
  • 1, 7, and 30 days after surgery

The levels of pain, nausea, fatigue, well-being, and anxiety were the same for the two groups before surgery. Surgery time was about 50 minutes in both groups.

Hypnosis didn’t help ease pain, but offered other benefits

The women who underwent hypnosis had a higher average breast pain score immediately before leaving the post-anesthesia care unit compared to women who didn’t have hypnosis. Still, there were no differences in pain levels later that day or the day after surgery.

But hypnosis did seem to offer some benefits. Women who underwent hypnosis had lower levels of fatigue in the evening after surgery. Women who underwent hypnosis also tended to have lower levels of fatigue and anxiety and better feelings of well-being at 1, 7, and 30 days after surgery compared to women who didn’t have hypnosis.

Did women’s perceptions of having hypnosis affect the results?

The researchers also looked to see if the women’s perceptions of whether they had hypnosis or not affected the outcomes.

While the women didn’t know who had hypnosis and who didn’t, about 75% of the women in each group figured out if they had hypnosis or not. This means that 25% of the women who didn’t have hypnosis believed they had it and 25% of the women who had hypnosis thought they didn’t have it.

Women who believed they had hypnosis reported lower levels of fatigue and anxiety the night of surgery and better well-being the day after surgery.

"This emphasizes the difficulty in analyzing the specific and intrinsic effect of hypnosis versus a putative placebo effect," the researchers wrote. "The subgroup analysis showed significantly lower postoperative fatigue and anxiety levels and better comfort/well-being in the perceived hypnosis subgroup compared with the no perceived hypnosis subgroup."

The researchers suggested there may be two reasons why the study found that hypnosis didn’t result in better pain control after surgery.

First, women who underwent hypnosis received lower doses of the two anesthesia drugs, propofol and sufentanil. This could be why women who didn’t have hypnosis had lower pain levels after lumpectomy. Second, because the women were having relatively minor surgery compared to mastectomy and were given a combination of several pain medicines, their pain levels were likely already low.

While this study didn’t find a link between hypnosis and less pain after lumpectomy, it does suggest that hypnosis can help ease fatigue and anxiety after the surgery.

If you’re interested in trying hypnosis before lumpectomy, talk to your surgeon or someone on your medical team to learn what’s available at your treatment center. It’s also important to know that hypnosis can occasionally trigger deep and sometimes upsetting emotions. Ask your doctor if you’re a good candidate for hypnosis, especially if you have a history of mental illness.

For more information, visit the Hypnosis page in the Complementary and Holistic Medicine section.

To talk with others about how hypnosis and other techniques can help treatment side effects like fatigue and anxiety, join the Discussion Board forum Complementary and Holistic Medicine and Treatment.

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