Donna Gould keeps a wooden box full of memories from her decade-long battle with breast cancer -- 500 get-well cards, a lock of her hair and a black cassette tape with a dog-eared label that reads "Donna's Hypnosis Tape."
The objects remind Gould of a time when she was "literally scared to death." After enduring two lumpectomies and a bout of radiation, Gould learned she would need a mastectomy.
"Isn't it weird how the thing that scares you the most finds you?" said Gould, who was first diagnosed with breast cancer at age 50. "I just couldn't cope. I was an absolute wreck every day."
Gould said she knew her worry was only making her sicker. But the two-week wait for the dreaded procedure that would claim her breast was unbearable. Her friend, a hypnotist, suggested she try hypnosis to calm her mind and change her outlook. Willing to try anything, Gould agreed and entered a trance to the soothing sound of her friend's voice.
The technique, which starts with relaxation, can change a willing participant's mind-set though softly spoken suggestions such as "You're doing this for your health," and "You're going to be fine." For Gould, the effects of hypnosis were so powerful that a tape-recorded session, played on a portable cassette player that she clutched until moments before her surgery gave her the comfort she needed to fight cancer.
"The thought of that surgery scared the living daylights out of me," said Gould, "and hypnosis made me less afraid to do what I needed to do."
The effects of hypnosis on reducing preoperative anxiety are well-documented. But increasingly, studies also support a role for hypnosis in reducing pain during and after surgery. The latest research, presented at the European Anaesthesiology Congress in June, found that patients who were hypnotized before breast cancer surgery done under local anesthetic fared better than patients who were put under general anesthetic without hypnosis. Those who underwent hypnosis with a local anesthetic experienced a faster recovery, a shorter hospital stay fewer painkillers.
Similarly, a 2007 study published in the Journal of the National Cancer Institute found that patients who were hypnotized briefly before breast cancer surgery needed less anesthetic and had less pain, nausea and fatigue after the procedure. The benefits even extended to the health care system, with a cost savings of $772.71 per patient, mainly due to reduced surgical time.
"The vast majority of patients can have some benefit from doing this," said Guy Montgemery, director of Mount Sinai School of Medicine's Integrative Behavioral Medicine Program and lead author of the study. "To me it's a no-brainer: It helps patients and it saves money."
Dr. Michael Schmitz, director of pediatric pain medicine at Arkansas Children's Hospital in Little Rock, Ark., described the state of anesthesia as consisting of four basic conditions: amnesia or loss of memory, analgesia or pain relief, sedation and relaxation.
"Hypnosis is used to assist with the other parts of anesthesia not covered by the local anesthetic," said Schmitz, explaining that it can help patients enter a calm, relaxed state, during which discomfort is tolerable and quickly forgotten.
Indeed Gould can't tell anyone what's on her hypnosis tape, because she can't remember. All she knows it that it worked. But it might not work for everyone.
"Not everyone is hypnotizable," said Dr. Elliot Krane, director of pediatric pain management at Lucile Packard Children's Hospital in Stanford, Calif., adding that children can't be hypnotized reliably and some faiths preclude followers from entering a trancelike state. And even if the patient is a good candidate, the hospital might not be.
"Hypnosis takes time, skill with hypnosis and patience, as well as a quiet location," said Krane, "and these three elements are not commonly found in a busy operating room in most hospitals."
But Mount Sinai's Montgomery hopes more research by him and others will encourage more hospitals to offer the service.
"Don't get me wrong. I'm really glad anesthetics were developed," said Montgemery. "I don't view hypnosis as a replacement; more so, I view it as a compliment."
Even anesthesiologists like Krane and Schmidt said they'd give it a try.
Gould credits hypnosis for her quick and spirited recovery from mastectomy. Even her nurse, whom she cheerfully mooned in the recovery room, was amazed.
"Hypnosis got me through one of the worst moments in my life," said Gould. "I'm proud to say I am a breast cancer survivor."