Over 90% of the 175,000 women diagnosed with breast cancer in 1999 will undergo surgical treatment. Despite improvements in pharmacological management, surgical procedures under general anesthesia continue to be associated with clinically significant side effects, chief among which are pain and nausea. These clinical problems are particularly severe following surgical treatment for breast cancer and can require additional pharmacologic intervention, prolong recovery room stay, delay discharge, and lead to unanticipated readmission. Clinical research with other surgical populations has indicated that hypnosis is effective for control of postoperative symptoms and enhancing recovery (e.g., reducing pain, nausea, hospital stays), however to our knowledge, the treatment efficacy of hypnotic techniques with breast surgical patients has not been established. The goals of this study are twofold: 1) To apply hypnotic techniques proven efficacious with other surgical patients to patients underlying lumpectomy for breast cancer; and 2) To better understand the basic behavioral mechanisms responsible for hypnosis effects by examining two likely """""""":active ingredients"""""""" (i.e., patients preoperative levels of distress and their expectations of side effects) of the hypnosis intervention. To achieve these goals, 140 breast cancer patients scheduled for lumpectomy will be randomly assigned to a hypnosis intervention group or a standard care control group. The impact of the hypnotic intervention on postoperative nausea, pain and recovery from surgery will be analyzed within an experimental study design. The influence of pre-surgery distress and expectations of side effects will be analyzed within a perspective study design using correlational approaches. In both analyses, the potential influence of additional factors (e.g., medical, demographic, patient characteristics) will be assessed. The results of this proposal to apply a hypnotic intervention to a new population (i.e., surgical breast cancer patients) and to examine the basic behavioral mechanisms responsible for beneficial effects of hypnotic suggestions will establish the background necessary for a more extended background of research to investigate the mechanisms and modifiers of the effects of hypnotic suggestion in this population.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Small Research Grants (R03)
Project #
5R03CA086562-02
Application #
6377935
Study Section
Special Emphasis Panel (ZCA1-SRRB-X (J1))
Program Officer
Nelson, Wendy
Project Start
2000-04-01
Project End
2003-03-31
Budget Start
2001-04-11
Budget End
2003-03-31
Support Year
2
Fiscal Year
2001
Total Cost
$84,750
Indirect Cost
Name
Mount Sinai School of Medicine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
114400633
City
New York
State
NY
Country
United States
Zip Code
10029
Tatrow, Kristin; Montgomery, Guy H (2006) Cognitive behavioral therapy techniques for distress and pain in breast cancer patients: a meta-analysis. J Behav Med 29:17-27
David, Daniel; Montgomery, Guy H; Macavei, Bianca et al. (2005) An empirical investigation of Albert Ellis's binary model of distress. J Clin Psychol 61:499-516
Tatrow, Kristin; Montgomery, Guy H; Avellino, Maria et al. (2004) Activity and sleep contribute to levels of anticipatory distress in breast surgery patients. Behav Med 30:85-91
Montgomery, Guy H; David, Daniel; Goldfarb, Alisan B et al. (2003) Sources of anticipatory distress among breast surgery patients. J Behav Med 26:153-64
Montgomery, Guy H; Weltz, Christina R; Seltz, Megan et al. (2002) Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. Int J Clin Exp Hypn 50:17-32