Life of Brian

Hypnosis Before Breast Cancer Surgery

This piece is from the

National Cancer Institute and is well worth a looksee.

Summary

Women undergoing surgery for breast cancer who received a brief hypnosis session before entering the operating room required less anesthesia and pain medication during surgery, and reported less pain, nausea, fatigue, and discomfort after surgery than women who did not receive hypnosis. The overall cost of surgery was also significantly less for women undergoing hypnosis.

Source

Journal of the National Cancer Institute, Sept. 5, 2007 (see the journal abstract).
(J Natl Cancer Inst. 2007 Sep 5;99(17):1304-12. Epub 2007 Aug 28)

Background

Surgery for breast cancer, either for diagnosis or treatment, can cause side effects, including pain, nausea, fatigue, and discomfort. While drugs including traditional pain medications can help provide relief, they can have side effects of their own and increase the overall cost of a surgical procedure.

Researchers have become interested in finding approaches other than drugs to help relieve the side effects of surgery. One technique under study is hypnosis, a type of guided relaxation in which participants become more open to suggestion.

The study described below tested whether a brief hypnosis session before breast cancer surgery could reduce the need for anesthesia and pain medication, reduce side effects experienced after surgery, or ease recovery.

The Study

Investigators from Mount Sinai Medical Center in New York City recruited 200 women scheduled to undergo either surgical breast biopsy for diagnosis or lumpectomy for treatment of breast cancer. The investigators randomly assigned participants to either the hypnosis group or a control group. Women scheduled for biopsy were randomized separately from women scheduled for lumpectomy, to evenly distribute the two types of surgery between the groups.

Women in the hypnosis group received a 15-minute hypnosis session within one hour prior to surgery. Psychologists trained in the use of hypnosis in the medical setting used a script including suggestions for relaxation, pleasant thoughts, and reduced experience of pain, nausea, and fatigue, as well as instructions on self-hypnosis for use after surgery. Women in the control group spent an equal amount of time with the psychologists within an hour of surgery to talk and receive emotional support.

All women received the drugs propofol and midazolam (anesthetics), and fentanyl and lidocaine (pain medications) during surgery. They also had access to additional pain medications after surgery, as needed.

Before leaving the hospital, the women reported their experiences of pain intensity, pain unpleasantness, fatigue, nausea, physical discomfort, and emotional upset. The investigators also collected information on the amount of anesthesia and pain medication used during and after surgery, the time spent in surgery, and the cost of the procedures, medications, and staff time.

Because the women knew their group assignment, the investigators took several precautions to reduce potential bias in the results.

• The same psychologists met with patients in both groups.
• The hypnosis and control sessions took place in a private room away from the anesthesiologists and surgeons, who did not know the group assignments.
• Data on anesthesia used was taken from computer records, not recorded by clinical staff.
• The psychologists did not collect the patient-reported data after surgery. Instead, research assistants who did not know the group assignments asked the women about their perceptions of pain and discomfort.

Results

Women in the hypnosis group required significantly less propofol and lidocaine, the doses of which were adjusted for individual patients as needed during surgery, than women in the control group. Use of fentanyl and midazolam did not differ significantly. Although use of pain medication after surgery did not differ between groups, women in the hypnosis group reported significantly less pain intensity, pain unpleasantness, nausea, fatigue, discomfort, and emotional upset than women in the control group.

Women in the hypnosis group also spent an average of about ten and a half fewer minutes in surgery than women in the control group. The researchers weren't able to say why this was so, only that the finding was statistically significant and resulted in cost savings. On average, the surgical procedures cost about $770 less per patient in the hypnosis group.

Limitations

One limitation of the study was that group assignment could not be hidden from participating women, since they actively participated in either the hypnosis or control sessions. When both participants and researchers in a study are unaware of the final group assignments, this is called a double-blind clinical trial, and is considered the best way to reduce potential bias in collecting results.

However, the researchers took precautions to make sure that the results were collected by staff that did not know which of the women had received hypnosis. The authors believed that their precautions "make it unlikely that either research or clinical staff were aware of study group assignment."

Also, in this study, the hypnosis was performed by specially trained psychologists, who may not be available at every hospital. More research is needed, explained the authors, to test whether other members of the clinical team could be taught to effectively give a similar hypnosis session.

The trial design did not allow for a definitive answer as to why the hypnosis group spent less time in surgery. "It is possible that the shorter procedure times in the hypnosis group were due to the patients being easier to prepare for surgery and to sedate or due to less time having been spent administering medications to patients," write the authors. "However, we did not investigate these mechanisms, and therefore, these possibilities are highly speculative."

Comments

"Overall, our results support the present hypnosis intervention as a brief, clinically effective means for controlling patients' pain, nausea, fatigue, discomfort, and emotional upset following breast cancer surgery beyond traditional pharmacotherapeutic approaches," stated the authors. "The present brief hypnosis intervention appears to be one of the rare clinical interventions that can simultaneously reduce both symptom burden and costs."

"If you can decrease the amount of pain using a technique such as hypnosis, and you can also at the same time reduce the cost involved in treating these patients, I think it's beneficial both ways," said Sonia Jakowlew, Ph.D., program director in the National Cancer Institute's (NCI) Cancer Cell Biology Branch. "It helps the patients and it helps the physicians as well."

Further studies are needed, explained the authors, to measure which specific parts of the hypnosis intervention are most effective, to see whether hypnosis had a long-term effect on the control of pain and discomfort, and to test hypnosis in patients with different types of cancer and from different demographic backgrounds. "Investigators should attempt to replicate [this study] and see if these are consistent findings," agreed Jeffrey White, M.D. director of NCI's Office of Cancer Complementary and Alternative Medicine.

All the best,
Brian

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WELCOME TO THE FUTURE AND IT SUCKS . . .US Live Expectancy Going Up and Down at the Same Time . . .. . . the healthcae gap is getting wider and it's killing women

Common understanding is that due to advanced in healthcare and technology and nuitrition, life expectancy has been rising.  Women tend to have a longer life expectancy than men.  A recent study on mortality rates by counties in the United States paints a very different - and rather depressing - picture.

The study by Majid Ezzati, Ari B. Friedman, Sandeep C. Kulkarni,  and Christopher J. L. Murray takes a hard look at actual county-by-county mortality data to uncover some disconcerting trends.  The PLos Medicine paper is The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States.  In the map above, you can compare mortality rates for men and women for the periods of 1961-1983 to those of 1983-1999.  The dark red areas are decreasing life expectancy while dark green areas are growing life expectancy.  Light red is below average but not decreasing and light green is above average but not increasing.  White areas are average.  Note the strong regional differences but also the nosedive in life expectancy for women.

The US is one of the most advanced nations on the planet but access to quality care is becoming limited  The cyberpunk dystopia is unfortunately becoming more and more increasingly accurate as a model for American society when it comes to access to healthcare.  Wealthier areas have always had more access to superior care and the gap between wealthy and the poor is widening as the middle class shrinks but also as many find their insurance  - if they can afford it - costs more and covers less.

The gap between male and female life expectancy is frightening as women naturally have higher expectancy but we are seeing a reveral.

What is causing the downturn?  For men, increased murder rates and HIV infections have has a real effect on life expectancy (but not for women).  Other culprits are factors for men and for women:

The researchers looked at differences in death rates between all counties in US states plus the District of Columbia over four decades, from 1961 to 1999. They obtained the data on number of deaths from the National Center for Health Statistics, and they obtained data on the number of people living in each county from the US Census. The NCHS did not provide death data after 2001. They broke the death rates down by sex and by disease to assess trends over time for women and men, and for different causes of death.

Over these four decades, the researchers found that the overall US life expectancy increased from 67 to 74 years of age for men and from 74 to 80 years for women. Between 1961 and 1983 the death rate fell in both men and women, largely due to reductions in deaths from cardiovascular disease (heart disease and stroke). During this same period, 1961-1983, the differences in death rates among/across different counties fell. However, beginning in the early 1980s the differences in death rates among/across different counties began to increase. The worst-off counties no longer experienced a fall in death rates, and in a substantial number of counties, mortality actually increased, especially for women, a shift that the researchers call "the reversal of fortunes." This stagnation in the worst-off counties was primarily caused by a slowdown or halt in the reduction of deaths from cardiovascular disease coupled with a moderate rise in a number of other diseases, such as lung cancer, chronic lung disease, and diabetes, in both men and women, and a rise in HIV/AIDS and homicide in men. The researchers' key finding, therefore, was that the differences in life expectancy across different counties initially narrowed and then widened.

This is scary stuff as the trends increase.  The folks at io9 offered their own take on the results:  So basically there is a growing health gap in the United States. Despite its status as a developed nation, the country is likely to harbor more and more communities where life expectancy is more like a developing nation. We're looking at a future where it's going to be increasingly difficult to say whether a country is "developing" or "developed" since it will exhibit characteristics of both.

Welcome to the future and it sucks.

All the best,
Brian

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Rupert Sheldrake Stabbed During Lecture!

Wow.  Rupert Sheldrake has been stabbed at the podium during his lecture at the International Conference on Science and Consciousness where he was appearing as keynote speaker (speaking on the topic of "thought transference").  The assailant was a Japanese man who evidently became more and more disturbed during the conference proceedings.  This local news story gives a strong impression that the reporter has no clue who Sheldrake is:

An Englishman speaking on "thought transference" during an international conference at La Fonda on Wednesday was stabbed in the leg by a Japanese man who seemed upset by his remarks, witnesses said.

Rupert Sheldrake of London was sitting up and alert as medics took him on a gurney to an ambulance outside Santa Fe's historic hotel at the southeast corner of the Plaza. Asked if he was OK, Sheldrake smiled and responded, "I hope so."

Hirano Kazuki, 33, of Yokohama, Japan, spent Wednesday night in jail after he was arrested on charges of aggravated battery and assault with intent to commit a violent felony. He provided no resistance as officers led him in handcuffs from the hotel.

Hirano had been attending the 10th International Conference on Science and Consciousness. Other attendees said he had been acting oddly. They said he confronted Sheldrake earlier this week, telling him he heard voices and saw demons. Another featured speaker at the conference told the man he was "full of negative energy" and counseled him to "calm down," said Evan Mecham, an attendee from Broomfield, Colo.

Another attendee, David Graves of Tel Aviv, Israel, said he had tried to talk to Hirano earlier in the conference, but he did not respond. On Tuesday, Graves said he watched Hirano as he sat on a bench, rocking back and forth, like an orthodox Jew in prayer. "Why the hell would he attack that guy?" he asked.

Sheldrake's keynote address was titled "Memory and Morphic Resonance," and his workshop was "Fields of the Mind: Experimental and Research and Practical Intuition," according to a catalog on the conference which began Monday and concluded today. Sheldrake, described as a biologist with a doctorate degree, is the author of Seven Experiences that Could Change the World.

David Edwards of Fresno, Calif., said Sheldrake had been talking about how thoughts can be transferred by staring into another's eyes. During the lecture in the main ballroom on La Fonda's second floor, an Asian man left the room and when he returned, he didn't take a seat but stood near the podium with his eyes closed like he was meditating, Edwards said.

The attack came when Sheldrake called for a break about 3 p.m. Edwards said he started to leave the room when he heard a commotion. By the time he looked back, he said, an Asian man was being held on the floor by four people while a fifth held a knife in a napkin. Mecham said the knife was a folding type that hunters typically use.

Edwards said Sheldrake had a 2- or 3-inch cut on the front of his left thigh, just above his kneecap, causing blood to spurt some 8 inches into the air as he lay on his back. Edwards, who is a physician, said he stemmed the blood loss while they waited for the ambulance and police. Had Sheldrake not been standing at the podium, Edwards said, the stab wound might have been more serious because it would have been higher on his body.

Edwards said when he asked Hirano why he stabbed Sheldrake, Hirano mumbled something he couldn't understand. "He seemed like he was in a trance or schizophrenic," Edward said. "He seemed to be angry."

Police Capt. Gary Johnson said the first law-enforcement officers to arrive on the scene were his brother, Chief Eric Johnson, and Sheriff's Lt. Marco Lucero, who both had been at a meeting at City Hall, and Officer Cecil Sena, who patrols the Plaza and downtown. By the time they arrived, conference attendees had subdued Hirano and were treating Sheldrake, Gary Johnson said. He said Sheldrake was taken to St. Vincent Regional Medical Center where his injuries were determined not to be life-threatening.

After police found Hirano's Japanese passport, which listed his home as Tokyo, Johnson said, "we notified the Japanese consulate to advise them of the custody of one of their nationals." Hirano was booked into the Santa Fe County jail about 9 p.m. and is expected to be arraigned this afternoon in Santa Fe County Magistrate Court. His online booking sheet listed his home as Yokohama.

Many people attending the conference appeared shaken by the incident and declined to comment. A man who helped subdue Hirano would only say, "The creator will take care of the rest of it." Attendees gathered for a prayer session before leaving La Fonda on Wednesday afternoon.

Wow.  Sheldrake is a favorite "crackpot" to some and a serious scientist to others - think morphic field.  There are a number of video lectures and panels out there of Sheldrake with Terence McKenna that are well worth playing with.

All the best,
Brian

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War of the Worlds . . .. . . media, influence, suggestibility, guillability . . .. . . and scaring the bejeepers our of ourselves

Radiolab produced a wonderful episode dealing with Orson Welles' infamous Halloween, Oct. 30, 1938 broadcast of a radio adaption of War of the Worlds by H.G. Wells.

This is a fascinating discussion of just HOW Welles and friends were able to create a broadcast event that literally scared the bejeepers out of thousands (over one million of the listeners believed the "hoax" about Martian invaders was true and that the events being portrayed on their radios were genuine.  Also discussed is the WHY listeners believed it.

The Welles hoax has been copied elsewhere, leading to riots, panic, and death.

Some characterize Welles success (accidental be that it may be) as based upon a time when folks were naive.  Not so, it's been repeated and resulted in panic.

The Radiolab commentators note how the emotions elicited by Welles are reminiscent of the emotions Americans felt during the aftermath of 9-11.  Coincidentally, after the aftermath of Welles' performance, one government offical called Welles and the rest of the Mercury Theatre to be "radio terrorists."

Read the background of the Radiolab production here.  Download the Radiolab audio file here.  Read news stories about the original Welles performance aftermath here, a transcript of the broadcast here, and download an audio file of the original Welles performance here (along with others).

Members of the Hypnosis Technique Exchange might enjoy exploring how this broadcast fits into our recent discussion of hypnotic operators.

All the best,
Brian

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Social Psychology, Influence, Perception . . .. . . and More Videos

A number of folks enjoyed the Test Your Awareness video which is an example of selective attention and bypassing the critical factor of the conscious mind. That is an intriguing advert which hedges its bets on ensuring that folks do not notice the dancing bear through color and motion masquing.

However, it is still a very clear demonstration of the effect.  Actually, I found it to be a wonderful demonstration as the concentration on the "white" players is definately enhanced.  This is not the original variation of the test and there are other variations out there.

So . . . in the interest of having more fun with perception . . . here are some more videos of various social psychology and other experiments as well as a few that have been adapted into popular entertainment.  The principles demonstrated are very powerful and extremely influential.

Visual Selective Attention Experiment
Becklen and Cervone (1983)

Selective Awareness
Dancing Bear

Selective Attention
Kids Version

Change Blindness
Harvard Experiment

Change Blindness: Person Swap
Derren Brown

Change Blindness
Young People Person Swap

Social Psychology Experiment
Students of University of Westminster (London)

Social Psychology Experiment
Crowds and Helping those in Distress

Conformity
S. Asche

Milgram Obedience Experiment
1963

Milgram Obedience Experiment
Derren Brown

Stanford Prison Experiment

Human Perception of Time
David Eagelman

Heightened Sensory Perception
Lee

Extra Sensory Perception
Adam Wasdin

As a number of the courses I teach at the university are in regard to critical thinking and communication with a very heavy component on influence, I often have my own students design their own experiments to test social influence principles (such as the "laws of influence" described in Robert Cialdini's book Influence: Science and Practice and more - yes, you can get that book and others related to social influence at the bookstore) as I find that when students are able to demonstrate through personal direct experience they understand the principles so much more powerfully than simply reading about them in a text.

Since I believe in experiential critical thinking, once in awhile, I will ask students to test bogus theories or controversial ones in addition to more accepted rules of social influence or behavior.  On a few occassions I have presented such material in class as if it were true and then asked them to test the theory to encourage original thought and a sense of relying upon empirical data rather than simply accepting uncritically material presented by a so-called authority figure a la Milton Rokeach's model of the mind or Cialdini's so-called law of power (albeit, I do occassionally warn my students that sometimes I lie in class so they need to be careful and watchful of the material).

All the best,
Brian

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Hacking DNA with Drew Endy

800 Year Lifespan? Sign me up!

Not quite as earth-shattering as the comments, but . . . very kool indeed . . . Geneticists Discover a Way to Extend Lifespans to 800 Years . . . the eight hundred years is only if the mutation in humans would be analogous to that in yeast which is still to be seen. Now, are they going to be able to simply repress the expression of the genes or is the genetherapy only good for newborns with in vitro genetic modifications?

Sex . . . it does a body good. . . health reasons to indulge in sensual pleasure

From Newsweek, a number of studies have shown that regular sex has various health benefits . . . I can think of many non-health benefits as well as a few more health benefits not listed in their Health Benefits of Weekly Sex article . . . regular sex (at least once a week, but the more the better) has a number of health benefits, especially for women.  The top six health reasons they give to encourage folks to have regular sex include:

1. It Fights Colds and Flu. Sexual intercourse once or twice a week raises the body's level of the immune-boosting antibody immunoglobin A by a third, according to research at Wilkes University in Pennsylvania.

2. It's a Beauty Treatment. In a study at the Royal Edinburgh Hospital in Scotland, a panel of judges viewed participants through a one-way mirror and guessed their ages. Those who looked seven to 12 years younger than their age (labeled "superyoung") were also enjoying lots of sex—four times a week, on average. OK, maybe they were having so much fun because they looked young. But it's likely the sex was helping, researchers say. One reason is that it raises a woman's estrogen level, which helps make hair shiny and skin supple.

3. It Burns Calories. A little over four calories a minute, or the equivalent of four Hershey's kisses in a half hour of love. Think of it as part of your weekly exercise regime, and burn, baby, burn.

4. Yes, Honey, I Have a Headache. For a woman a migraine might actually be a reason for making love rather than avoiding intercourse: the increase in endorphins and corticosteroids during arousal and orgasm is analgesic.

5. It Promotes Regular Menstrual Cycles. A series of studies by behavioral endocrinologist Winnifred Cutler and colleagues at Columbia and Stanford universities found that women who have intercourse at least weekly (except during their period) cycle more regularly than abstainers or the sporadically active. (Related research found that lesbian lovemaking also smoothes out menstrual cycles.) Cutler argues that intimacy is essential, not orgasms: "Regular exposure to a loving partner has extraordinary effects on health and well-being."

6. It Can Prevent Accidents. Women use the muscles of the pelvic floor to stem the flow of urine. As they age, they need to keep these strong to avoid peeing accidentally. The same muscles are exercised during intercourse, and as with all muscle-building programs, the benefits require consistency.

Of course, a major benefit for regular sex . . . it certainly is an enjoyable experience.  We'll save the social and bonding and other benefits for another post sometime.  In the meantime, go get healthy!

All the best,
Brian

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The Invincible Man

I agree with Woody Allen and so think Aubrey de Grey is worth checking out . . . The Invincible Man . . . Robert Anton Wilson's life corpus has some resonance here, although Wilson did not live to reap the benefits.

Strippers, Menstrual Cycles, and Earning Power

The journal Evolution and Human Behavior is publishing a study that tracked the earning power of strippers and compared that to their menstrual cycles - see Strippers' Earning Potential Affected by Hormone Cycle - where they found that when strippers are in their most fertile period of their menstrual cycle they earn much more than those who are in the least fertile period of their cycle.  Stippers on "the pill" where fertility is flattened out did not experience cycles in earning power.  So . . . when women are most fertile, they tend to behave more sexually open and aggressive which translates into attractiveness and earning potential.  Or, more bluntly . . . women who at the peak of their fertility are sexier (in their behavior and how men perceive them).

All the best,
Brian

Waking Dreams Hypnosis ShowOct. 19 & 20, Live Comedy Club Taipeihttp://www.comedy.com.twSee you in February 2008 . . . mini-US tour :-)HYPNOTICON hypnosis convention, Feb. 1-3, Atlantahttp://www.hypnoticon.orgWALKABOUT TRANCE BEACH RESORT GETAWAY, Feb. 9-10, Los Angeles http://walkabouttrancebeachresortgetaway.blogspot.comSign Up for Hypnosis CoursesEnjoy Great Entertainment! Hypnosis Showshttp://www.BrianDavidPhillips.com for details!. . . and Much Much More!

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