Posts Tagged ‘breast cancer’

Hypnotherapy Can Aid Some With Surgery

December 12, 2019

The title of this post is identical to the title of an article by Debra Bruno in the Health & Science Section to the 12 November 2019 issue of the Washington Post. Some U.S. hospitals are offering hypnosis to patients to lessen preoperative anxiety, to manage postoperative pain, and even to substitute for general anesthesia for partial mastectomies in breast cancer. The article notes that hypnosis has been used of years to help people quit smoking, lose weight, get to sleep, and control stress.

Staff anesthesiologist Elizabeth Rebello of Houston MD Anderson Cancer Center uses hypnotherapy for segmental (partial) mastectomies and sentinel node biopsies, in which doctors identify and remove a lymph node in the underarm area as well as cancerous tumors in the breast.

Although there have been no published results yet of the hospital’s ongoing randomized control study comparing surgical patients who get either general anesthesia or hypnosis with local anesthesia, the feedback from the 60 hypnotized patients in the study has been positive. Before the surgery, patients have a 15 to 20 minute practice session with a hypnotherapist. During the breast surgery itself, the patients are awake and EEG monitoring of brain electric impulses show many patients responding to the hypnotherapy as if they were under sedation. When asked if whether they would undergo hypnotherapy again, the overwhelming response is “yes.”

The definition for hypnotherapy is “focused attention that allows a patient to enhance control over mind and body.” It can work for minor surgeries. It also could be an option for older patients who are more susceptible to delirium after general anesthesia.

Patients need to be able to expect that their pain can be controlled by a combination of local anesthesia and hypnosis. Anesthesiologists don’t want to compromise the procedure because the patient is suffering and in pain.

It is not surprising that hypnotherapy works with pain management. Pain perception, because it originates in the brain, can be different for every person. Hypnotherapy can alter how much pain a person feels. Stanford medical school offers patients classes in self-hypnosis to deal with a variety of medical issues, including pain, stress-related neurological problems, phobias, and side effects from medical treatments, such as nausea, vomiting, and cancer.

Dr. Elizabeth Rebello, an associate professor in anesthesiology at MD Anderson Cancer Center in Houston, notes that using hypnotherapy in place of sedating and pain medications in some breast cancer surgeries has resulted in less reliance on opioids for relief during and after the procedure. She says, “Hypnosedation will not completely replace general anesthesia, but in some cases when the standard of care is general anesthesia, hypnosedation might be a better plan. If this is the case we owe it to our patients to explore this option.”

Screening Performance

July 16, 2019

This post is based on a book by Stefan Van Der Stigchel titled “How Attention Works: Finding Your Way in a World Full of Distraction.” Radiologists have a difficult task when screening for breast cancer. Studies in the Netherlands have shown that the initial screening procedure has a detection probability of about 70%. So radiologists fail to detect incidences of cancer in over one quarter of all women who do in fact have breast cancer. These radiologists are not incompetent; they have a very difficult cancer to detect.

There is also the problem of falsely detecting a cancerous tumor. Additional examinations are very painful, and reacting to every minimal sign would lead to a lot of unnecessary discomfort. The chances of detecting a tumor on the basis of a minimal sign are known to be very low. But when scans in which a tumor was missed are checked again, the tumor usually turns out to be visible. The radiologist now knows that the scan does in fact contain a tumor and there is a maximum probability of actually finding it.

Scans are also done at airports for checking hand luggage. Security scanner operators spend hours every day searching the contents of bags and suitcases. Of course, the education and training of these airport security scanners is much less than that of radiologists. And the chance of finding dangerous content in these bags is much lower than the chance of correctly detecting dangerous objects in luggage. So fake explosives are placed in luggage for purposes of training and assessment. There are reports that operators fail to spot up to 75% of the fake explosives that are hidden in bags for test purposes.

An Americans study in to the performance of airport security personnel revealed that having to scrutinize scans on a daily basis helps them to be more precise when carrying out other unrelated search work. Out of a group of test subjects who were asked to find a well-hidden object on a computer screen, 82% were successful. A group of professional security scanner operators scored 88% for the same test although they did take longer to complete the task compared to nonprofessionals.

If you would like to check your prowess as a security scanner operator you can down load Airport Scanner, a free app (airportscannergame.com) that allows people to play
the task of finding dangerous items in luggage scans. This app has been a huge success worldwide and has millions of users. This app is partly funded by the American government, which is pleased with the amazing amount of information they are able to glean from the game. Researchers are also involved in the development of the game, and the first scientific articles were recently published containing the data retrieved from one billion searches. Some players have become so addicted that they have already competed thousands of searches. And this has provided developers with the opportunity to insert certain objects, only at sporadic intervals (in less than 0.15% of the searches). Dr. Van Der Stigchel notes that this research could not be done in a laboratory because the research subjects would end up running screaming from the lab after being subjected to hours and hours of tests. Based on a probability of 0.1%, an object will appear once every 1,000 searches, and in order to reach any firm conclusions about a player’s performance when attempting to find an extremely are object, 20,000 searches would need to be conducted. These data are now available thanks to the Airport Scanner app, and it has proven beyond doubt that players/professionals frequently fail to spot these rare, hidden objects.