Tuning in may be what’s needed to tune out discomfort for men undergoing a prostate biopsy. A team of Duke Cancer Institute researchers found that noise-cancelling headphones playing a classical melody may reduce the pain and anxiety of the procedure, according to a study published in the January issue of Urology.
An estimated 700,000 U.S. men undergo a prostate biopsy each year, and the addition of headphones could be a simple and inexpensive way to help patients through the uncomfortable procedure.
Matvey Tsivian, MD, a Duke University urologic oncology fellow, and colleagues wrote in the study background information that musical distractions activate the cingulo-frontal cortex and have been proven to be an effective tool in mitigating perceived pain.
"It's a matter of shifting attention, so the music provides a distraction from the procedure," wrote Tsivian.
Eighty-eight patients were enrolled and randomly assigned to three groups. The first had no headphones; the second wore the noise-cancelling headphones, but heard no music; and the third listened to Bach concertos on the headphones.
The men underwent a trans-rectal biopsy, which involves the use of a spring-loaded needle that has a loud trigger. Twenty percent of men experience high stress and anxiety about the procedure, according to the authors.
In the groups without music, diastolic blood pressure, which was measured to indicate physiological response, remained elevated after the procedure, compared to before. However, the men who wore the headphones and listened to Bach had no such spike in blood pressure indicating less anxiety.
Study participants who had the music also reported less pain, as measured by questionnaires. The authors explained that acute emotional anxiety activates the sympathetic nervous system, which in turn stimulates the release of specific neurotransmitters and heightens sensitivity.
“Thus anxiety increases pain perception through physiological mechanisms, mainly by activation of an adrenergic response,” wrote the authors.
Limitations of the study included a small sample size and the fact that it was not blinded, which could have led to response bias. The researchers also said they did not determine whether the choice of music might have had an impact.
"We couldn't study all the permutations and variables, but it's evident that this kind of approach works," wrote Thomas Polascik, MD, director of Urologic Oncology at the Duke Cancer Institute, in a statement. "This is something that could be broadly employed. It's easy and inexpensive–a set of headphones and music. That's it."