Virtual Reality for Cancer Pain Management

Overseen By Cheryl Kefauver, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Southern California

Must not be taking: Pain medications, Steroids

Disqualifiers: Epilepsy, Dementia, Chronic pain, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

60 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial studies how well virtual reality (VR) works in reducing pain and anxiety in cancer participants undergoing bone marrow biopsy or lumbar puncture. Virtual reality may impact pain and anxiety during and after the procedure.

Will I have to stop taking my current medications?

Yes, if you are on any acute or chronic pain medication, or on chronic steroids over a certain dose, you will need to stop taking them to participate in this trial.

What data supports the effectiveness of this treatment for cancer pain management?

Research shows that virtual reality (VR) can help reduce pain, anxiety, and other symptoms in cancer patients. Studies have found that VR-based treatments can significantly lower pain levels and improve quality of life for those undergoing cancer treatment. ^{1 2 3 4 5}

Is virtual reality safe for managing cancer pain?

Research suggests that virtual reality (VR) is generally safe for managing pain and anxiety in cancer patients. Studies have shown it to be feasible and acceptable, with no significant safety concerns reported in patients using VR for pain relief during medical procedures or for improving living conditions. ^{1 3 6 7 8}

How does virtual reality treatment differ from other treatments for cancer pain management?

Virtual reality (VR) treatment for cancer pain management is unique because it uses immersive digital environments to help reduce pain and anxiety without medication. Unlike traditional pain treatments that often rely on drugs, VR provides a non-drug option that can be tailored to individual needs, offering experiences like virtual underwater environments to distract and relax patients. ^{1 3 4 6 9}

Research Team

Jacek Pinski, MD

Principal Investigator

University of Southern California

Eligibility Criteria

This trial is for cancer patients at USC Norris Comprehensive Cancer Center and Hospital who are undergoing bone marrow biopsy or lumbar puncture. It's not for those with epilepsy, dementia, Parkinson’s disease, certain brain conditions, severe hearing/vision issues, high BMI (>35), recent transplants, or on pain/immunosuppressant drugs.

Inclusion Criteria

I have been diagnosed with cancer.

I am currently in the hospital at USC Norris Comprehensive Cancer Center for cancer treatment.

I am scheduled for a bone marrow biopsy or lumbar puncture.

Exclusion Criteria

I am currently infected with Clostridium difficile.

I have been on steroids or other immune-weakening drugs for more than a week.

I am currently taking pain medication, including opioids, NSAIDs, or steroids.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Procedure

Participants undergo bone marrow biopsy or lumbar puncture with or without VR intervention

1 day

1 visit (in-person)

Follow-up

Participants are monitored for pain and anxiety using the State-Trait Anxiety Inventory and visual analog scale

Up to 1 year

Treatment Details

Interventions

• Oculus Rift Headset

Trial Overview The study tests if using a VR headset (Oculus Rift) during painful procedures like bone marrow biopsies or lumbar punctures can reduce pain and anxiety in cancer patients compared to standard care practices.

Participant Groups

Group I: Arm I: Virtual Reality Experimental Treatment 3 Interventions

Participants receive the VR intervention during bone marrow biopsy or lumbar puncture lasting until completion of the procedure. Participants will be trained to use VR equipment prior to the bone marrow biopsy or lumbar puncture. The headset will cover both eyes with a strap along the back to hold the headset in place. The headset will be attached by a wire to a laptop which will power the headset and provide content. A remote control will be available for assistance in setting up or stopping the content in the case of an event. The VR content will consist of meditation and relaxing techniques through visual and auditory input which can last up to one hour. There will be minimal stimulatory effort to decrease excess movement for the procedure.

Group II: Arm II: No Virtual Reality Active Control 3 Interventions

Participants receive standard of care during bone marrow biopsy or lumbar puncture.

Who Is Running the Clinical Trial?

University of Southern California

Lead Sponsor

Trials

956

Recruited

1,609,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Virtually Strong, LLC

Collaborator

Trials

1

Recruited

60+

Findings from Research

The study demonstrated that a 30-minute virtual reality session in an underwater environment significantly reduced pain by 59% and improved relaxation, tension, stress, anxiety, and mood in 20 patients with advanced colorectal cancer, indicating its potential as a non-pharmacological pain management tool.

All participants completed the VR session without significant side effects, showing high satisfaction (83%), which supports the feasibility and safety of using virtual reality for pain relief in this patient population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality for improving pain and pain-related symptoms in patients with advanced stage colorectal cancer: A pilot trial to test feasibility and acceptability. Kelleher, SA., Fisher, HM., Winger, JG., et al.[2022]

Virtual reality (VR) interventions have been shown to significantly reduce symptoms of anxiety, depression, pain, and fatigue in cancer patients, based on a meta-analysis of 6 studies.

The findings suggest that while VR is effective for managing acute symptoms during cancer treatment, further research is needed to explore its benefits for long-term side effects in cancer survivorship care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meta-Analysis of the Efficacy of Virtual Reality-Based Interventions in Cancer-Related Symptom Management. Zeng, Y., Zhang, JE., Cheng, ASK., et al.[2020]

A systematic review of nine studies on the use of immersive virtual reality (VR) for pain and anxiety management in cancer patients showed a trend towards improvement, but only two studies demonstrated statistically significant results.

The current evidence is inconclusive due to methodological limitations and small sample sizes, highlighting the need for further research to better understand the effectiveness of VR in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Virtual Reality Therapy in Reducing Pain and Anxiety for Cancer-Related Medical Procedures: A Systematic Narrative Review. Chow, H., Hon, J., Chua, W., et al.[2021]

A new virtual reality pain therapy program designed for cancer patients with neuropathic pain was found to be feasible and acceptable, with 39 out of 87 eligible patients participating in the study.

Patients using the virtual reality therapy reported less cybersickness and showed trends towards reduced opioid consumption and pain severity compared to the control group, suggesting potential benefits for pain management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of virtual reality-delivered pain psychology therapy for cancer-related neuropathic pain: a pilot randomised controlled trial. Chuan, A., Hatty, M., Shelley, M., et al.[2023]

A systematic review of 122 randomized controlled trials involving 9,138 patients found that virtual reality (VR) significantly reduces pain, with a standardized mean difference of -0.65, indicating a strong effect across various types of pain, including acute, chronic, and procedural.

The effectiveness of VR in pain management was particularly notable in younger patients and those experiencing moderate to severe pain, suggesting that VR could be a valuable tool for these groups, although the studies showed considerable variability and moderate to high risk of bias.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis. Lier, EJ., de Vries, M., Steggink, EM., et al.[2023]

Virtual reality (VR) technology in medicine allows for repeated practice of medical procedures and offers diverse experiences with virtual organs, enhancing both learning and evaluation of clinical skills.

In clinical oncology, VR can simulate surgeries, aid in cancer diagnosis, improve patient education, and even help manage the psychological stress of cancer patients, showcasing its potential in palliative care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality for palliative medicine. Oyama, H.[2004]

Virtual reality (VR) significantly enhances emotional well-being in women with breast cancer by increasing positive emotions and reducing anxiety during physiotherapy sessions, regardless of the immersion method used.

Participatory VR was found to create a stronger sense of presence compared to contemplative VR, suggesting that the level of patient involvement in the virtual experience can impact emotional outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contemplating or Acting? Which Immersive Modes Should Be Favored in Virtual Reality During Physiotherapy for Breast Cancer Rehabilitation. Buche, H., Michel, A., Piccoli, C., et al.[2022]

In a pilot study involving 30 adolescents with cancer undergoing lumbar punctures, the use of virtual reality (VR) glasses showed a trend towards lower pain scores compared to a control group, although the difference was not statistically significant.

77% of the adolescents using VR reported that it helped distract them from the procedure, suggesting that VR could be a useful nonpharmacologic tool for pain management during painful medical procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer. Sander Wint, S., Eshelman, D., Steele, J., et al.[2022]

In a feasibility study involving 14 veterans, a virtual reality (VR) treatment modeled after mirror therapy significantly reduced phantom limb pain (PLP) intensity, with only 28.6% of participants reporting PLP after treatment compared to 57.1% before.

Participants rated the VR treatment highly in terms of helpfulness, realism, and satisfaction, with no adverse experiences reported, indicating that VR could be a safe and effective option for managing PLP.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Virtual Reality Intervention for the Treatment of Phantom Limb Pain: Development and Feasibility Results. Rutledge, T., Velez, D., Depp, C., et al.[2020]

References

1. England pubmed.ncbi.nlm.nih.gov

Virtual reality for improving pain and pain-related symptoms in patients with advanced stage colorectal cancer: A pilot trial to test feasibility and acceptability. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Meta-Analysis of the Efficacy of Virtual Reality-Based Interventions in Cancer-Related Symptom Management. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Effect of Virtual Reality Therapy in Reducing Pain and Anxiety for Cancer-Related Medical Procedures: A Systematic Narrative Review. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Feasibility of virtual reality-delivered pain psychology therapy for cancer-related neuropathic pain: a pilot randomised controlled trial. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis. [2023]

6. Netherlands pubmed.ncbi.nlm.nih.gov

Virtual reality for palliative medicine. [2004]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Contemplating or Acting? Which Immersive Modes Should Be Favored in Virtual Reality During Physiotherapy for Breast Cancer Rehabilitation. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer. [2022]

9. England pubmed.ncbi.nlm.nih.gov

A Virtual Reality Intervention for the Treatment of Phantom Limb Pain: Development and Feasibility Results. [2020]