Virtual Reality for Cancer Pain Management

Overseen By Christian Gonzalezgomez

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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether virtual reality (VR) can reduce pain and anxiety for cancer patients during procedures like bone marrow biopsies or lumbar punctures. Participants will use an Oculus Rift headset with calming VR content to determine if it lessens stress compared to standard care. The trial seeks cancer patients currently undergoing treatment at USC who are scheduled for one of these procedures. As an unphased trial, it offers a unique opportunity for patients to explore innovative methods to manage pain and anxiety.

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 prior data suggests that this virtual reality technique is safe for cancer pain management?

Research has shown that using virtual reality (VR) in medical settings is generally safe. Studies have found that VR can help reduce pain and anxiety during procedures like biopsies. Some trials have demonstrated that patients tolerate VR well, easing discomfort without major side effects.

In one study, 60 adults undergoing a bone marrow biopsy found VR easy to use and enjoyable. No serious negative effects were reported, suggesting that the VR headset is safe for most people.

Overall, VR appears to be a promising tool for relieving pain and anxiety during medical procedures, with minimal risk involved. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using virtual reality (VR) for managing cancer pain because it's a non-invasive and immersive approach that can potentially reduce the need for pain medication during procedures. Unlike standard care, which typically involves medications and physical interventions, VR uses an Oculus Rift headset to transport patients to a calming virtual environment. This technique employs visual and auditory relaxation methods, which may help distract patients from pain and anxiety during procedures like bone marrow biopsies or lumbar punctures. By offering a new form of pain management, VR has the potential to enhance patient comfort and reduce the side effects associated with conventional pain relief methods.

What evidence suggests that virtual reality is effective for reducing pain and anxiety in cancer patients?

Research has shown that virtual reality (VR) can reduce pain during medical procedures. In this trial, one group of participants will receive a VR intervention during procedures such as bone marrow biopsies or lumbar punctures. Studies have found that VR helps cancer patients experience less pain compared to traditional methods. Reviews of multiple studies have confirmed that VR makes a noticeable difference in patient comfort. This suggests that VR could be a useful tool for managing pain and anxiety in cancer treatments. Meanwhile, participants in the other group will receive standard care without VR intervention. ^{1 6 7 8 9}

Who Is on the Research Team?

Jacek Pinski, MD

Principal Investigator

University of Southern California

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10865524/

Efficacy of virtual reality for pain relief in medical procedures Immersive VR technology offers effective pain control across various medical procedures, albeit statistical heterogeneity.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12338295/

Effect of virtual reality on pain in oncology patients Meta-analyses have demonstrated that VR-based interventions significantly reduce pain intensity in cancer patients compared to conventional ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT03568292

Virtual Reality in Reducing Pain and Anxiety in Cancer ... This trial studies how well virtual reality (VR) works in reducing pain and anxiety in cancer participants undergoing bone marrow biopsy or lumbar puncture.

4. withpower.com withpower.com/trial/phase-neoplasms-6-2021-f7b9d?lat=36.65114&lng=-97.3517

Virtual Reality for Cancer Pain Management This trial studies how well virtual reality (VR) works in reducing pain and anxiety in cancer participants undergoing bone marrow biopsy or lumbar puncture.

5. sciencedirect.com sciencedirect.com/science/article/pii/S2451865422000126

Virtual reality for management of cancer pain: Study ... This is a prospective, two-armed, single center randomized controlled study of a virtual reality intervention in 128 hospitalized subjects with cancer.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12380292/

The efficacy of virtual reality in adults during puncture biopsy Some clinical trials have demonstrated the efficacy of VR in mitigating pain and anxiety during puncture biopsy. Korkmaz et al. found that the ...

7. xr.jmir.org xr.jmir.org/2025/1/e65324

The Feasibility and Acceptability of a Stand-Alone Virtual ... Methods: This pilot study enrolled 60 adult participants receiving a bone marrow biopsy to assess the acceptability and feasibility of VR to ...

8. researchgate.net researchgate.net/publication/394974058_The_efficacy_of_virtual_reality_in_adults_during_puncture_biopsy_A_systematic_review_and_meta-analysis_of_randomized_controlled_trials

The efficacy of virtual reality in adults during puncture biopsy VR intervention would be effective in relieving pain and anxiety during puncture biopsy in adults. Methods. Registration. In order to enhance ...

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9607885/

Pain Assessment Using Virtual Reality Facemask During ... Bone marrow aspiration (BMA) is a medical procedure necessary to the diagnosis and monitoring of patients with hematological or nonhematological disorders.