Virtual Reality as a Non-Pharmacologic Intervention for the Management of Pain Among Cancer Patients

Keywords

Pain, cancer, patients, neurofeedback, virtual reality, alternative care

Types of Research

Research methods development/testing; community-based participatory; clinical research; pilot and feasibility testing

Summary

This pilot study will utilize a 3x2 factorial study design to evaluate the impact of differing VRNF dosages and frequencies on patient pain and anxiety during treatment. This study will recruit patients with a cancer diagnosis receiving curative intent therapy at the outpatient infusion clinic within the University of Colorado Cancer Center or Highlands Ranch Hospital.

Significance

The significance of this project is to adapt the usage of VRNF based on patient feedback, EEG signals in response to VRNF, and assessed optimal dosage. Upon doing so, we will explore the accessibility and feasibility of VRNF among outpatient settings. Furthermore, we will gain an understanding of how VRNF affects patients' mood, pain, and anxiety management.

Impact

Through this multi-site clinical trial, we will gain an understanding of how to alter the usage of VRNF in order to best implement it as a concurrent therapy with systemic treatment for cancer patients. We will be able to better understand the optimal implementation of VRNF as a method to manage pain and anxiety, increasing patients’ quality of life. 

Implications for Reducing Health Disparities

People who have been diagnosed with cancer endure intensive treatments such as chemotherapy or immunotherapy which can intensify pain and anxiety,2-4 therefore diminishing their quality of life.6 Psychological distress and pain management from these treatments emphasize the need for intervention.

Virtual Reality and neurofeedback are evidence-based non-pharmacologic approaches but have never been explored as an intervention for managing cancer symptoms during systemic treatment.12-14 The results of this clinical trial would allow insight into the future implementation of this intervention approach. Virtual reality is a way to deliver mindfulness activities, which have been proven to reduce pain and distress among patients who have cancer.3 The integration of this intervention would allow for a therapeutic, innovative approach to pain management.

References

 

  1. Scarborough BM, Smith CB. Optimal pain management for patients with cancer in the modern era. CA: a cancer journal for clinicians. 2018;68(3):182-196. doi:10.3322/caac.21453 
  2. Zaza C, Baine N. Cancer pain and psychosocial factors: a critical review of the literature. J Pain Symptom Manage. Nov 2002;24(5):526-42. doi:10.1016/s0885-3924(02)00497-9 
  3. Rouleau CR, Garland SN, Carlson LE. The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients. Cancer Manag Res. 2015;7:121-31. doi:10.2147/cmar.S64165 
  4. Wiederhold BK, Gao K, Sulea C, Wiederhold MD. Virtual reality as a distraction technique in chronic pain patients. Cyberpsychology, Behavior, and Social Networking. 2014;17(6):346-352. 
  5. Baydoun, M., Gajtani, Z., Patton, M., McLennan, A., Cartwright, S., & Carlson, L. E. (2024). Virtual reality–guided mindfulness for chronic pain in cancer survivors: Protocol for the virtual mind study—a single-group feasibility trial. Frontiers in Pain Research, 5. https://doi.org/10.3389/fpain.2024.1291374 
  6. Keng, S.-L., Smoski, M. J., & Robins, C. J. (2011). Effects of Mindfulness on Psychological Health: A Review of Empirical Studies. Clinical Psychology Review, 31(6), 1041–1056. https://doi.org/10.1016/j.cpr.2011.04.006 
  7. Rolbiecki, A. J., Froeliger, B., Smith, J., Ying, J., Canfield, S., Posley, K., Polniak, M., & Dotson, D. (2024). Virtual reality and neurofeedback as a supportive approach to managing cancer symptoms for patients receiving treatment: A brief report of a feasibility trial. Palliative & Supportive Care, 22(4), 811–817. https://doi.org/10.1017/S1478951524000385 
  8. Rolbiecki, A. J., Craig, K., Megan Polniak, null, Smith, J., Ghosh, P., & Mehr, D. R. (2023). Virtual Reality and Neurofeedback for Management of Cancer Symptoms: A Feasibility Pilot. The American Journal of Hospice & Palliative Care, 40(3), 291–298. https://doi.org/10.1177/10499091221109900 
  9. Richardson LA, Jones GW. A review of the reliability and validity of the Edmonton Symptom Assessment System. Curr Oncol. Jan 2009;16(1):55. doi:10.3747/co.v16i1.261 
  10. Kim HK, Park J, Choi Y, Choe M. Virtual reality sickness questionnaire (VRSQ): Motion sickness measurement index in a virtual reality environment. Applied Ergonomics. 2018/05/01/ 2018;69:66-73. 
  11. Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. May 22 2006;166(10):1092-7. doi:10.1001/archinte.166.10.1092 
  12. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). Nov 2011;63 Suppl 11:S240-52. doi:10.1002/acr.20543 
  13. Korstjens I, Moser A. Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. European Journal of General Practice. 2018/01/01 2018;24(1):120-124. doi:10.1080/13814788.2017.1375092 
  14. Connelly LM. Understanding Research. Trustworthiness in Qualitative Research. Article. MEDSURG Nursing. 2016;25(6):435-436.  
  15. Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. https://doi.org/10.1002/ev.1427. New Directions for Program Evaluation. 1986/06/01 1986;1986(30):73-84. doi:https://doi.org/10.1002/ev.1427 

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