Virtual reality for outpatient management of cancer pain: a pilot dosing study

Growing evidence supports the analgesic benefit of virtual reality (VR) for cancer-related pain. However, little is known about the effects of repeated use in the outpatient setting on chronic cancer pain severity or the ideal "dose" of VR interventions to mitigate cancer pain.

Single arm unblinded pilot dosing study. Participants were taught how to use and given a Meta Quest 2 VR headset with hand controllers, instructed to use daily × 10 min for 1 week, then twice-daily × 10 min for 1 week, then "as needed" (per participant choice) daily for 1 week. Outcomes were self-reported pain score (SRPS), PROMIS Pain Interference Short Form score, and satisfaction with overall pain management. The study recruited adults living with any solid cancer who reported baseline cancer-related pain ≥ 4/10 from a large urban cancer center in Washington, DC.

Thirty-three participants (mean age 55 years (SD = 11); 73% women; 91% African American) were included in the analysis. Linear mixed-effects models demonstrated significant time trends across the 3-week study period for improved SRPS (p = 0.04), pain interference scores (p = 0.001), and satisfaction with overall pain management (p < 0.001). Among participants who had been prescribed as needed opioids to manage their cancer pain, no change was observed in self-reported use of breakthrough opioids (p = 0.49).

In this pilot, daily use of VR-delivered distraction therapy improved chronic cancer pain compared to baseline. Twice-daily VR dosing may have helped more than once-daily dosing. Future, larger studies should seek to verify optimal dosing of nonpharmacological VR intervention for cancer pain.

NCT05442866 (June 28, 2022).