Study Incorporates Patient Experience to Design Virtual Reality Tool for Cancer Pain Management.

Our new research study, funded by the National Cancer Institute and in collaboration with Duke Health, explores a patient-centered approach to developing a virtual reality tool for cancer pain management.

Living with chronic cancer pain can be debilitating, impacting a person’s emotional health, daily activities, and quality of life. But the last thing some patients want is to take more medication to manage the discomfort.

Our new research explores a drug-free option to help relieve chronic cancer pain. The Cognitive Behavioral Theory-Assisted Virtual Reality for Chronic Cancer Pain (VR-CAN) study builds on prior research demonstrating that using a VR headset to immerse patients in a calm, natural virtual environment can help alleviate pain associated with cancer.

The VR-CAN study will collect firsthand patient experiences and preferences, building upon past learnings to guide the design of a VR software that maximizes pain management benefits. 

Designing a patient-centered pain intervention.

An estimated 20-50% of U.S. cancer survivors live with cancer-related pain. Chronic cancer-related pain lasts more than three months and is directly caused by cancer or treatments such as surgery, radiation therapy, or chemotherapy. 

To advance our understanding of how VR can alleviate chronic cancer-related pain, we’re conducting focus groups and interviews with patients to gather their experiences and explore how we can tailor a VR tool to benefit them.

We’ll use that information to develop a VR software program tailored to our participants’ preferences. Then, we’ll conduct a small, randomized controlled trial to determine if our prototype is usable. Patients who participate will be in one of two groups:

• One group will use the immersive VR-CAN program at home for at least 10 minutes per day for two weeks. 

• One group uses a tablet-based version at home for at least 10 minutes per day for two weeks.

Both groups will be asked to complete two surveys—before and after using VR-CAN—and will receive compensation.

Participants must be over age 18, have a diagnosis of any stage I-IV solid tumor cancer, be receiving cancer treatment, and have cancer-related pain for at least the last three months. To learn more, contact me or our Clinical Research Coordinator, Santiago Bedoya Moreno, at 202-877-7659.

Related reading: Research Proves Massage Therapy Improves Quality of Life for Seriously Ill Patients.

Beyond distraction: How VR helps with pain.

Traditional management of chronic cancer pain includes medications, including opioid and non-opioid pain relievers, as well as non-drug cancer rehabilitation options like physical therapy, massage, and relaxation techniques. 

VR gives patients a new option. In 2021, the Food and Drug Administration approved a prescription device that delivers cognitive-behavioral therapy via a VR platform for patients with chronic lower back pain. Working with patients, we’re developing a similar solution to manage chronic cancer pain.

Pain is more than just a signal sent to the brain. It’s a complex experience that also engages our emotions, memories, and attention. By providing an experience that is both engaging and immersive, VR utilizes a significant portion of the brain’s processing power that might otherwise be dedicated to pain. 

VR is great at distraction, and it’s also a new way to help us deliver proven therapies. When you’re handling chronic pain, it can be hard to talk with a therapist or meditate. 

Putting on the VR glasses can help patients engage with pain management techniques such as:

• Cognitive behavioral therapy: CBT is a psychological treatment designed to help individuals change their thinking and behavior. Multiple clinical trials have shown that CBT can help improve pain and related challenges among patients with chronic pain. 

• Mindfulness and meditation: Calming, natural settings in VR can help patients regulate their breathing and stay present in their surroundings. Research has shown this can reduce pain intensity and shift brain activity away from pain networks.

• Guided imagery: In the VR setting, patients can truly visualize themselves in a calm environment, which helps refocus the mind and improve their ability to relax.

Our prior studies on VR and chronic pain have produced some fascinating results that we’re working to understand as we continue our research. Not only did VR provide pain relief while patients were wearing the headset, but this benefit also lingered for hours and sometimes even days after the experience ended. This suggests that, unlike medications that wear off after a few hours, VR may help alter the brain pathways that lead to chronic pain.

Related reading: Two Studies Show Promise of Virtual Reality for Palliative Care.

A next step for new pain management options.

The VR-CAN study is a critical step that prioritizes meeting patient needs by creating a customized therapy based on their feedback. Next, we’ll look to expand our research. If our VR software is useful, we’ll design a larger study at multiple sites. This randomized control trial will be designed to explore whether our VR platform is effective at managing chronic cancer pain.

In my lab, and in the lab of my co-Principal Investigator, Sarah Kelleher, PhD, at Duke Health, we’ve been studying the promise of virtual reality for years. That’s because we’re working to expand the options for treating serious illnesses beyond the traditional. 

Medication therapies like opioids are very effective for some people, but they can have drawbacks, including potential addiction. By expanding access to methods like CBT and VR, we can offer patients a full suite of drug and non-drug options to manage pain.