VR therapy mitigates pain for hospitalized cancer patients

Virtual reality (VR) provided significantly more pain relief to hospitalized cancer patients than a two-dimensional guided imagery experience, according to a new study.

Published in Cancer, the American Cancer Society (ACS) journal, the study assessed whether VR can alleviate acute and chronic pain among hospitalized cancer patients. According to the latest data from ACS, a little over 2 million new cancer cases are expected to be diagnosed, and 611,720 cancer patients are estimated to die in the United States in 2024. Still, much progress has been made in the cancer treatment arena, with the cancer death rate dropping by 1.6 percent per year between 2012 and 2021.

According to the study, pain is common among cancer patients. About half of cancer patients experience pain early in the disease course, jumping to 75 percent of patients in the advanced stages. The pain can be acute, which is severe and lasts a shorter time than other pain types; chronic, which can be mild to severe and lasts for more than three months; or breakthrough, which can occur when the patient is taking pain medicine regularly.

VR is increasingly being used to support pain management. However, few studies examine whether it can mitigate cancer-related pain specifically. Thus, researchers from MedStar Health Research Institute and Roswell Park Comprehensive Cancer Center conducted a randomized controlled trial (RCT) to compare VR’s efficacy against an active control in mitigating moderate-to-severe cancer-related pain.

They conducted the RCT at MedStar Washington Hospital Center in Washington, D.C., between March 2021 and June 2022. They included 127 adult hospitalized patients with cancer who reported pain in the previous 24 hours with a severity of four or more on a scale of zero to ten, where ten was the “worst possible pain.”

The patients were divided into two groups: one received ten minutes of immersive VR distraction therapy via the Meta Oculus Quest 2, while the other received ten minutes of two-dimensional guided imagery distraction therapy delivered by a handheld tablet.

Of the 127 patients in the analysis, 63 were in the VR arm, and 64 were in the tablet arm. The mean baseline pain burden was 6.6 for the VR group and 6.8 for the tablet group.

The researchers found that both groups reported statistically significant decreases in self-reported pain scores. However, participants in the VR group experienced an average reduction of 1.4 in pain scores from baseline to post-intervention, while those in the tablet arm experienced an average decrease of 0.7.

Additionally, the improvement in follow-up self-reported pain scores was more significant in the VR group than in the tablet group.

The study further showed that more participants in the tablet group rated using the device as easy, whereas more participants in the VR group rated using the device as difficult. Still, a majority of participants in both groups reported willingness to use their respective devices again.

“Although participants were more likely to rate VR as difficult to use compared with [tablet use], this was not a barrier to participants’ willingness to use VR and did not negatively impact satisfaction with overall pain management,” the researchers wrote. “Ease of use will likely improve as commercially available device portability and functionality is refined.”

The use of VR in healthcare is growing, with healthcare provider organizations using it to address pain, anxiety, and social isolation. As a result, federal agencies are taking steps toward reimbursement pathways.

Last year, the Centers for Medicare and Medicaid Services (CMS) established a unique Healthcare Common Procedure Coding System (HCPCS) Level II code for a virtual reality program for the first time. The code categorizes the RelieVRx program, virtual reality therapeutics provider AppliedVR's flagship product, as durable medical equipment (DME). This creates a more definitive pathway for securing Medicare coverage eligibility.