Virtual
Reality Aids Women During Chemotherapy Treatment
Distraction Takes
Focus Off Treatment
Women with breast
cancer have fewer adverse effects from chemotherapy and less
fatigue when using virtual reality as a distraction intervention
during treatments, according to a report in the Oncology
Nursing Forum.
The researchers, from
the Duke University School of Nursing and Case Western Reserve
Comprehensive Cancer Center, described how chemotherapy
patients eased their fatigue and discomfort by solving a mystery,
touring an art gallery, or going deep-sea diving in a virtual
environment as they underwent treatment.
Virtual reality enables
people to immerse themselves in a computer-generated visual
and aural environment by wearing a head-mounted display device.
The researchers believe
that virtual reality makes for an excellent distraction intervention
because it is interactive, engages several senses simultaneously,
and immerses participants in a new world, thereby blocking out
their current and often stressful environment.
Patient
Recounts Chemotherapy Experience
That stressful environment
was almost too much for chemotherapy patient Donna Honeycutt
of Elon, NC. She worried that she would not be able to
complete the entire series of treatments she needed to have
the best chance of beating her breast cancer.
"You're in a room
with many other people receiving chemotherapy," says Honeycutt. "Some
are very sick and you tend to always look at the individual
who's sickest. For me, I felt sicker when I was in this environment." Honeycutt
underwent chemotherapy two years ago and completed a portion
of her treatments using virtual reality.
Dr. Susan Schneider,
director of the oncology program at Duke University School of
Nursing and lead author on the paper, said that helping patients
keep their minds off the stresses of chemotherapy can be both
physically and mentally important to patients.
"I've been a nurse
for more than 20 years, and I've noticed if patients can focus
on something other than their treatments, they have less nausea
and vomiting and they tolerate the treatments better," said
Dr. Schneider. "For some that distraction intervention might
be knitting or reading a book, but our study examined the effectiveness
of virtual reality, specifically in breast cancer patients."
Walking
on a Beach, Deep-sea Diving
Dr. Schneider and
researchers at Case Western Reserve enrolled 20 breast cancer
patients, between the ages of 18 and 55, who were scheduled
to receive chemotherapy.
Participants alternatively
received chemotherapy treatments with the help of virtual reality
and without. While using virtual reality, patients could choose
between a variety of commercially available programs, such as
walking on a beach, touring an art gallery, or deep-sea diving.
"We carefully reviewed
these programs," Dr. Schneider says. "They had to be G-rated
and interactive, but not overstimulating. Fast movements can
cause nausea or dizziness, and scenarios requiring too much
focus on details can be overly demanding for patients receiving
chemotherapy."
The goal of the intervention
was to ease anxiety, fatigue, and symptom distress. Symptom
distress encompasses the discomfort the patients experienced
from receiving chemotherapy.
Such symptoms include
nausea and vomiting, inability to concentrate, and fatigue.
According to the researchers, such distress interferes with
a person's ability to perform activities of daily living and
affects quality of life. Nearly 60 percent of chemotherapy patients
report some form of symptom distress.
After each treatment,
the women were asked to complete surveys about their symptom
distress, anxiety level, and fatigue level. After treatments
using the virtual reality, the participants answered open-ended
surveys about their thoughts and opinions on the technology.
Distress
and Fatigue Lessened
The results showed
that women who used virtual reality during chemotherapy treatments
reported significant decreases in symptom distress and fatigue
immediately following treatments.
Anxiety levels were
not directly impacted by the intervention, found the researchers.
"Our data show a drop
in anxiety levels directly after the treatment, but we attributed
this to the patient's relief about the treatment being over,"
said Dr. Schneider. "However, one added benefit was that the
virtual reality seemed to make patients feel as though time
was moving faster. For example, on average, a chemotherapy treatment
might last 67 minutes, but patients would perceive that it only
lasted 42 minutes."
All the study participants
preferred chemotherapy treatments with virtual reality rather
than using no intervention, and 95 percent of the participants
said they would be willing to use it again.
No participants reported
"cyber sickness," which is dizziness, queasiness, or visual
disturbances resulting from use of virtual reality. No patients
reported headaches due to the eight-ounce headsets or from using
the technology.
Honneycutt, who participated
in a similar trial of Dr. Schneider's at Duke University Medical
Center, said she benefited greatly from using virtual reality.
"I just did not get
sick," she said. "I did not get nauseated. I didn't get violently
ill like most people. And I think it's because you separate
yourself from that initially. The virtual reality helps take
you away from it all."
Dr. Schneider's results
confirm other studies she has conducted in pediatric cancer
patients and women over 55 with breast cancer.
Currently she is conducting
a larger trial of 120 patients to study how the virtual reality
intervention works for patients with colon, lung, and breast
cancer. The goal of the study, open to men and women over the
age of 21, will determine if age, diagnosis, or coping style
influence how well the virtual reality works during chemotherapy
treatments.
Dr. Schneider is encouraged
by the results and said that virtual reality is a cost-effective
intervention that works in a real world setting.
"The headsets and
programs are cost-effective and easy to use for both patients
and providers," she says. "The equipment can be set up in five
minutes and several patients can use a single set of equipment
throughout the day. A clinic can purchase a headset, computer,
and software for about $1,800, and the cost of using virtual
reality for a single treatment is about $5."
Dr. Schneider said
larger studies are needed to further understand for whom virtual
reality works best, how virtual reality compares to other distraction
interventions, and how to achieve lasting reductions in symptom
distress and fatigue for patients after they have left the clinical
setting.
Always consult your
physician for more information.
Online
Resources
(Our Organization
is not responsible for the content of Internet sites.)
American
Cancer Society
American
Society for Clinical Oncology
Centers
for Disease Control and Prevention (CDC)
National
Cancer Institute
National
Institutes of Health (NIH)
National
Institutes of Mental Health
National
Women's Health Information Center
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March 2004
Virtual
Reality Aids Women During Chemotherapy Treatment
Patient
Recounts Chemotherapy Experience
Distress
and Fatigue Lessened
What
Is Chemotherapy?
Experiencing
Chemotherapy
Online
Resources
What
Is Chemotherapy?
Chemotherapy is the
use of anticancer drugs to treat cancerous cells. Chemotherapy
has been used for many years and is one of the most common treatments
for cancer.
In most cases, chemotherapy
works by interfering with the cancer cell's ability to grow
or reproduce.
Different groups of
drugs work in different ways to fight cancer cells. Chemotherapy
may be used alone for some types of cancer or in combination
with other treatments such as radiation or surgery.
Often, a combination
of chemotherapy drugs is used to fight a specific cancer. Certain
chemotherapy drugs may be given in a specific order depending
on the type of cancer being treated.
While chemotherapy
can be quite effective in treating certain cancers, chemotherapy
drugs reach all parts of the body, not just the cancer cells.
Because of this, there
may be many side effects during treatment. Being able to anticipate
these side effects can help you and your caregivers prepare,
and, in some cases prevent these symptoms from occurring.
Chemotherapy can be
given in many different places: at home, a physician's office,
a clinic, a hospital's outpatient department, or as an "inpatient"
in a hospital, states the National Cancer Institute
(NCI).
The choice of where a
woman receives chemotherapy depends on which medications
she is getting, her insurance, and sometimes her
own and her physician's wishes.
Most patients receive
their treatment as an "outpatient" and are not hospitalized.
Sometimes, a patient starting chemotherapy may need to stay
at the hospital for a short time so that the medication's effects
can be watched closely and any needed changes can be made.
Chemotherapy can be
given in several ways:
-
as a pill to swallow
-
as an injection into the
muscle or fat tissue
-
intravenously (directly to
the bloodstream; also called IV)
-
topically (applied to the
skin)
-
directly into a body cavity
Experiencing
Chemotherapy
According to the National
Cancer Institute (NCI), most women receiving chemotherapy
find that they tire easily, but many feel well enough to continue
to lead active lives.
Each woman and
treatment is different, so it is not always possible to tell
exactly how a person will react.
An individual's general
state of health, the type and extent of cancer she has, and
the kind of medications that are given can all affect how someone
feels.
Women may want
to have someone available to drive them to and from treatment
if, for example, they are taking medicine for nausea or
vomiting that could make them tired.
Following treatment,
a woman may feel especially tired from the chemotherapy
as early as one day later and for several days.
It may help for individuals
to schedule treatment when they can take off the day of
and the day after their treatment. If they have young
children, scheduling the treatment with someone at home the
day of and at least the day after treatment is helpful.
Most women can
continue working while receiving chemotherapy.
However, they
may need to change a work schedule for a while if chemotherapy
makes results in fatigue or other side effects.
Women should
talk with their employer about needs and wishes. It
may be possible to agree on a part-time schedule, find
an area for a short nap during the day, or perhaps work at home.
Questions to ask a
physician include:
-
What are the short-term side
effects that may occur?
-
What are the long-term side
effects that may occur?
-
How serious are the side
effects likely to be?
-
How long will the side effects
last?
-
What can I do to relieve
or lessen the side effects?
-
When should I call my
physician or nurse about side effects?
-
What can I do to feel better
emotionally while trying to cope with the side effects?
Always consult your
physician for more information.
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