Home-based virtual reality for pain and psychological distress in young adults with cancer: feasibility, acceptability, and preliminary efficacy from a pilot proof-of-concept study
Young adults represent a distinct oncologic population in which pain management poses unique challenges. Although opioid therapy remains central to cancer pain relief, this group is particularly vulnerable to misuse. Virtual reality (VR) offers a non-pharmacological, immersive approach that may alleviate symptoms. This single-arm pilot proof-of-concept (POC) evaluated the feasibility, acceptability, and preliminary effects of a short-term, home-based VR program among seven young adults (aged 25–40 years) with chronic cancer-related pain on opioid drug regimens. The participants used a standalone VR headset running the VRReliever application for 48 h. Assessments at baseline, 24 h, and 48 h included the Numeric Rating Scale for pain (NRS), the Hospital Anxiety and Depression Scale (HADS), and the Sheehan Disability Scale (SDS). Opioid use was documented qualitatively. Feasibility outcomes included recruitment, retention, and usage; acceptability was rated on a 0–10 scale. Analyses emphasized estimation, reporting Cohen’s dz with 95% confidence intervals for baseline-to-48-h changes. Recruitment was 70% with full retention. Median satisfaction was 5/10 at both follow-ups; median per-session VR durations were 20 min (24 h) and 15 min (48 h), with one participant contributing an 80-min outlier at 48 h. Small-to-large, mostly non-significant improvements were observed in pain ( dz = −0.29), anxiety ( dz = −0.71), and depression ( dz = −0.12). Functional outcomes showed consistent gains, including a large improvement in SDS total scores ( dz = −0.81), with the most prominent and statistically significant changes observed in social functioning ( dz = −1.57, p < 0.01) and a reduction in inefficient workdays ( dz = −2.27, p = 0.006). This pilot suggests that home-based VR interventions for young adults with cancer are feasible and acceptable, and produced preliminary signals of benefit in pain, function, and mood. Causal inferences cannot be drawn from this single-arm design; larger, randomized controlled trials are needed to evaluate efficacy and to explore VR’s potential to reduce opioid reliance.