Objective. Virtual reality (VR) has the potential to improve pain and pain-related symptoms.
We examined the feasibility, acceptability, safety, and impact of a 30-min virtual underwater/
sea environment (VR Blue) for reducing pain and pain-related symptoms in advanced colorectal
cancer patients. A qualitative exit interview was conducted to understand preferences,
thoughts, and feelings about the VR session.
Method. Participants (N = 20) had stage IV colorectal cancer and moderate-to-severe pain.
Participants completed a 30-min VR Blue session that visually and aurally immersed them
in virtual ocean scenarios. Feasibility was assessed by accrual (N = 20), protocol adherence
(≥80% completing VR Blue), and completed data (≥80% assessment completion).
Acceptability was determined by patients reporting ≥80% intervention satisfaction. Safety
was determined by ≥80% of patients completing the session without self-reported side effects.
Measures of pain, tension, relaxation, stress, anxiety, and mood were collected before, during,
and after the VR Blue session. A semi-structured qualitative interview was conducted after VR
Blue to assess participants’ VR experiences.
Results. All participants (100%) completed the VR Blue session. There was 100% data collection
at the pre- and post-assessments. Satisfaction with VR Blue was high M= 3.3 (SD = 0.4)
(83%). No significant side effects were reported. Pain decreased by 59% (Pre-M= 3 ; Post-
M= 1 ). Tension decreased by 74% (Pre-M= 30 ; Post-M= 8 ). Relaxation
improved by 38% (Pre-M= 62 ); Post-M= 86 ). Stress decreased by 68% (Pre-M=
24 ; Post-M= 8 ). Anxiety decreased by 65% (Pre-M= 20 ; Post-M= 7 ).
Mood improved by 70% (Pre-M= 13 ; Post-M= 4 ). Qualitative data suggested a positive
response to the VR Blue protocol.
Significance of results. This work supports the feasibility, acceptability, and safety of VR Blue
for advanced colorectal cancer patients. Participants showed significant pre-post improvement
in pain and pain-related symptoms hinting to the potential feasibility of VR interventions in
this population. Larger, randomized trials with a control condition are needed to examine the
efficacy of VR-based interventions for patients with advanced colorectal cancer and pain.