A Novel Palliative Care Approach Using Virtual Reality for Improving Various Symptoms of Terminal Cancer Patients: A Preliminary Prospective, Multicenter Study.

Background: Some terminal cancer patients wish to "go to a memorable place" or "return home." However, owing to various symptom burdens and physical dysfunction, these wishes are difficult for them to realize. Objective: The aim of the study is to verify whether simulated travel using virtual reality (VR travel) is efficacious in improving symptoms in terminal cancer patients. Design: This is a prospective, multicenter, single-arm study. Setting/Subjects: Twenty participants with terminal cancer were recruited from two palliative care wards; data were collected from November 2017 to April 2018. Measurements: The VR software Google Earth VR® was used. The primary endpoint was the change in the Edmonton Symptom Assessment System scores for each symptom before and after VR travel. Results: The average age of the participants was 72.3 (standard deviation [SD] = 11.9) years. Significant improvements were observed for pain (2.35, SD = 2.25 vs. 1.15, SD = 2.03, p  = 0.005), tiredness (2.90, SD = 2.71 vs. 1.35, SD = 1.90, p  = 0.004), drowsiness (2.70, SD = 2.87 vs. 1.35, SD = 2.30, p  = 0.012), shortness of breath (1.74, SD = 2.73 vs. 0.35, SD = 0.99, p  = 0.022), depression (2.45, SD = 2.63 vs. 0.40, SD = 0.82, p  = 0.001), anxiety (2.60, SD = 2.64 vs. 0.80, SD = 1.51, p  < 0.001), and well-being (4.50, SD = 2.78 vs. 2.20, SD = 1.99, p  < 0.001; pre- vs. post-VR travel score, respectively). No participants complained of serious side effects. Conclusions: This preliminary study suggests that VR travel can be efficacious and safe for terminal cancer patients for improving symptom burden.