Feasibility and Acceptability of Virtual Reality to Mitigate Cancer Restaging Scan-Associated Anxiety

Outcomes 1. Describe the burden of distress and anxiety that cancer patients often experience associated with their cancer restaging imaging. 2. Articulate how virtual reality headset use may represent a feasible and well-tolerated treatment modality for cancer scan-associated anxiety and how additional study is warranted. Key Message Anxiety linked to cancer-related imaging, commonly termed "scanxiety," is highly prevalent among cancer patients/survivors. Scant research has been performed regarding treatment of this phenomenon. Virtual reality is a non-pharmacological treatment modality with evidence for durable symptom relief. This study suggests that home use of VR-administered meditation is both feasible and acceptable to patients, encouraging further research to establish treatment efficacy. Introduction/Context Cancer scan-associated anxiety, or 'scanxiety', affects up to 83% of cancer survivors, significantly impacting quality of life, sometimes even leading to delayed or deferred cancer care. (1) To date, nonpharmacologic interventions to mitigate scanxiety have shown mixed results. (2-3) Virtual reality (VR) has been shown to effectively lower acute and chronic anxiety among different patient populations, but has not yet been tested in this setting. (4) We sought to perform feasibility and acceptability testing of a VR-delivered intervention towards scanxiety. Methods Unblinded single-arm intervention trial with qualitative exploration of patients undergoing cancer re-staging scans. After consent and completion of baseline measures, patients were educated on VR system/software and completed a 10-minute VR meditation session. Participants were then directed to repeat the VR session daily until their follow-up oncologist appointment, when final measures and a semi-structured interview were completed. Results 10 participants (5M/5F, 100% Black, age range 21-72) with various solid tumor types (90% with metastatic disease) completed the intervention and study measures. Regarding feasibility, 8 of 10 participants used VR as directed at least 50% of the days at home. Regarding acceptability, 70% agreed/strongly agreed that VR use for scanxiety was appealing and easy to use, with 90% noting that they would use it again if offered. 80% of participants would recommend this intervention to others. State Trait Anxiety Inventory-5 scores improved from a baseline average of 7.3 to 5.6 immediately post-intervention, with an average score of 5.9 at appointment follow-up. Qualitative data themes included enjoyment of immersive experience in VR, ease of technology use, and suggestions for VR applications at other points of cancer care. Conclusion VR therapy for mitigation of scanxiety appears feasible and acceptable among adults with cancer. Future studies should evaluate efficacy. Keywords Managing Suffering and Distress / Innovative Technologies