Background: Chemotherapy is an essential component of breast cancer (BC) treatment, yet side effects are common and may worsen over time due to its toxicity and anticipatory anxiety. Virtual reality (VR), an increasingly affordable technology already used in healthcare, has gained interest in oncology. Its distractive mechanism may serve as supportive therapy to reduce chemotherapy-related discomfort, including pain and anxiety; however, its integration into outpatient chemotherapy units—characterised by high patient turnover and limited availability of nurses—remains understudied.
Objectives: We examined the feasibility, acceptability among patients and nurses, and tolerability of providing a VR-based experience to breast cancer (BC) patients undergoing chemotherapy.
Methods: VRtuose (Virtual RealiTy and mUsic in the Oncology Setting) (ClinicalTrial.gov: NCT06305117) was a non-randomised single-centre feasibility study conducted in the outpatient chemotherapy unit of the Centre Léon Bérard, a comprehensive cancer centre in Lyon, France. Eligible participants were adult women (≥18 years) with BC of any stage, without brain metastases or contraindications to VR, scheduled to receive at least four remaining chemotherapy cycles. All participants were offered one VR session at each of four consecutive chemotherapy visits. Women accepted or declined and selected the video content. Trained oncology nurses, responsible for chemotherapy administration, managed all VR-related procedures. The primary outcome was within-woman VR uptake across visits. Acceptability among women and nurses was repeatedly assessed using self-reported feedback questionnaires. Tolerability was evaluated after each session using the Simulator Sickness Questionnaire (SSQ).
Results: A total of 60 women (median age: 51 years, IQR: 44, 62) were recruited between November 2024 and July 2025; 38% had prior VR experience, and equal proportions received neoadjuvant or adjuvant chemotherapy (43% each) while 8 women (13%) who had metastatic disease received palliative chemotherapy. Median study participation was 28 days (IQR: 21, 63). Overall, 217 VR sessions were offered, of which 167 (77%) were accepted and received. Most women (63%) accepted at least three of the four sessions, and 42% accepted all sessions; women with low uptake (i.e., <50%) (20%) had a lower prevalence of prior VR experience than those with higher uptake (17% vs 44%). During sessions, women predominantly viewed international travel videos (49%) for a median of 10 minutes (10,15). Nurses considered VR safe during chemotherapy visits (no risk: 86%, uncertain: 14%).VR was well tolerated, with a low median total SSQ score (1 (1, 4)) also observed across all domains (nausea and disorientation: 0; oculomotor disturbance: 2). Women’s satisfaction with VR sessions was high (median: 8/10; IQR: 7, 10), and 91% were willing to repeat the experience. Among nurses, median willingness to implement VR routinely was 5/10 (3, 6), due to the impact on workload (7/10 (6, 8)); setup accounted for approximately half of the total implementation time (median durations: 7 (4, 9) and 15 (10, 20) minutes, respectively).
Conclusions/Implications for practice or policy: VR-based distraction is acceptable and safe for BC patients, and feasible in chemotherapy settings, provided implementation minimises nurses’ involvement. Further clinical trials are needed to assess its effects on patients' well-being during chemotherapy and its cost-effectiveness.
Objectives: We examined the feasibility, acceptability among patients and nurses, and tolerability of providing a VR-based experience to breast cancer (BC) patients undergoing chemotherapy.
Methods: VRtuose (Virtual RealiTy and mUsic in the Oncology Setting) (ClinicalTrial.gov: NCT06305117) was a non-randomised single-centre feasibility study conducted in the outpatient chemotherapy unit of the Centre Léon Bérard, a comprehensive cancer centre in Lyon, France. Eligible participants were adult women (≥18 years) with BC of any stage, without brain metastases or contraindications to VR, scheduled to receive at least four remaining chemotherapy cycles. All participants were offered one VR session at each of four consecutive chemotherapy visits. Women accepted or declined and selected the video content. Trained oncology nurses, responsible for chemotherapy administration, managed all VR-related procedures. The primary outcome was within-woman VR uptake across visits. Acceptability among women and nurses was repeatedly assessed using self-reported feedback questionnaires. Tolerability was evaluated after each session using the Simulator Sickness Questionnaire (SSQ).
Results: A total of 60 women (median age: 51 years, IQR: 44, 62) were recruited between November 2024 and July 2025; 38% had prior VR experience, and equal proportions received neoadjuvant or adjuvant chemotherapy (43% each) while 8 women (13%) who had metastatic disease received palliative chemotherapy. Median study participation was 28 days (IQR: 21, 63). Overall, 217 VR sessions were offered, of which 167 (77%) were accepted and received. Most women (63%) accepted at least three of the four sessions, and 42% accepted all sessions; women with low uptake (i.e., <50%) (20%) had a lower prevalence of prior VR experience than those with higher uptake (17% vs 44%). During sessions, women predominantly viewed international travel videos (49%) for a median of 10 minutes (10,15). Nurses considered VR safe during chemotherapy visits (no risk: 86%, uncertain: 14%).VR was well tolerated, with a low median total SSQ score (1 (1, 4)) also observed across all domains (nausea and disorientation: 0; oculomotor disturbance: 2). Women’s satisfaction with VR sessions was high (median: 8/10; IQR: 7, 10), and 91% were willing to repeat the experience. Among nurses, median willingness to implement VR routinely was 5/10 (3, 6), due to the impact on workload (7/10 (6, 8)); setup accounted for approximately half of the total implementation time (median durations: 7 (4, 9) and 15 (10, 20) minutes, respectively).
Conclusions/Implications for practice or policy: VR-based distraction is acceptable and safe for BC patients, and feasible in chemotherapy settings, provided implementation minimises nurses’ involvement. Further clinical trials are needed to assess its effects on patients' well-being during chemotherapy and its cost-effectiveness.
Intervention setup