Digital Intervention for Symptom Management in Cancer and Opioid Sparing Using Virtual Reality (DISCOVR) Study

Patients living with cancer commonly experience chronic pain, defined as pain lasting at least three months. While cancer pain management has traditionally focused on pharmacologic therapies, particularly opioids, pain experts, clinical guidelines, and patients living with cancer increasingly support the use of non-pharmacologic therapies (including mind-body modalities such as distraction, mindfulness, and cognitive behavioral therapy) to mitigate pain and potentially reduce pain medication needs. Virtual reality (VR), a rapidly evolving technology that immerses the user in pleasant, virtual environments, has been shown to lower different forms of acute and chronic pain syndromes, but has not been developed specifically to improve chronic cancer pain. The long-term goal of the investigators is to develop and disseminate a patient-centered, patient-driven VR intervention that significantly improves the chronic cancer pain experience. Towards this end, they propose a multi-phase project involving active patient stakeholder input and an iterative design process that will achieve the following Specific Aims: Aim 1 - to identify patient perceptions around chronic cancer pain experiences and management strategies; Aim 2 - to develop a highly feasible, acceptable, usable, safe VR prototype enabling patient-directed management of cancer pain; Aim 3 - to conduct a trial to assess prototype feasibility, acceptability, usability, and safety. Completion of this project will lead towards development of a scalable VR intervention to mitigate pain that has potential to dramatically improve quality of life and clinical outcomes in patients living with chronic cancer pain.

Inclusion criteria

• age ≥18 years old
• living with active cancer diagnosis (any solid tumor type)
• report chronic cancer pain (≥3 months) with baseline severity moderate-severe (i.e., self-report pain score (SRPS) ≥4/10, where 0=no pain, 10=worst pain)
• prescribed chronic opioid therapies (may be long-acting formulations, short-acting formulations, or both)

Exclusion criteria

• history of intractable nausea/vomiting, motion sickness, seizures/epilepsy, and/or cranial structure abnormalities preventing VR headset use
• moderate-severe pain of non-cancer etiology (e.g., chronic lumbago)
• enrolled in another pain study
• unable to complete surveys in English or Spanish.