A Whole New World

19 Aug 2021

We spoke to gynaecological oncologist Clinical Associate Professor Selvan Pather about embracing the 3D world and technological advances to assist with anxiety and nausea-related symptoms in ovarian cancer patients.

How is Virtual Reality (VR) being used currently?

Professor Pather: “VR is an emerging technology, which, up to now is seen as a realm for gamers. At the moment VR devices are becoming cheaper and accessible. VR may reduce anxiety in patients undergoing medical procedures, however, little data is available on the role of VR in reducing anxiety in the immediate perioperative setting. We wanted to look at ways to reduce anxiety (in our patients) during various forms of treatment whether it’s pre-cancer and cancer.

“The Gynaecologic Oncologic Department at the Chris O’Brien Lifehouse is currently conducting a Randomised Controlled Trial to assess the impact of VR in patients undergoing colposcopy in an ambulatory clinic.

“At the moment we have a randomised control study group, made up of women who have had abnormal pap smears. It’s a trial with randomising procedures: either standard treatment or treatment alongside the VR. Those in the VR group are visually taken away from the clinic and put into a 3D space. There’s no form of interaction by doctors, they just wear the device and move their head around as directed by the clinician.

“We currently have 80 patients recruited and hope to have data available in the next 4-6 months.

“The data shows that VR has been well accepted.”

How else will VR be used?

Professor Pather: “We have applied to the ethics committee for a VR randomised trial for the use in the anaesthetic room. If you have pre-cancer, suspected or cancer you would normally wait in the anaesthetic bay before treatment. It’s a room with a bright light, and most people lie there thinking about the procedure they’re about to undergo. We hope that using VR will help people relax.

“We’ve applied for permission to assess a waiting patient’s anxiety scores. Logically, their anxiety scores are lower when using the VR device, but we need data before seeing if it works within that environment.” 

How can VR prepare a patient before treatment?

Professor Pather: “We haven’t launched this component yet, but we hope to soon. Let’s say the patient is determined that they need chemotherapy or radiotherapy. They’ve had counselling, but no treatment as yet. It’s understandable that they may be worried or feel anxious.

“We hope to create a point-of-view video. This means we’d strap a 3D camera onto someone and record a 360-degree video to show the patient what they can expect to face when it’s time for their treatment. From their point of view, we'd show from arrival, check-in, where to sit down, canula insertion – everything they need to know to become familiar with the environment. Right down to where to leave their stuff, where to put valuables. We’d show them how to get to the chemotherapy room and what that looks and sounds like. Seeing how machines move around and letting patients hear in real-time what they’ll see, hear and experience will help them get mentally prepared - just by watching a video.

“It’s a useful benefit. We live in a Youtube environment and we now want to predict and know what to expect. When you go anywhere we can look it up before arriving and know what you’ll see and experience.”

Why is VR a good treatment accompaniment?

Professor Pather: “Using VR is beneficial for counselling and helping reduce apprehension for people before their treatment. Chemotherapy and radiotherapy are the most comment types of treatment for ovarian cancers. By using a video recording from the point of view of a patient undergoing these treatments, we can intersperse the journey with some facts and information to make it useful and more interesting and help reduce a patient’s anxiety.

Can VR help reduce treatment side effects?

Professor Pather: “We are looking at how 3D can help prevent nausea. There’s lots of data that shows that VR and 3D videos can if the video is appropriate, reduce the need for medication. We hope to use this for post-operative and post-chemotherapy patients, in adjunct with pharmacotherapy, we hope it will reduce symptoms. It also means we could use fewer drugs to reduce nausea with this natural method.

Will this VR be available to everyone?

Professor Pather: “We aim to have the VR video available in downloadable form. A patient can buy a piece of cardboard, download the video onto the phone and for ten dollars, watch and view what’s going to happen to them. They can watch the video until they feel fully prepared and calm about what to expect.

“We hope that this will give them the strength and hope about their fight and journey ahead. It’s not a dangerous procedure, it’s part of their treatment.

“Even patients who are getting supportive care and lying in the hospital, you can go into a patient’s home and video or 3D-record their favourite room. They can then sit in the hospital and watch a video of their own home so they can feel relaxed, as though they’re at home.”