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WEDNESDAY, June 30 (HealthDayNews) -- Outpatient chemotherapy rooms at most cancer centers look the same: rows of beds with a dozen or more patients in various stages of disease, hooked up to IV drug feeds.

"You look around the room and you see very sick patients, and you worry -- 'Will this be me in two months?' or 'Will that patient be here next week, will they be alive?'" said Susan M. Schneider, director of the graduate oncology nursing program at Duke University Medical School.

"All these anxious feelings and concerns during the infusion can make you more anxious, and you know that symptoms -- things like nausea, lack of concentration fatigue --- are all related to being worried," she said.

But for patient volunteers in three recent Duke studies led by Schneider, regular chemo sessions suddenly became a lot less grim.

Looking for ways to ease their chemo symptoms, Schneider's team of researchers had breast cancer patients undergo chemotherapy as usual, but allowed them to wear special virtual reality headsets that sent them into a computerized world of play. In these richly detailed virtual worlds, patients could solve mysteries, visit an art gallery, or even go deep-sea diving -- all while receiving their chemo infusion.

And in each study, "we've found that using virtual reality during chemotherapy helps relieve some of the symptoms that patients experience" in the hours and days after therapy, Schneider said.

In fact, "I had one patient say after she was finished, 'That was fun! I was kind of frustrated when the chemotherapy ended because I didn't get to finish the game.'"

Cancer patients aren't the only ones benefiting from virtual reality.

"Some burn patients responded amazingly strongly to virtual reality, even with really severe burns," said Hunter Hoffmann, director of the Virtual Reality Analgesia Research Center at the University of Washington in Seattle.

The pain felt by burn victims is so intense that even the most gentle of hospital procedures -- actions such as delicately cleaning wounds or replacing bandages -- can be excruciating. But according to Hoffman, many burn patients in his study reported a 40 percent to 50 percent drop in perceived pain if given virtual reality headsets.

Trying to get a better understanding of the mind-body connections underlying this phenomenon, Hoffmann's team clipped a heat-emitting device to the feet of eight healthy volunteers, enough to cause them mild discomfort. Half of the volunteers wore headsets that let them enter "SnowWorld" -- a realistic, fantasy game environment where the goal was to lob snowballs at Arctic characters such as snowmen, igloos and penguins. The other study participants had no such distraction.

Watching their brain activity on high-tech magnetic resonance imaging (MRI), Hoffmann said he saw "dramatic reductions in pain-related brain activity when the people were in virtual reality." While pain centers in the brains of individuals without the virtual reality lit up whenever foot pain was induced, volunteers diverted by "SnowWorld" showed much less activity.

"They also gave us strong [positive] ratings of going inside the computer-generated environment," Hoffmann said. The study, published in the June issue of NeuroReport, was funded by grants from the National Institutes of Health and Paul Allen, co-founder of Microsoft Inc.

While the exact mechanisms by which virtual reality reduces pain remain unclear, "it's very likely to involve attentional distraction," Hoffmann said.

"People have a limited amount of information that can be processed, and the perceptual system seems to be able to focus the spotlight of attention only at specific things," he said. "We draw the spotlight of attention into this virtual world, instead, leaving less attention available to process incoming pain signals."

Schneider, who is familiar with Hoffmann's work, agreed with his theory, adding that virtual reality may also help cancer patients by removing some of the dread from chemotherapy.

"If you're really anxious and worried about something, you can feel stressed out for a couple of days. But if you get through the chemotherapy experience and it's actually more pleasant, then we break that cycle of anxiety and your symptoms are less likely to be magnified," she said. "It's like giving people a mental vacation from the stress."

It wouldn't cost much to provide patients with these mini-vacations, either, she added. Schneider's team estimates the cost to hospitals of adding virtual reality to chemotherapy would total only about $5 per session.

Computerized worlds are helping in other fields of medicine, as well. Virtual reality is already standard therapy for helping individuals conquer phobias such as fear of flying or of spiders, allowing them to confront their fears in a safe, controlled manner.

"There's huge room for improving the virtual world," Hoffmann said. "We're just getting started."

More information

There's more on Hoffmann's virtual reality research at the University of Washington.

(SOURCES: Susan M. Schneider, Ph.D., director, Graduate Oncology Nursing Program, Duke University Medical School, Durham, N.C.; Hunter Hoffmann, Ph.D., director, Virtual Reality Analgesia Research Center, Human Interface Technology Lab, University of Washington, Seattle; January 2004 Oncology Nursing Forum; June 2004 NeuroReport)

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