Memorial Sloan Kettering Cancer Center's Anesthesia Pain Service (APS), working with an APP/RN-led multidisciplinary team, implemented virtual reality as a distraction therapy to reduce pain and anxiety in both adult and pediatric oncology patients. After a literature review, stakeholder buy-in, cost analysis, device procurement, and creation of a nursing policy, infection-control guidelines, patient/nursing education materials, exclusion criteria and a workflow, VR was integrated into MSK's Adult Anesthesia Pain Service and Pediatric Ambulatory Care Center.
The program was illustrated in a case presented at JADPRO Live 2025 (abstract JL1301C, Preti K, Ferraro L, Donoghue P): a 43-year-old woman with ER+/HER2- invasive left breast carcinoma and a history of generalized anxiety disorder, depression, claustrophobia, and panic attacks had aborted a radiation therapy CT simulation and a prior MRI due to panic attacks despite pre-medication. Her oncologist noted that if she could not tolerate CT simulation and radiation therapy, she would require a mastectomy instead. An APS-led interdisciplinary team (anesthesia pain service, radiation oncology, psychiatry) developed a multimodal plan: a head-mounted VR device with handheld touch controllers, running a 360-degree calming nature video with ambient music, combined with quetiapine (25mg night before, 50mg one hour before) and lorazepam (2mg 15 minutes before). The patient completed CT simulation successfully, reported no benefit from medication alone, and said she would use VR again. The plan avoided delay in her oncologic treatment and avoided a mastectomy not aligned with her or her provider's goals.
MSK's own patient-education materials (mskcc.org) independently document VR as a standing clinical resource: patients are issued a headset, two controllers, a disposable eye mask and hair bonnet, and are guided by nursing staff through app selection (guided meditation, virtual settings, movies, games), with defined session limits (up to 30 minutes) and stop criteria for dizziness or disorientation.
