Enhancing cancer-supportive care through virtual reality: a policy brief

Abstract

Background

Virtual reality (VR) technology has been useful in enhancing cancer-supportive care by alleviating pain, anxiety and emotional distress. However, its integration into oncology faces multiple barriers, including limited funding, insufficient clinician training, accessibility challenges, absence of standard guidelines and reimbursement policies. This policy brief highlighted policy options needed for VR technology interventions in cancer-supportive care.

Methods

This policy brief was developed upon a previous systematic review that examined the role of VR in cancer-supportive care. To translate these findings into actionable recommendations, we conducted a secondary analysis of policy-related opportunities and challenges. The extracted evidence was synthesized to propose strategic policy options that facilitate VR adoption in oncology.

Results

A total of five key policy options were identified: (1) increasing funding for VR research and development, (2) training programs for healthcare professionals, (3) expanding patient access through financial support mechanisms, (4) establishing standard clinical guidelines and (5) developing reimbursement policies. These recommendations aim to bridge the gap between technological advancements and their practical implementation in cancer care.

Conclusions

Integrating VR into cancer-supportive care requires a coordinated effort among policymakers, healthcare institutions and technology developers. By implementing these evidence-based policy strategies, stakeholders can enhance patient access, improve clinical outcomes and ensure sustainable adoption of VR in oncology.

Background

Patients with cancer experience a significant physical and emotional burden throughout their treatment journey. Supportive-care interventions aim to manage symptoms, alleviate distress and enhance patients’ quality of life [1]. However, conventional supportive-care approaches, such as pharmacological pain management, psychological counselling and physical rehabilitation, may not fully address the diverse needs of all patients, particularly in managing chronic anxiety, depression and treatment-related distress [2, 3].

Virtual reality (VR) has emerged as an innovative tool in healthcare, offering immersive environments that can supplement traditional supportive-care methods [4]. VR applications have demonstrated significant benefits in oncology by alleviating cancer-related pain, reducing anxiety before and during treatment procedures and improving patients’ emotional well-being [5, 6]. For example, VR distraction techniques have been used to reduce pain perception in patients with cancer undergoing chemotherapy and radiation therapy by engaging them in interactive environments that shift focus away from discomfort [7]. In additional, VR-based relaxation programs incorporating guided meditation and mindfulness training have been reported to be effective in reducing psychological distress, improving mood states and enhancing coping mechanisms among patients with cancer and cancer survivors [4, 8].

Beyond pain and stress management, VR is increasingly recognized for its potential in addressing cancer-related fatigue, cognitive impairment and emotional resilience [9]. Studies suggest that VR-based cognitive rehabilitation programs can help patients with cancer experiencing chemotherapy-induced cognitive decline, commonly known as chemo brain [10, 11]. Moreover, VR-enhanced physical therapy interventions have been successfully utilized to support rehabilitation in patients with cancer suffering from mobility challenges due to treatment side effects [11]. The use of VR in palliative care has also been explored, with evidence indicating that immersive experiences, such as virtual nature therapy and reminiscence therapy contribute to improve emotional well-being and reduce feelings of isolation in terminal patients with cancer [12].

Despite these promising applications, several barriers hinder the widespread integration of VR into cancer-supportive care. Key challenges include limited research funding, a lack of standard protocols for VR implementation, insufficient training among healthcare professionals, accessibility issues and the absence of reimbursement policies that would encourage broader adoption [13, 14]. While existing research highlights the therapeutic potential of VR, there remains a gap in policy frameworks that would facilitate its systematic integration into oncology care settings.

This policy brief seeks to address these challenges by suggesting policy options needed for strategic policy interventions of VR technology adoption in cancer-supportive care. An evidence-based policy approach can ensure that patients with cancer benefit from the full potential of VR as a complementary supportive-care modality.

Analysis

The analysis underpinning this policy brief is based on evidence derived from a systematic review conducted in 2024, which examined the application of VR in supportive care for patients with cancer [15]. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to ensure a rigorous and transparent methodology. A systematic search was conducted across seven major English-language databases – PubMed, Web of Science, Scopus, the Cochrane Library, Ovid, IEEE Xplore and ProQuest – covering studies published up to 20 May 2024. The search strategy incorporated key terms related to supportive care, virtual reality and cancer, utilizing a combination of Medical Subject Headings (MeSH) and Boolean operators to maximize comprehensiveness. In additional, reference lists and citations of relevant studies were reviewed to identify additional sources. Strict inclusion criteria were applied to ensure the relevance and quality of included studies. Original research articles or conference proceedings published in English, employing quantitative, qualitative or mixed-method designs and explicitly investigating VR-based supportive care for patients with cancer were included. Studies were excluded if they were non-English, were review articles, were letters to the editor, were research protocols, focused solely on cancer survivors or lacked full-text availability.

The quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Moreover, risk of bias was assessed using the Cochrane Risk-of-Bias 2.0 (RoB 2.0) tool for randomized controlled trials and the ROBINS-I tool for nonrandomized studies. Data were extracted using a form that captured study characteristics, intervention details, outcomes and key findings. Extracted data were cross-checked by two reviewers to ensure accuracy. The results of this systematic review were synthesized narratively owing to the diversity of study designs and outcome measures. Then, key themes were identified from the systematic review. The headings were aligned with the WHO guidance on policy briefs, ensuring clarity in decision-making [16]. Each heading reflects key policy dimensions such as cost considerations, equity implications and stakeholder responsibilities. These themes emerged from the analysis of existing barriers to VR adoption, including financial constraints, accessibility challenges and the need for regulatory frameworks. The structured approach ensures that policy recommendations are grounded in both empirical evidence and practical feasibility, providing a comprehensive framework for decision-makers.

Policy implications

In addressing the existing barriers of utilizing VR technologies for cancer-supportive care, several policy options offer promising areas for improvement. These options are discussed in the below sections and summarized in Table 1.

Table 1 Summary of policy options

Option 1: augmenting research and investment

Investing in research and development is crucial for integrating VR into cancer-supportive care. In cancer centres, more funding should be allocated to clinical trials to evaluate VR efficacy in pain management, anxiety reduction and overall well-being. These trials should investigate optimal VR intervention protocols, patient suitability and long-term effects on quality of life. In community hospitals, research investment should focus on developing cost-effective, scalable VR interventions that can be easily implemented without requiring extensive infrastructure. Comparative studies assessing VR interventions against traditional supportive-care options will provide critical evidence for wider adoption.

Reimbursement models should include government and private sector incentives to encourage research institutions and healthcare providers to explore VR applications in cancer care. Grants should be allocated to facilitate pilot studies, and tax incentives can be introduced for private sector investments in VR healthcare research. High-resource settings can allocate substantial funds towards artificial intelligence-driven VR simulations and multimodal interventions combining VR with cognitive behavioural therapy. Low-resource settings should focus on practical and affordable VR tools that require minimal hardware. Policymakers play a pivotal role in ensuring consistent funding, while healthcare institutions and VR developers must collaborate to design and test patient-centred VR applications that align with clinical needs.

Option 2: equipping healthcare professionals with VR expertise

The successful implementation of VR in cancer-supportive care depends on equipping healthcare professionals with the necessary expertise. Oncologists, nurses and psychologists should undergo comprehensive training on VR applications tailored to patients with cancer. These training programs should include theoretical components covering the mechanisms behind VR’s therapeutic effects along with practical sessions where professionals get involved in VR interventions. Standard training protocols should be developed in collaboration with medical education institutions, ensuring competency-based learning and certification.

In academic medical centres, VR should be embedded into oncology residency programs, ensuring future healthcare providers are well-versed in its applications. Community hospitals and smaller clinics should introduce VR workshops for healthcare staff, enabling them to integrate VR-based interventions into routine cancer care. Institutions with limited resources can leverage online VR training modules and collaborative learning networks to provide cost-effective educational opportunities. Reimbursement models should support training programs through government funds, continuing medical education credits or hospital subsidies to offset costs for medical professionals. Healthcare institutions must take the lead in facilitating training, supported by policymakers and VR technology developers who provide tailored educational resources, simulation tools and software updates to maintain technological proficiency.

Option 3: expanding VR accessibility through grant programs

Expanding VR access in cancer care requires targeted grant programs to support hospitals and cancer treatment centres in acquiring and maintaining VR technology. These grants should cover initial hardware and software procurement, staff training and ongoing maintenance costs to ensure sustainability. Grant applications should emphasize data collection, requiring institutions to document patient outcomes, user engagement and cost-effectiveness to inform future funding decisions.

In large hospitals, grants can help integrate VR into broader supportive-care programs, allowing for a seamless blend of traditional and immersive interventions. Smaller healthcare facilities can use grants to introduce targeted VR interventions, such as relaxation therapy for chemotherapy patients or VR-based rehabilitation programs for those recovering from cancer treatments. Public–private partnerships should be encouraged, where VR developers collaborate with healthcare institutions to provide subsidized equipment in exchange for clinical research opportunities. Reimbursement policies should include insurance incentives that cover hospital-acquired VR therapy, ensuring that financial constraints do not limit patient access. Resource allocation should prioritize underserved hospitals and rural healthcare centres to bridge accessibility gaps. Policymakers must establish and allocate funding for VR grants, while healthcare institutions should actively apply and outline clear implementation strategies for sustained VR integration.

Option 4: establishing standard guidelines for VR in cancer care

The development of standard guidelines is essential to ensure the safe and effective integration of VR in cancer-supportive care. These guidelines should outline appropriate patient selection criteria, recommended session duration, safety considerations and evidence-based treatment protocols. Regulatory agencies should collaborate with professional medical organizations to create these frameworks, ensuring they align with existing oncology care guidelines.

Large healthcare institutions should adhere to national and regional VR guidelines that establish protocols for patient selection, treatment duration and safety measures. Smaller facilities can follow adapted guidelines that align with their capacity and available resources, ensuring that VR integration remains feasible, regardless of institutional size. Reimbursement models should require healthcare providers to comply with standard VR guidelines to qualify for insurance coverage, ensuring uniformity in VR implementation. High-resource settings should invest in research to refine best practices, while low-resource settings should focus on adapting global recommendations to local contexts. Policymakers, researchers, healthcare institutions and technology developers must work together to establish evidence-based VR guidelines, balancing standardization with flexibility to foster innovation.

Option 5: implementing VR reimbursement policies

Establishing reimbursement policies for VR-based supportive care is essential to promote widespread adoption. Insurance companies and healthcare policymakers must develop clear reimbursement frameworks that classify VR interventions under supportive cancer care services. Cost-effective evaluation studies should be conducted to identify the financial benefits of VR in reducing hospital stays, medication dependence and psychological distress.

In public hospitals, VR interventions should be reimbursed for evidence-based applications such as pain management, anxiety reduction and palliative care support, ensuring that financial barriers do not hinder patient access. In private healthcare settings, insurers should develop tiered reimbursement models that account for the cost-effectiveness of various VR interventions. Governments should mandate the inclusion of VR therapies in supportive-care reimbursement plans, while private insurers should explore financial models that balance affordability with sustainability. Value-based care models can incentivize hospitals to adopt VR by linking reimbursement to demonstrated patient outcomes. In low-resource settings, government-subsidized VR programs should be implemented to support patient access without excessive financial burden. Policymakers, insurers, healthcare institutions and patient advocacy groups must collaborate to ensure VR reimbursement policies are equitable, sustainable and adaptable to evolving healthcare needs.

Further important considerations

Beyond the primary policy options, additional considerations must be addressed to ensure the successful integration of VR in cancer-supportive care. Robust monitoring and evaluation mechanisms should be established to track implementation progress, patient outcomes, adherence to guidelines and overall cost-effectiveness. Regular assessments will allow policymakers and healthcare institutions to make evidence-based adjustments to VR policies and interventions. In addition, cross-sector collaboration between technology companies, regulatory bodies and patient advocacy groups is essential to create a cohesive ecosystem that supports VR adoption. Public awareness campaigns should be launched to educate both patients and healthcare providers on the benefits and appropriate applications of VR in oncology care, ensuring greater acceptance and utilization.