Interest of Virtual Reality to Prevent Cancer Patient Anxiety Before Chemotherapy or an Invasive Act

Study Overview
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Brief Summary
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The aim of the REV clinical trial is to evaluate the impact of a virtual reality exposure to decrease patient anxiety before chemotherapy or an invasive act. If positive, the access to virtual reality exposure is aimed to be used as standard of care at Lyon's hospital to improve cancer patient well-being in a drug-free manner. The majority of cancer patients lives with high level of anxiety as soon as diagnosed. This level anxiety is particularly high before invasive acts but also before chemotherapy by side effects anticipation. Hypnosis is a highly interesting drug-free approach to decrease patient's anxiety. It however requires on site specialists to be available whenever needed. Virtual reality provides a distractive environment enabled to shift patient focus. It can support a switch of patient mindset by providing positive emotions. Since 5 years, this disruptive technology is being more and more used as medical support thanks to a new generation of headsets enabling improved performance at cheaper prices. Many publications have now demonstrated the positive impact of virtual reality to take in charge patients' pain or pre-operational anxiety.

Detailed Description
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The primary objective of the REV study is to demonstrate the difference of anxiety before and after a virtual reality exposure using the State-Trait Anxiety Inventory (STAI-Y) before patients undergo an oncological procedure (invasive act or chemotherapy (C1D1). The investigator's REV study aims to recruit 66 patients among three cohorts (22 patients per cohort) in 12 months. Breast cancer cohort (patient receiving an adjuvant or neoadjuvant chemotherapy with doxorubicin and cyclophosphamide) Head or neck cancer cohort (patient treated by concomitant radiochemotherapy) Cancer patient for which an invasive act inducing anxiety is planned (lumbar puncture, ascites puncture, thoracocentesis, myelogram, bone marrow biopsy, urinary catheterization, ..) The REV study aims to impact Lyon's hospital patients' quality of life and well-being by decreasing their anxiety level during oncological treatments thanks to innovative supportive cares.

Official Title
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Interest of Virtual Reality to Prevent Cancer Patient Anxiety Before Chemotherapy or an Invasive Act

Conditions
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Anxiety, Chemotherapy Effect, Breast Cancer, Head Cancer Neck

Intervention / Treatment
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* Behavioral: Virtual reality exposure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: For all patients: Patient Study Information and written informed consent Social Security Affiliation For breast cancer cohort : Adult patient (>18 years) Histological or cytological proven breast cancer Eligible to an adjuvant or neo-adjuvant IV chemotherapy given every 2 to 3 weeks (with protocol doxorubicin- cyclophosphamide, docetaxel-cyclophosmadide, docetaxel-cyclophosphamide-trastuzumab, docetaxel, carboplatine, trastuzumab, epirubicin-cyclophosphamide, etc) Therapeutic strategy validated in multidisciplinary meeting First chemotherapy cure (C1D1) not initiated yet Patients with a complete healing after resection (for adjuvant chemotherapy) Patients that do not report residual pain with an intensity > 4. For head, neck and bladder cancer cohort : Adult patient (>18 years) Histological or cytological proven head, neck or bladder cancer Patient eligible for an adjuvant or neoadjuvant based on cisplatin. Therapeutic strategy validated in multidisciplinary meeting First chemotherapy cure (C1D1) not initiated yet Patients with a complete healing after resection. Patients that do not report residual pain with an intensity > 4. For invasive act leading to potential anxiety cohort : Adult patient (>18 years) Histological or cytological proven cancer Patient with a planned hospitalization at oncological unit Eupneic patient Afebrile patient Patient for whom an invasive act leading to potential anxiety is planned (excluding percutaneous implantable chamber) : Puncture Deep biopsy Sounding Endoscopy without general anesthesia myelogram Exclusion Criteria: Patient with a consciousness disturbance or a spatio-temporal disturbance Claustrophobic patient Patient with a non-stabilized psychiatric pathology Patient with seizure crisis background Patient with a visual or hearing disturbance that is not compatible with video watching and sound listening Patients with out-of range clinical parameters (arterial pressure, cardiac frequency,..) Patients with out-of range blood parameters that are not compatible with chemotherapy or an invasive act. Patient with a life expectancy below 3 months. Impossibility to track and follow patient (any reason) Patient deprived of liberty or subjected to guardianship

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Virtual reality exposure<br>Virtual reality exposure just before an oncological procedure (invasive act or a chemotherapy) | Behavioral: Virtual reality exposure<br>* Patients will be exposed to a 10-20 min virtual reality session just before an oncological procedure (invasive act or chemotherapy). Patients will be able to choose between 4 virtual universes (beach, underwater, forest, space) and seven musical content.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference of anxiety using the State-Trait Anxiety Inventory before oncologic procedure | Difference of anxiety before and after a virtual reality exposure using the State-Trait Anxiety Inventory (STAI-Y; A-State Scale) before patients undergo an oncologic procedure (invasive act or chemotherapy (C1D1). | Before an invasive act or a chemotherapy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference of anxiety using a self-evaluation anxiety inventory before oncologic procedure | Difference of anxiety before and after a virtual reality exposure using a self-evaluation anxiety inventory before patients undergo an oncologic procedure (invasive act or chemotherapy (C1D1). Comparison of responses between self-evaluation anxiety inventory before and after virtual reality exposure just before an oncologic procedure (invasive act or a chemotherapy) | Before an invasive act or a chemotherapy | 
| Difference of anxiety using the State-Trait Anxiety Inventory before chemotherapy | Difference of anxiety before and after a virtual reality exposure using the State-Trait Anxiety Inventory (STAI-Y; A-State Scale) or the Self-evaluation anxiety inventory before patients undergo chemotherapy (C1D1, C2D1, C3D1). Comparison of responses between the STAI-Y; A-State Scale or the Self-evaluation anxiety inventory before and after virtual reality exposure just before chemotherapy | Just before chemotherapy | 
| Difference of anxiety using the State-Trait Anxiety Inventory before invasive act | Difference of anxiety before and after a virtual reality exposure using the State-Trait Anxiety Inventory (STAI-Y; A-State Scale) or the Self-evaluation anxiety inventory before patients undergo an invasive act. Comparison of responses between the STAI-Y; A-State Scale or the Self-evaluation anxiety inventory before and after virtual reality exposure just before an invasive act | Just before an invasive act | 
| Patient basal anxiety level just before an oncologic procedure | Patient basal anxiety level using STAI-Y; A-State Scale, STAI-Y; Trait-State Scale or the Self-evaluation anxiety inventory just before an oncologic procedure (invasive act or a chemotherapy). Quotation of patient basal anxiety level using STAI-Y; A-State Scale, STAI-Y; Trait-State Scale or the Self-evaluation anxiety inventory just before an oncological procedure (invasive act or a chemotherapy) | Just before an oncologic procedure | 
| Determination of patient anxiety level evolution through 3 cycles of chemotherapy | Determination of patient anxiety level evolution through 3 cycles of chemotherapy using the STAI-Y; A-State Scale and the Self-evaluation anxiety inventory (just before virtual reality exposure, after virtual reality exposure, after 1 hour of chemotherapy). Comparison of responses between the STAI-Y; A-State Scale and the Self-evaluation anxiety inventory before virtual reality exposure, after virtual reality exposure and after 1 hour of chemotherapy | just before virtual reality exposure, after virtual reality exposure, after 1 hour of chemotherapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hypnosis