Abstract
Dear Editor:
We read with great interest the recent article, “A Novel Palliative Care Approach Using Virtual Reality for Improving Various Symptoms of Terminal Cancer Patients: A Preliminary Prospective, Multicenter Study,” by Niki et al. 1 The authors concluded that virtual travel could improve the symptom burden of terminally ill cancer patients.
Virtual reality (VR) is a computer-generated visual experience that seeks to convince our senses and perceptions that we are experiencing a phenomenon as if it were actually occurring in real life. This technology has numerous potentials, and we strongly suspect that Niki et al.'s study illustrates a powerful example of one of them. That is, it is really amazing and wonderful that terminal cancer patients—who may not be able to realize wishes, such as “I want to go to a memorable place I once visited,” in the real world because of their various symptoms and physical dysfunction—can experience a version of the wishes using VR.
The authors reported that the greatest benefits of using VR were related to psychological symptoms. According to Folkman, a modified coping process model suggests a relationship between positive emotion and psychological stress. 2 Therefore, the alleviation of psychological symptoms may be related to experiencing positive emotions. To give a simple example, if patients could share an experience of virtual travel with their family and friends, they would likely experience more positive emotions and, hence, reduce any psychological symptoms related to their illness. This is because Niki et al. report the effectiveness of returning to a memorable place for the reduction of psychological symptoms. Moreover, patients and their loved ones will be able to share these memorable experiences together, which means that VR technology will be increasing positive emotions even more.
We believe that commercially released products, including VR, can also be useful from the viewpoint of cost-effectiveness and utility. We are also studying the palliation of dyspnea in terminally ill cancer patients using a different commercially released product: an electrical fan.3,4 Fan therapy, which uses an electrical fan to blow air in the direction of the patient's face, is a highly valuable intervention for terminally ill cancer patients with dyspnea in terms of safety, convenience, low costs, and effectiveness. Furthermore, we agree with the authors' opinion that it is essential to collect additional objective data. It is also interesting to evaluate the relationship between objective and subjective data in trajectory.
This VR treatment, a novel palliative care approach, is a feasible and safe intervention. It is expected to be effective in alleviating symptoms in terminally ill cancer patients and can be used in clinical settings.