Interest of Virtual Reality to Prevent Cancer Patient Anxiety Before Chemotherapy or an Invasive Act
Interest of Virtual Reality to Prevent Cancer Patient Anxiety Before Chemotherapy or an Invasive Act
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.
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.
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 with the protocol doxorubicin-
 cyclophosphamide

 -  Therapeutic strategy validated in multidisciplinary meeting

 -  First chemotherapy cure (C1D1) with doxorubicin- cyclophosphamide 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 and neck cancer cohort :

 -  Adult patient (>18 years)

 -  Histological or cytological proven head or neck cancer

 -  Eligible to concomitant radiochemotherapy with cisplatin every 21 days as chemotherapy

 -  Therapeutic strategy validated in multidisciplinary meeting

 -  First radiochemotherapy 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 :

 -  lumbar puncture for patient without meningitis syndrome

 -  ascites puncture

 -  thoracocentesis

 -  myelogram

 -  bone marrow biopsy

 -  urinary catheterization

 -  gastric probing

 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