Clinical trial tests impact of actual and virtual nature on cancer patients

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Researchers at Houston Methodist Cancer Center are exploring whether exposure to nature, through either a live garden or virtual reality, can alleviate pain and distress in cancer patients undergoing chemotherapy, possibly reducing the need for prescription narcotics.

The clinical trial is a joint project led by Houston Methodist and Texas A&M University. Renee Stubbins, Ph.D., a clinical dietitian, and Ashley Verzwyvelt, an infusion oncology nurse, both with Houston Methodist Cancer Center, proposed the research after several years of studying ways nature aids the healing process.

Anything that affects our patients' comfort, including easing pain and anxiety, and possibly reducing the need for pain medications, is important to their recovery. People have an innate connection to nature, and we hope the patients will respond positively."

Renee Stubbins, Ph.D., clinical dietitian

Thirty-six oncology patients receiving infusions every two weeks for at least six cycles will be randomly assigned to one of three rooms: a live garden-view room; a window-less control room; and a room where the patient will experience nature through a virtual reality headset.

In partnership with Skyline Art, local artist Gonzo247 created a nature-inspired mural on a wall behind the live garden to create an overall immersive environment. The mural depicts a flowering garden, blue sky and sunset that enhances the live garden of Texas wildflowers in the forefront.

Researchers will assess pain, distress, blood pressure, heart rate, and saliva cortisol at the beginning and end of each infusion visit. Saliva cortisol, a hormone produced when the body is stressed, is an objective measurement of patient condition.

"If this study proves that real or virtual elements of nature help the healing process, then it has potential to positively impact our patients," Verzwyvelt said. "Some of them are hesitant to take pain medication due to concerns of addiction and adverse side effects, so I'm excited to see the possibilities this kind of research could bring."

The virtual reality aspect will allow patients to experience nature up close and personal within the confines of their rooms. Studying patients' experience with virtual reality is important for future clinical applications with immunocompromised or immobile patients.

"We looked at multiple studies that showed exposure to nature can reduce stress levels and actually increase productivity and creativity," said Ann McNamara, Ph.D., associate professor in the Department of Visualization at Texas A&M University. "We want to see if we can reproduce those effects in a natural environment in virtual reality."

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