Clinical Trial Hopes to Reduce Stress and Improve Mood for People Living with Brain Tumors

June 9, 2021, by Molly Maher, NCI Communications Fellow

People living with a brain or spine tumor can often experience unpleasant side effects that can impact their life. Amanda King, Ph.D., an iCURE fellow in the Patient Outcomes Research Program at the NCI Center for Cancer Research's Neuro-Oncology Branch, is passionate about finding innovative ways to improve how people feel and function. She researches ways to improve psychological symptoms and quality of life for patients with brain and spine tumors.

Dr. King is trained in biology and nursing. “I am fascinated by the underlying biological pathways that drive how patients experience illness, but I wanted to study them in humans rather than in a laboratory,” shares Dr. King. She became a nurse practitioner at Marquette University and worked closely with patients and their families.

During her time caring for patients in the intensive care unit (ICU), she noticed some patients seem to heal, recover, or cope with their illness better than others. She began thinking about how stress might influence the way that patients and families experience an illness—and what impact that could have on their clinical outcome. This idea inspired her to get a Ph.D. in nursing at Marquette University. During her doctoral training, she studied physiological and psychological aspects of the stress response (how a body responds to stress) and how this contributes to increased risk for chronic diseases, including cancer.

Patient-Reported Outcome Surveys

Under the leadership of Terri Armstrong, Ph.D., Dr. King joined the Neuro-Oncology Branch after finishing her doctorate degree. She researches how people feel and function throughout their illness and how stress influences their symptoms.

Dr. King uses patient-reported outcome surveys to capture patients’ experiences. The information collected through these questionnaires help researchers, clinicians, and patients understand how cancer can impact symptoms and functions. This information also helps inform interventional studies—studies to prevent or treat disease—to determine the best approach for managing brain and spine tumor symptoms and providing supportive care.

Data collected from these surveys help Dr. King and the Patient Outcomes Research Program recognize patterns and relationships of symptoms that occur. They look at differences or patterns in symptoms that occur across different racial and ethnic groups. “We hope to provide personalized symptom management interventions that improve quality of life for our patients,” shares Dr. King.

Virtual Reality Study

Patient outcomes research found that patients with brain tumors have many moderate to severe symptoms. Patients often report distress or anxiety, which can influence outcomes and the way they think and feel.

In an effort to improve distress and anxiety experienced by people with brain tumors, Drs. King and Armstrong developed a clinical trial using virtual reality to target psychological symptoms. Virtual reality is a computer-generated experience of a place or environment that is not real but is immersive so that it feels real. People can use a headset that allows them to explore these virtual environments and provides them with an opportunity to escape their illness and experience more positive thoughts and emotions. “Virtual reality is meant to feel real and provide an escape for patients to go to a different place that is beautiful or relaxing,” shares Dr. King.

The clinical trial will explore if virtual reality relaxation scenarios can help reduce stress and improve mood for adults with primary brain tumors. “Having a brain tumor can be very distressing and unpleasant. We hope this can provide an outlet for people to feel better and to teach them positive coping skills, such as how to slow down their breathing and heart rate,” says Dr. King.

The study uses virtual reality relaxation technology to teach breathing and mindfulness techniques that may improve peoples’ mood and how they feel. By learning positive coping strategies, the study hopes that people can use these skills when stressful situations occur in the future.

This trial is being conducted virtually through telehealth appointments. Participants are mailed a virtual reality headset to use at home. The study involves: 

• An initial telehealth session with the study team, where participants are instructed how to use the virtual reality headset, followed by a five-minute virtual reality intervention
• Unlimited use of the virtual reality headset after the initial session
• An interview with the study team one week after the intervention to talk about the experience of using virtual reality
• Questionnaires about health and symptoms at four timepoints over one month
• Optional saliva sampling to measure stress hormones

“We hope this clinical trial makes a positive impact in the lives of people living with a primary brain tumor. By providing effective coping skills, we hope to help carry them through the stressful situations throughout their entire illness,” shares Dr. King.