VR and Radiotherapy: Reducing Anxiety in Repeated Sessions

30 sessions. 30 times the same fear.

Radiotherapy is a fractionated dose treatment. This means that the patient does not go to the hospital once: they go 20, 25, 30 times. Almost every day, for weeks.

And each time, the same sequence: waiting room, table, positioning, forced immobility, noise of the machine, loneliness. For some patients, the thermoplastic mask fixed to the face.

The treatment itself does not hurt. Radiotherapy is painless. But the repeated experience generates a different type of suffering: cumulative anxiety.

Cumulative anxiety

The first session is often "manageable". The patient is nervous but motivated. They know it is necessary. They grit their teeth.

But by the fifth session, the anxiety has not decreased. It has increased. Because the brain has learned: this environment = stress. This table = immobility. This mask = claustrophobia.

By the tenth session, the patient begins to sleep poorly the night before. By the twentieth, they arrive with shaking hands. By the thirtieth, some can no longer enter the room.

This phenomenon is called sensitization: the stress response does not diminish with habit, but amplifies with repetition.

The specific problem of radiotherapy

Compared to other procedures, radiotherapy has characteristics that make it particularly anxiety-inducing:

Forced immobility

The patient must remain perfectly still for minutes. Any movement compromises the precision of the irradiation. This constraint triggers claustrophobic responses even in those who are not claustrophobic.

The mask

For head and neck cancers, the thermoplastic mask fixed to the table is the most traumatic element. The face is locked. Breathing is perceived as limited. Many patients describe panic attacks.

Loneliness

During irradiation, the staff leaves the room. The patient is alone, motionless, in a room with a machine making noises. Rationally, they know they are safe. Emotionally, they feel abandoned.

Repetition

None of these things improve over time. They get worse. And the patient knows they will have to come back tomorrow, and the day after tomorrow, and the day after that.

How VR changes the experience

Immersive audio during treatment

Even if the headset cannot be worn with the face mask (in some setups), headphones with immersive spatial audio can transport the patient to a different acoustic environment. The noise of the machinery disappears, replaced by natural sounds or guided meditation.

VR in the waiting room and pre-positioning

The minutes before treatment are the ones with the highest anxiety. A short VR session (5-10 minutes) before entering the treatment room lowers cortisol levels and prepares the patient for immobility.

VR post-treatment

A relaxation session after the treatment helps "reset" the emotional state, preventing the patient from taking stress home and accumulating it for the next day.

VR as desensitization

For patients with severe anxiety or mask claustrophobia, gradual exposure VR sessions can help build tolerance before starting the cycle.

The impact on therapeutic adherence

Adherence in radiotherapy is crucial. Every missed session compromises the effectiveness of the treatment. The irradiation plan is calculated on a precise number of fractions — skipping one is not like skipping a pill.

Patients who develop severe anxiety:

Ask to discontinue treatment
Skip sessions
Require pharmacological sedation for each session (with costs and complexity)
Have worse therapeutic outcomes

The same paradigm of reducing medication while maintaining results applies strongly here: VR offers an alternative to sedation without side effects.

Reducing anxiety with VR is therefore also an intervention that protects the effectiveness of the cure itself.

For radiation therapists

The practical advantage: a less anxious patient is positioned more easily, stays more still, requires fewer repositionings. The patient workflow is smoother. Fewer delays from anxiety attacks.

The emotional advantage: managing patients in panic every day is exhausting also for those who operate the machines. Knowing that the patient arrives already relaxed changes the quality of the workday.

An investment for 30 sessions, not for one

Unlike a single procedure (a blood draw, a colonoscopy), in radiotherapy the same patient uses VR 20-30 times. The initial investment quickly amortizes over such high volumes of sessions per patient.

And the effect accumulates positively: each less anxious session makes the next one even more tolerable. The vicious cycle of sensitization is reversed into a virtuous cycle of desensitization.

30 sessions do not have to mean 30 times the same suffering. Lemons in the Room, already in over 30 facilities, transforms radiotherapy from a stress marathon into a manageable journey — with specific immersive audio content for repeated sessions and progressive desensitization protocols.