Five-Element Music and VR for Pain and Psychological Distress in Advanced Cancer: A Randomized Trial.

Abstract

Pain and psychological distress are common and debilitating symptoms in patients with advanced cancer. Non-pharmacological interventions such as Five-Element Music therapy and virtual reality (VR) have shown promise in improving symptom management, but their combined effects remain unclear. This study aimed to evaluate the clinical effectiveness of the combination of Five-Element Music and VR in improving pain, anxiety, depression, and sleep quality in cancer patients, as well as its impact on serum β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) levels, providing an innovative non-pharmacological therapy for cancer patients. In this randomized controlled trial, 66 patients were allocated to an experimental group (standard care plus Five-Element Music and VR) or a control group (standard care only). The intervention comprised daily 12-minute sessions over seven consecutive days. Outcomes were analyzed using mixed-design analysis of variance (mixed ANOVA), with time (baseline vs. postintervention) as the within-subject factor and group allocation as the between-subject factor. Significant time × group interaction effects were found for pain intensity (NRS), anxiety (SAS), depression (SDS), sleep quality (PSQI), and serum 5-HT. The experimental group showed significantly greater improvements over time compared to the control group in all primary and secondary outcomes (P < .05). Although serum β-EP levels increased in both groups over time (P < .001), no significant interaction effect was found. Partial eta squared values indicated moderate to large effect sizes for outcomes with significant interactions. The combination of Five-Element Music and VR significantly improved pain, anxiety, depression, and sleep quality in patients with advanced cancer, and modulated serum 5-HT levels. These findings support the feasibility and potential efficacy of using this non-pharmacological intervention to manage symptoms in cancer care.