# Show people the radiotherapy room and the treatment before the planning appointment, using virtual reality or a guided visit

Source: https://onco.cc/ideas/idea-pu-radiotherapy-walkthrough-before-planning/  
OnCo record `idea-pu-radiotherapy-walkthrough-before-planning` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A randomised trial of 196 women about to have breast radiotherapy found that explaining the treatment with a virtual-reality walkthrough lowered anxiety and improved understanding compared with the usual explanation. A review of 15 education studies found that leaflets and brief talks made little difference, and more intensive, staff-led preparation did.

## Summary

The trial. At a single institution, 196 women about to have adjuvant breast radiotherapy were randomised to an immersive virtual-reality explanation of the planning and treatment process or the standard explanation. Anxiety fell immediately by 26.0, 16.1 and 55.8 per cent on three scales with virtual reality against 8.1, 8.5 and 13.7 per cent with standard care; only one of the three scales showed a lasting difference. Knowledge of the procedure (81.9 against 76.8 out of 100) and satisfaction with the explanation were higher, and the effect did not depend on the physician, baseline anxiety or health literacy.

The wider picture. A 2026 systematic review of 15 intervention studies with 1,988 participants found anxiety before radiotherapy fell over time in both intervention and control groups, most educational programmes did no better than standard education, and interventions that were more intensive and delivered by professional staff were more likely to reduce anxiety. Its authors recommend routine anxiety screening before radiotherapy and tailored rather than passive education.

What this adds up to: a leaflet is not preparation. Seeing the room, the machine and the sequence of a session, whether through a headset, a video recorded in the department or a visit with a radiographer, is the version with evidence. Adoption is not measured.

## Fields

- Kind: Idea
- Last checked: 2026-10-20
- Tags: protocol-upgrade; upgrade:promising; evidence:moderate
- Hypothesis: A structured, staff-led preview of the radiotherapy room and session, by virtual reality or an in-person visit, before the planning appointment reduces anxiety at planning and first treatment and shortens the planning appointment, compared with written information.
- Rationale: One adequately sized randomised trial found an immediate effect on anxiety and understanding, and a systematic review identifies intensity and staff delivery as what separates the programmes that work from those that do not.
- Proposed test: A randomised trial across several tumour sites comparing a virtual-reality preview, an in-person radiographer-led visit and written information, with anxiety at planning and first treatment, appointment length and cost per patient as endpoints.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Shin et al., An investigation of the effect of virtual reality on alleviating anxiety in patients with breast cancer undergoing radiation therapy: a randomized controlled trial (International Journal of Radiation Oncology, Biology, Physics 2023): https://doi.org/10.1016/j.ijrobp.2023.06.275
- Hanum et al., Patient education to reduce anxiety among cancer patients undergoing radiotherapy procedure: a systematic review of interventional studies (Journal of Preventive Medicine and Public Health 2026): https://doi.org/10.3961/jpmph.25.318

## Connected records

- ideas: [Ask about mask anxiety at every head and neck radiotherapy visit, and offer music and guided relaxation](https://onco.cc/ideas/idea-pu-mask-anxiety-screening/), [Breath-hold coaching and home practice a week before the planning scan, in the patient's own language](https://onco.cc/ideas/idea-pu-breath-hold-coaching-before-planning/)
- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/)
- fronts: [Radiation Therapy](https://onco.cc/fronts/radiation/)
- technologies: [Psycho-oncology and distress screening](https://onco.cc/technologies/psycho-oncology/), [Screening for distress: what the thermometer can and cannot do](https://onco.cc/technologies/rejuv-mind-distress-screening/)
- terms: [Radiotherapy](https://onco.cc/terms/radiotherapy/)
- bottlenecks: [Patients lack understanding, navigation and agency](https://onco.cc/bottlenecks/b-patient-voice/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)

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