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

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.