Five-Element Music and VR for Pain and Psychological Distress in Advanced Cancer: A Randomized Trial
J Pain Symptom Manage. 2026 Apr 7:S0885-3924(26)00146-6. doi: 10.1016/j.jpainsymman.2026.03.020. Online ahead of print.
ABSTRACT
BACKGROUND: 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.
MEASURES: 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.
METHODS: 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. post-intervention) as the within-subject factor and group allocation as the between-subject factor.
RESULTS: 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 < 0.05). Although serum β-EP levels increased in both groups over time (p < 0.001), no significant interaction effect was found. Partial eta squared values indicated moderate to large effect sizes for outcomes with significant interactions.
CONCLUSIONS: 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.
PMID:41956303 | DOI:10.1016/j.jpainsymman.2026.03.020