Virtual reality as a non-pharmacological adjuvant for anxiety in oncology care: a systematic review and meta-analysis

Background: Despite its growing presence in healthcare settings, research on the effectiveness of virtual reality (VR) interventions for symptom experience of patients with cancer remains varied and requires a comprehensive synthesis to reach definitive conclusions. Objective: This systematic review and meta-analysis aimed to assess the effectiveness of VR interventions in managing anxiety among individuals diagnosed with cancer. Methods: A comprehensive search of Ovid MEDLINE, PubMed, CINAHL, Web of Science, and Scopus databases was conducted for studies published from 2000 to November 2025. Publications were evaluated by independent reviewers for inclusion. The methodological quality of the included studies was assessed via Joanna Briggs Institute (JBI) critical appraisal tools for randomized controlled trials and quasi-experimental studies. Results: Twenty-one publications satisfied the requirements for review inclusion. The meta-analysis demonstrated that VR-based interventions were significantly effective in the management of patients’ anxiety, yielding a moderate-to-high effect size (SMD = −0.793, 95% CI = −1.403 to −0.184; Z = −2.551; p = 0.011). Most studies reported statistically significant decreases in anxiety scores across various cancer types, including breast, prostate, and ovarian cancers. No major side effects were reported, although minor instances of cyber sickness were managed by adjusting session durations. User satisfaction was exceptionally high, with satisfaction scores reaching 4.47/5 and 7.35/10. Implications for practice: The results support the use of VR as an effective and safe non-pharmacological intervention for anxiety management. The findings highlight the potential for VR to be integrated into routine oncology nursing and palliative care to improve the patient experience during stressful treatments like chemotherapy. Conclusion: VR-based interventions are an effective, safe, and highly acceptable approach for managing anxiety in patients with cancer. Further research is needed to support wider clinical implementation and to investigate the potential benefits of VR for other physical and psychological symptoms over longer follow-up periods. Trial registration: PROSPERO International Prospective Register of Systematic Reviews CRD42022351573.