[Here’s a timely news item related to presence. It’s from the Huntsman Cancer Institute at the University of Utah, where the original includes three more images. Watch a short video of Doug Neilsen using VR on the Institute’s Instagram. Note the link to the new publication, “Patient Perceptions of Virtual Reality in Cancer Rehabilitation: A Qualitative Study”; here’s the abstract:

“This study investigates the use of virtual reality (VR) for cancer rehabilitation (CR) among patients with metastatic prostate cancer (mPC) undergoing androgen deprivation therapy (ADT). Interviews with 20 participants revealed that the engaging visuals and gamified exercise routines of the VR system enhanced motivation and supported personalized activities. However, some participants encountered challenges, including difficulty using the headset with glasses, initial confusion with technical terms, and concerns about cost and equipment durability. While most appreciated the system’s flexibility for home-based rehabilitation, one participant preferred traditional, non-technological exercises. These findings suggest that VR can effectively address barriers in conventional cancer rehabilitation programs, but improvements in user support and cost considerations are necessary for wider acceptance. Further research should focus on the long-term effects of VR on patient outcomes.”

–Matthew]

How Virtual Reality Could Transform Prostate Cancer Rehabilitation

May 13, 2025

Doug pedals fast, feeling the exhilaration of speeding along a bike track as his heart rate rises and he starts to breathe harder. Since being diagnosed with stage 4 metastatic prostate cancer in April 2023, Doug Neilsen’s symptoms—both from the cancer itself and his treatments—have made exercising like this difficult and often painful. But he does his best to stay in the lines on the path ahead, maneuvering and turning while he continues to pedal hard.

As Doug reaches the end of his ride, his pedaling slowing down, he reaches up and takes off a headset. Despite feeling completely immersed in the experience, Doug’s bike ride took place entirely in a doctor’s office—all thanks to the power of virtual reality (VR).

Doug is part of ongoing clinical trial at Huntsman Cancer Institute at the University of Utah (the U) that is exploring how virtual reality can be used as a form of rehabilitation for people who have been diagnosed with prostate cancer.

Rebuilding Health in Virtual Reality

Prostate cancer is one of the most common cancers worldwide. In fact, 1 in 8 men will be diagnosed with prostate cancer during their lifetime. Treatments for this disease often involve androgen deprivation therapy (ADT), also known as hormone therapy, which reduces testosterone levels, causing prostate cancer cells to die or slowing their growth. This can lead to several side effects, including loss of muscle mass, fatigue, osteoporosis, and metabolic syndrome.

Cancer rehabilitation can help patients manage these symptoms and improve overall quality of life through a variety of services, including physical therapy to increase strength, improve balance, and help patients return to a hobby, sport, or work.

Huntsman Cancer Institute is committed to clinical innovation and developing new models to improve clinical cancer care delivery, including rehabilitation services. This is why a cross-disciplinary team led by Huntsman Cancer Institute researchers Manish Kohli, MD, a specialist in prostate cancer research, and Joseph Finkelstein, MD, PhD, a professor in the Department of Biomedical Informatics at the U, is using VR as a cutting-edge tool to transform traditional cancer rehabilitation.

Through a funded grant from the Department of Defense, research studies into VR for rehabilitation are taking place at both Huntsman Cancer Institute and the George E. Wahlen Department of Veterans Affairs Medical Center to advance innovative treatments for prostate cancer patients.

The research team brought together experts in artificial intelligence, telerehabilitation, clinical and cancer oncology, nursing, and psychology, to create an interactive, gamified exercise in VR to help with rehabilitation.

While wearing a VR headset, patients are presented with a virtual racetrack where their race car moves with a speed based on their real-life cycling speed on a portable bike. In Doug’s case, he used a hand bike to pedal and follow along a line on a road in VR. Patients are given a prescribed exercise routine displayed on a virtual dashboard with metrics to hit during their exercise session.

Drs. Kohli and Finkelstein and their team published their findings in a recent study in the peer-reviewed journal Studies in Health Technology and Informatics. They found that even though most patients had never used VR before, including Doug, the engaging visuals and the gamified activity enhanced their motivation while exercising.

“The VR device helps patients focus on their exercise prescription and makes their exercise plan more enjoyable,” Dr. Kohli says.

Bridging Distance Through Telerehabilitation

Not only does VR rehabilitation help patients with improved motivation during exercise and make the experience more entertaining, but it is also particularly helpful for patients living in rural or frontier areas.

Access to in-person rehabilitation services may be scarce in rural and frontier areas. By serving the five-state Mountain West, including Utah, Idaho, Montana, Nevada, and Wyoming, Huntsman Cancer Institute provides care to the largest geographic region of any National Cancer Institute-designated Comprehensive Cancer Center. This means that patients often travel large distances to access care.

“Distance can be a significant barrier to accessing rehabilitation services. Traveling to rehabilitation centers can be impractical or even impossible for many patients.” Dr. Kohli explains. “For those living in remote or rural areas far from Salt Lake City, traveling such long distances for rehabilitation—particularly on a daily basis—can quickly become exhausting and discouraging. The time, effort, and logistical burden of a round trip to the hospital often lead patients to give up after just a few days.”

However, being able to receive these services at home bridges this gap in cancer care for rural and frontier patients. “Virtual reality provides an innovative solution to these challenges, allowing patients to engage in rehabilitation exercises from the comfort of their homes,” Dr. Kohli says.

The ongoing research into VR as a form of telerehabilitation, or rehabilitation services provided at a distance, demonstrates Huntsman Cancer Institute’s goal to increase access to the benefits of the institute’s science-based cancer care, including a focus on addressing distance as a barrier to care. By focusing on innovative technologies to increase access, Huntsman Cancer Institute is working to achieve its vision: passionate individuals and teams delivering a cancer-free frontier through scientific discovery and human touch.

While there is still a need for further research into the benefits of VR for telerehabilitation, Doug is optimistic that this technology can help patients like him better manage side effects and rebuild their health while improving access to more patients diagnosed with prostate cancer.

“For elderly people and people who are really having a tough time with side effects or the disease like me, VR could be hugely beneficial and has the potential to change lives,” Doug says.