Music Therapy Combined with Virtual Reality Reduces Prevalent Symptoms in Adult Patients with Advanced Cancer: Randomized Clinical Trial

Background: Music therapy (MT) and virtual reality (VR) are increasingly being used in palliative care for symptom management, though evidence quality remains low. Objectives: The aim of our study was to assess the effect of combined MT + VR on the main symptom in palliative cancer patients. Design: This study employed an explanatory sequential mixed methods design based on a randomized controlled clinical trial, integrating quantitative outcomes with qualitative patient experiences. Measurements: The main symptom was the symptom rated as most severe by the patient on the Edmonton Symptom Assessment System Revised (ESAS-r) scale. Secondary outcomes included the global ESAS-r score, anxiety (additionally measured with State-Trait Anxiety Inventory—State [STAI-S]), emotional distress (DME scale), and heart rate. All variables were assessed at three time points: baseline (T1), post-intervention (T2), and 24 hours post-intervention (T3). Patients and Settings: Adult patients attended by palliative care with advanced cancer at a university hospital in Argentina. Results: Sixty patients completed the protocol. Significant differences between baseline (T1) and immediate post-intervention (T2) were observed when comparing the MT + VR condition to the control group for the main symptom (1.5 vs. 0, p < 0.001); global symptom score (9 vs. 0.5, p < 0.001); and anxiety (0.2 vs. 0.1, p < 0.001). No significant differences were found between groups at 24 hours post-intervention (T3) compared with baseline. Several categories of interest emerged: (a) affective states, (b) projections, and (c) transcendental experiences. Conclusion: The combination of MT + VR improved the main symptom, as compared with the control group. Patient perceptions add valuable information about the factors that influenced this difference.