Gaming to help beat cancer

All opinions my own and do not necessarily reflect those of Novo Nordisk.

Plants versus Zombies 2: It’s About Time just came out.  My son spent a significant fraction of his weekend playing it on my iPad.  Okay, fine, I did too.  It’s a lot of fun, it challenges (but not too much) and it teaches you facts like, uh, like that Egyptian society in the past had a real fascination with pyramids.

So it’s not the most educational of games.

Which is why I was stoked to see the writeup of Re-Mission 2 in FierceBiotechIT.  This game takes elements of cancer treatment and places them in the context of a game that both educates patients undergoing cancer treatment as well as provides them a way to feel more in control of their situation.  Version 2 also builds on the impact of the first Re-Mission game, which showed success in improving adherence of patients to their treatment regimens.  Adherence is an important element of medical treatment and trying to make sure people take their medicines is an ongoing problem as we try to improve the efficiency of our healthcare systems.

In addition to behavioral metrics being changed by Re-Mission, functional Magnetic Resonance Imaging (fMRI) also showed that playing the game activated brain areas associated with motivation–again, tying gameplay to elements of adherence.  Some brain region activations also correlated with subject described positive and improved attitudes towards chemotherapy after gameplay.

To provide a short, short review of what version 2 holds, I played the game.  Purely for research, you understand.  The game contains six modules: Nanobot’s Revenge, Leukemia, Nano Dropbot, Stem Cell Defender, Feeding Frenzy and Special Ops.  Most of them have you play as a nanobot on a mission.  Nanobot’s revenge is a simple left-right scrolling shoot-down game, in which your nanobot moves back and forth across the top of the screen, raining down a variety of cancer-fighting weapons to defeat an increasingly complex array of tumor cells.  Leukemia has a simple mouse point and click attack method to hit enemy cells falling from the top of the screen. In Nano Dropbot you pick up chemotherapy packets to drop on evil tumor cells, using an arrow key/WASD control method to maneuver in 2D across the stage.  Stem Cell Defender has you seeks out bacteria and fling them at white blood cells to power them up.  When the white blood cells have seen enough of the bacterial invaders, they activate and clear out the rest of the level.  Feeding Frenzy (my favorite) has you play as a white blood cell and uses a mouse-directed vector movement interface to allow your blood cell to travel around the bloodstream gobbling up cancer cells and tumors.  I couldn’t play Special Ops yet as you need to reach 5 levels in the other 5 games and I haven’t done that.  Yet.

The games are simple, and yes, they simplify the science and medicine.  There are always tradeoffs in games and education.  For something meant to be played by sick kids, it seems appropriate to have a shallow learning curve and rapid feedback and rewards.

As I played the games I also thought of the effort Northeastern University is leading, trying to create games to encourage girls to enter STEM careers.  Looking at Re-Mission 2, the games have the element of shoot-’em-up fast action and rapid manipulation that seem important to hold the attention of people (boys) like me.  But I wonder if they also might be of appeal to girls because of the element of empathy.  I freely admit I may be completely wrong about this and what really would need to be done is measuring how well the game is taken up by boys and girls.  But the backstory of how and why the games were developed, and the context of helping cure a virtual patient, seem like elements that might help broaden Re-Mission 2’s appeal.

The power of games is amazing.  I’ve been reading Flow by Mihaly Csikszentmihalyi, and he talks about the mental state that comes from finding activities that stimulate and engage the mind.  Games do that.  They do that really well.  And when the power of games is combined with collaboration from scientists and other medical researchers, and is game-tested and optimized for patients, the result is more than just something that entertains and passes the time.  Games become tools for helping us get better, grow, change, do things that help us, and become an element of environmental design.

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