Feature Article August08

Using Video Games to Combat Cancer
- Study links game play to improved treatment adherence
by Julia Loughran

I will be showing my age to admit that the most popular video game when I was growing up was Atari's coin-operated video game "Pong." There wasn't much to the game; just a black screen with white lines representing paddles and a small white ball that bounced from paddle to paddle (player to player). Although it seems antiquated now, it was fun and my brothers and I got into some deadly Pong Tournaments. Thirty-six years later, video games have come a long way, with super-high-end visual graphics, sounds, simulations and realistic artificial intelligence. However, more impressive than all that is today, in the healthy games space, we now have evidence video games can help improve patient health for conditions like cancer.

This week, the publication Pediatrics, the Official Journal of the American Academy of Pediatrics, released a report that shows evidence that use of the video-game Re-Mission by Hope Lab "significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy." Re-Mission is a video game targeted for adolescents and young adults with cancer. The game is of the "first person shooter" genre. Players assume the role of Roxxi, the nanobot, as she travels through bodies of fictional cancer patients fighting cancer cells, bacterial infections and other side effects associated with cancer.

I recently spent some time playing Re-Mission and I was pleasantly surprised with how fun it is - and it is educational too. Since I am a cancer survivor (diagnosed with Stage 3 melanoma when I was 24), I think the game had a special interest for me, but I think cancer and non-cancer patients alike would find the visual graphics and fast game play exciting. The game is available free on re-mission.net and as of December 2007, 110,000 copies it has been downloaded in 78 countries. The game is designed for PCs using the Windows OS (Windows Me, Windows 98, Windows 2000, Windows XP). There are some minimum system requirements, so check on the re-mission.net web site for more information.

The game starts by providing background materials, conveying the goals of the game, and explaining how to play. I found this part to be a bit tedious --- I wanted to jump in and start fighting cancer cells right away! During this introductory period, you have to demonstrate your skills using the keyboard to navigate, shoot your weapon, etc. before you are unleashed to navigate through the body with your radiation and chemo arsenals. Despite my impatience, I was soon on my way, fighting and killing cancer cells.

The educational component occurs when players learn what types of treatment methods are effective for different types of cancer. You also learn some of the side effects that can happen during cancer treatment. These teaching points do not come across heavy-handed, and they enhance your ability to play the game effectively. While I was playing the game, I considered the power it might have on making a mind-body connection. I found myself asking, "If my mind thinks I'm killing cancer cells in the game, might my body be better at killing the cancer cells that might be in my body?"

Overall, the game was fun to play and the graphics were impressive. I'm not very agile at playing these games (remember, I grew up on Pong). I haven't made it through the various levels of the game - but, the game is fun and I could be convinced to try it again.

Whether or not playing the game is actually helping to fight cancer has yet to be seen, but as the study reports, people playing the game in the intervention group were more likely to adhere to treatment. In the case of the study, both groups were prescribed prophylactic antibiotics and adherence was confirmed by electronic pill monitoring devices or through serum assays. The hypotheses of why playing Re-Mission may have led to higher treatment adherence are that the video-game playing group may have increased knowledge of how treatment relates to their health, their increased perceived control regarding their health outcomes and improved confidence in their ability to treat and recover from cancer.

No matter what the underlying reasons, this study shows that there are exciting and new approaches for improving health and condition management with gaming technology.