Working as a research assistant in an immunology laboratory watching cancer cells multiply under a microscope during the day and playing video games at home with her husband in the evening gave Pam Omidyar the idea to develop a video game specifically for adolescents and young adults with cancer.
She teamed up with oncologists, behavioral psychologists, nurses, game developers, and young cancer patients to build a video game designed to combine biologic accuracy with an honest depiction of the challenges faced by these patients.
The game, Re-Mission, which was released last spring by the company she founded, HopeLab, was shown in a randomized controlled trial to significantly improve young cancer patients' cancer-related knowledge, quality of life, cancer-specific self-efficacy, and adherence to medical treatment.
The data were reported at the Society of Behavioral Medicine's Annual Meeting & Scientific Sessions and at the Teenage Cancer Trust's International Conference on Teenage and Young Adult Cancer Medicine.
“This game works,” study investigator Steve W. Cole, PhD, Vice President of Research at HopeLab, said in an interview. “Re-Mission impacts children's sense of control over cancer and behaviors that we know are important for the long-term health and well-being of kids with cancer.”
The computer-based video game consists of 20 “missions” inside fictional cancer patients undergoing chemotherapy, radiation, or immunotherapy. Players control a microscopic robot that destroys tumor cells, battles bacteria, and manages side effects with traditional therapies.
“Surprisingly, this is the first randomized clinical trial of any intervention that is focused specifically on adolescents with cancer,” Dr. Cole said.
The trial, led by Pamela M. Kato, EdM, PhD, of HopeLab and the Department of Pediatrics at Stanford University School of Medicine, involved 375 male and female cancer patients age 13 to 29 from 34 medical centers in the United States, Canada, and Australia.
The participants were randomly assigned to receive computers containing a control video game, Indiana Jones and the Emperor's Tomb, or computers containing the control video game and Re-Mission.
About 80% of patients eligible to play Re-Mission did, and the results were assessed at baseline and at one and three months. Young people who played Re-Mission maintained higher blood levels of chemotherapy and showed higher rates of antibiotic utilization.
“This is really a demonstration that video games can be effective tools for behavior change in the real world,” Dr. Cole said.
“Just playing a video game sometimes seems trivial, but if the game is constructed in the right way, if it's engineered with care and precision, then these can actually be very effective tools for behavior change—for behaviors that really matter in terms of health and well-being.”
The game can be ordered free of charge at www.re-mission.net. The Web site also provides an interactive, online community for teens and young adults with cancer. The video game is available in English, French, and Spanish.