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Young patients fight cancer, one video game at a time

Re-Mission 2
A young cancer patient playing one of HopeLab's "Re-Mission 2" games.HopeLab
Re-Mission 2
A young cancer patient playing one of HopeLab'sHopeLab

Jose Guevara was 16 when his doctor first told him that he had leukemia.

"They gave me a breakdown," Guevara told NBC News. "'You have leukemia, you're staying in the hospital,' and they brought a wheelchair."

"Staying in the hospital" meant that Guevara had to spend upwards of three months at a time in a children's ward, an ordeal he endured thanks in part to constant care and support from both of his parents. But he was struck by the lack of emotional and psychological support for other young cancer patients — some as young as 10 years old. At one point, he estimated that for the roughly 130 children on his floor, there was just one therapist.

"I know there are a lot of improvements, new treatments, a lot of this, a lot of that. But we are neglecting the emotional part of the human being," Guevara said. "It's just: 'make the body better, make the body better.' But we forget about the mind!"

So when Guevara saw a poster in the waiting room roughly a year after his original diagnosis asking for consultants for a video game being developed for cancer patients, he jumped at the opportunity to give other children the kind of support he wanted to see.

Guevara was one of more than 120 young cancer patients who served as advisers for "Re-Mission 2," a bundle of browser-based games made by the non-profit health and technology company HopeLab and released for free online this week.

As the name suggests, the "Re-Mission 2" pack is all about fighting cancer in one way or another. The titles draw inspiration from the kind of casual games you might find for free online or download onto your mobile device. "Feeding Frenzy" has players steer a fanged white blood cell to chomp away festering tumors, while "Leukemia" and "Nanobot's Revenge" both cast players as a tiny robot fending off "Space Invader"-like waves of cancer cells. "Stem Cell Defender," our favorite, has you fling grumpy-looking bacteria towards a white blood cell in the center of the screen.

Taken together, they form something of a sequel (if you can call it that) to the original "Re-Mission," a first-person shooter released in 2006. While it wasn't a commercial blockbuster of, say, "Call of Duty" stature, "Re-Mission" was arguably a greater success: It demonstrably improved the lives of its players.

A study published in the Pediatrics medical journal two years after the game was released said that "the video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy." In other words, patients who played "Re-Mission" learned about their own condition faster and stuck to their treatment regimens more closely.

The study concluded: "The findings support current efforts to develop effective video-game interventions for education and training in health care."

Effective as it may have been, the original "Re-Mission" shooter wasn't a hit with every player. "It was a great game," said Ben Sawyer, one of the founders of Games for Health, an online community and conference program that brings together health and video game professionals. "But what was maybe a little more effective was something more bite-sized."

Hence the more cartoony, casual games of "Re-Mission 2."

"They asked the patients: 'Do you want the cancer cells to be medically accurate or to have personalities?'" Debra Lieberman, the director of Health Games Research at the University of California, Santa Barbara, told NBC News. "Overwhelmingly, [the patients] said: 'Make them as evil and menacing as you possibly can.' They were asking for evil cells because they want to confront them."

It's tempting to see a game like "Re-Mission 2," like any game about a serious real-world issue, as inherently trivializing. Or worse, it could give young and susceptible patients what Dr. Ernie Katz, director of Behavior Services at Children’s Hospital Los Angeles, calls "false hope," a suggestion that it's easy to cure cancer.

Katz emphasizes that while the "Re-Mission" games might have some didactic benefits, they're still meant to just be seen as, well, games.

"These are all complementary therapies," Katz told NBC News. "No reputable person is going to focus only on that at this point in time. These games are not meant to be a substantive or conventional medical approach, but rather help in creating the environment for real medical care to be effective."

Still, if games are only meant to provide a therapeutic outlet for patients, why turn their attention back to cancer once again? Lieberman said that while that may work for some patients, having the experience of combating one's own disease still offers profound psychological and emotional benefits.

"I'm sure there were some kids who didn't want to play the game because they didn't want to keep thinking about their cancer," Lieberman said. "But when they were thinking about it, boy, they wanted to play that game."

Guevara agrees. A video game on its own may not be enough to help people through their illnesses, he admitted, but "having this come to you shows that someone cares."

"There is some resentment in all of us; even after 'Re-Mission,' I was still a bit angry," Guevara said. "But there's also a bit of hope. At least as an adviser [to the game project], it makes me feel like I was part of a larger movement."

Yannick LeJacq is a contributing writer for NBC News who has also covered games for Kill Screen, The Wall Street Journal and The Atlantic. You can follow him on Twitter at @YannickLeJacq and reach him by email at ylejacq@gmail.com.