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Nico Poux, 14, plays the HopeLab game, called Remission 2.0, .in his Palo Alto home Wednesday, April 24, 2013. Diagnosed with Acute lymphoblastic leukemia when he was 6, he's undergone radiation and a bone marrow transplant while battling two relapses. The key he says, is having a positive outlook. That and being able to kill time during the long stretches in waiting rooms, treatment rooms, hospital beds. He's found something that helps. A video game developed by HopeLab, a nonprofit founded and supported by Pam Omidyar (also supported by husband Pierre, who founded eBay). Poux was among 120 young cancer patients who helped develop the game, by playing it and offering suggestions. (Patrick Tehan/Bay Area News Group)

Nico Poux knows a lot about cancer.

More than I do. And if you're lucky, more than you do, too. The 14-year-old Palo Alto boy was diagnosed with acute lymphoblastic leukemia when he was 6. He's undergone chemotherapy, radiation and a bone marrow transplant, all while battling two relapses.

He's developed a certain unfortunate expertise -- the kind he was able to deploy in helping an innovative nonprofit build a set of video games that researchers have determined actually helps young cancer patients stick with their treatment programs and generally feel better about themselves.

"I've had a lot of practice with this one," Nico says, as he sits down at the computer keyboard and prepares to dominate "Nanobot's Revenge," a game that stumped me at Level 3.

Liz Poux with her son, Nico, 14, in their Palo Alto home Wednesday, April 24, 2013. (Patrick Tehan/Bay Area News Group)
Liz Poux with her son, Nico, 14, in their Palo Alto home Wednesday, April 24, 2013. (Patrick Tehan/Bay Area News Group) (Patrick Tehan)

The game, one of six new titles that HopeLab of Redwood City will release on Monday, is the latest product from the nonprofit that was launched in 2001 by Pam Omidyar, a former immunology researcher and the wife of eBay founder Pierre Omidyar. Pam Omidyar, a gaming enthusiast, wondered whether there was a way to use the power of video games (ever watch a kid play a game he or she was really into?) to help young cancer patients get a handle on their devastating diseases.

Seven years ago, HopeLab launched "Re-Mission," a game that sent a nanobot into a cancer patient's body to wipe out cancer, eliminate infections and manage side effects from treatment. In part, the game was designed to educate kids about cancer and the treatments that were necessary to help them get well. HopeLab researchers assumed that better educated kids would be more likely to diligently take their medications, even when they were in remission and felt fine.


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And follow-up studies did show that kids who played the game were more likely to be true to their treatment. But not for the reasons that researchers first assumed, explains Steve Cole, HopeLab's vice president of research and development. Rather than becoming better patients because they were better educated, he says, the game-players became better patients because they felt more in control, more in power to take steps to battle back against their cancer. The kids became more "resilient," the researchers like to say.

Nico Poux, 14, plays the HopeLab game, called Remission 2.0, .in his Palo Alto home Wednesday, April 24, 2013.   (Patrick Tehan/Bay Area News Group)
Nico Poux, 14, plays the HopeLab game, called Remission 2.0, .in his Palo Alto home Wednesday, April 24, 2013. (Patrick Tehan/Bay Area News Group) (Patrick Tehan)

"It really taught us that games can be powerful," Cole says. "But maybe what's most powerful about them isn't what they make you think, but how they make you feel."

After playing the game, for instance, young patients see needing a pill not as a symbol of weakness, but as a symbol of being powerful, of having the tools to wipe out what is wiping them out. It is the sort of finding that has encouraged HopeLab to press on in the gaming area.

The idea makes sense to Dr. Gary V. Dahl, a Stanford University professor of pediatric hematology and oncology, who treats young patients and has followed HopeLab's work over the years.

"One of the things for patients, for kids, is that it allows you to get away from the reality of being sick in a hospital facility with different things happening to you that are out of your control," Dahl says. "It gives you some control."

Monday's release will be a radical re-working of the original "Re-Mission," which was a bulky game with lots of code, meaning it had to be downloaded or installed from a disc. It took hours to play through to the finish.

As technology raced ahead and the lab's research piled up, HopeLab's game experts realized they could be much more nimble. Why not build multi-level "mini-games," that can be played on the Web? No need for downloads or CD-ROMs. Why not games that can be played in bursts, while waiting in a doctor's office, or lying in bed? In fact, why not look for games that are already popular and work with their developers to "reskin" them -- redrawing, say, a knight in armor as a cancer fighting drug and a gothic monster as a malicious cancer cell?

The result is "Re-Mission 2," a suite of six games that were designed with the help of 120 young cancer patients like Nico Poux. Nico, a slight teenager with doe eyes, a quick laugh and a quicker mind, says he isn't sure playing the games has made him a better cancer patient. But he has no doubt that the games will serve a powerful purpose.

Kids with cancer spend a lot of time waiting -- for doctors, for test results, for procedures. Normal routines are obliterated by chemotherapy. Marrow transplants can mean long stretches -- a year even -- of isolation, during which kids can't be around crowds or accept many visitors for fear of infection. Having something to do, a diversion, a project, a game that encourages you to improve your skills and conquer level after level, is a godsend.

"Keeping busy is the most important thing in treatment," Nico says. "Because if you get bored, you have lots of time to think about how horrible your situation is. Thinking positive is a key to recovery."

It's been nearly two years since Nico's marrow transplant; and his doctors are very encouraged.

"They told me to throw away all the medicine,'' says Liz Poux, Nico's mother. Is there a medical term for Nico's current condition, I ask?

"Uh, cured," Nico says.

Which, of course, is incredibly good news. Especially when the news comes from such an expert.

Contact Mike Cassidy at mcassidy@mercurynews.com or 408-920-5536. Follow him at Twitter.com/mikecassidy.





STUDIES OF THE EFFECTS OF THE VIDEO GAME 'RE-MISSION' ON YOUNG CANCER PATIENTS

  • For a look at the effects of HopeLab's "Re-Mission" video game on the brains of cancer patients, go to www.plosone.org and search for Steven Cole and Re-Mission.
  • For a look on the way the game appeared to improve patients' adherence to treatment, go to http://pediatrics.aappublications.org and search for Cole and Re-Mission.