Transcript for Susan Millar & Kurt Squires on Treating Cancer with Games

Jim Fleming: Imagine you’re sitting on the bus, returning home from work. You pass the time. You take out your Smartphone or computer notebook. You play a game. But instead of shooting angry birds or harvesting crops in farm field you choose a game that lets you blast imaginary cancer cells, except they are not imaginary. They are from a real cancer patient and the game you play may help save a life. That’s the future. And interdisciplinary team of biologists, education researchers and game designers is working on it with University of Wisconsin Medicine. Anne Strainchamps visited the educational game lab at the Wisconsin Institutes for discovery. And got Professor Susan Millar, Kurt Squire and one other student to show her a game.

Kurt Squire: So Oncology, this is a game prototype that’s designed to give you, the player, the experience of being a doctor. So we’ll pick a patient here. We’ll pick Mr. Badger. And this is a patient who, you start reading about their history and you realize, that they’re here because of a carcinoma in their tongue. The first that you do is you talk to the patient, get a little sense of their life history. In this case we find out that he smoked for 30 years and is attempting to quit. That’s probably going to be part of what’s happening.

Anne Strainchamps : So he’s says grumble.

Kurt Squire: He says grumbling. He’s not happy about having to quit smoking. And here what you are seeing is actual authentic patient C T scan, that you are looking at it here. This is a real thing that doctors will look at. We have some kinds of hints and guides to help the new player who may have never looked at this before. When a physician looks at this and they can kind of jump right in and start to know where are the cancers? And what you do is, as you go down, you pick the different slices and then you target where you think it would be. And then when you’re done you hit submit. And you get feedback. So you can see your accuracy, actually had zero percent accuracy. And I wasn’t getting any healthy tissue, so I have to go back and try it again. Once it’s kind of close enough we let the person go into the next phase which is where they set up the beams and they actually treat the player.

Anne Strainchamps : And then once you’ve treated the player, does it say success?  You’ve eradicated the tumor.

Susan Millar:  It’s more complicated than that. It’s like how much of the healthy tissue did you harm that you shouldn’t have? How much of the cancerous tissue did you actually get?

Kurt Squire: That can have a really strong emotional impact on the player, particularly if they’re kind of trying to save this player. Sometimes they realize no what matter what they do there’s nothing they can do to save them. And we have people worry, you know, they start kind of tearing up a bit. This going to be too emotional. We think that’s a good thing. We think having people emotionally [xx] in their learning and  really caring. Because that really makes a difference in the world. We think that’s really a good thing.

Anne Strainchamps : So unlike having your 15 year old kid play hours of call of duty and become extremely good at killing people, in this case your 15 year old could play Oncology and become incredibly good at targeting tumors.

Susan Millar:  Right. In an ideal world, if they’re participating in helping to identify a cancerous tumor for real patient and if we would get the medical people to provide information about the outcomes for those patients, that’d be extremely powerful.

Anne Strainchamps : So explain this, you might actually at some level these wouldn’t be just fictional patients, there might be real patients.

Susan Millar:  They would be anonymised. The players would never know who the actual individuals were , but they would be able to know that there were successful treatments.

Anne Strainchamps : Or maybe they wouldn’t be so successful in which case it is a little scary.

Kurt Squire: One of the issues that there’s actually a lot of variance right now and how different doctors read these images and then how they treat them. There’s enough that it’s a little scary and I suggest anyone out there to get a second, third, fourth opinion. And this is bit because research finding is based on this. Like they would take five doctors, line them up, look at the same image and they would treat in five wildly different ways.

Anne Strainchamps : So explain again how this would work? How do you get the mythical 13-year-old kid, who is playing this? At what point does that kid go from playing a fictional game to actually being able to treat real or help treat real patients?

Kurt Squire: So imagine they encounter this game first as a part of health class where they are learning probably a couple of things. One some basic anatomy so having encountered the parts of the body. And they learn both the names of the systems and what they actually do. And two they could be learning about future careers in science. Many people may not know there are huge career opportunities for technicians, radiologists. And then third they might say, you know, if you’re playing this then play some at home and you get really good at it. There actually is an opportunity to work with the real patients. And at that point they would be playing the game but they would also be in online community of different players some of them are medical professionals. And then at that point, largely, probably be outside the class. Although it’s entirely possible, a teacher could say, you know what, one way to get in hanging in this course is to actually get to become that level of , you know

Anne Strainchamps : So it’s performance based.

Susan Millar:  Definitely performance based. You’ll have to be able to perform largely at the level of expert radiologist.

Anne Strainchamps : Can you imagine a day when  a doctor, who is treating a patient for cancer, might get a scan and say, you know what, I’m not really sure of my reading on this. Let me see what the 8th grade class down the street thinks about this.

Kurt Squire: Yes we’re talking about getting a second opinion or a third opinion or two millionth of opinions. You could imagine them seeing here’s someone who’s rated may be 500 images and has been rated to be a real expert. And they could go look at that person’s experience. We could even combine the expert’s kind of second opinions of millions of people and then create an aggregate optimized sort of solution that is based on pulling all those different opinions together. 

Anne Strainchamps : Is it eventually leading to crowd sourcing cancer treatment?

Susan Millar:  That’s our dream. We believe that there’s a lot of energy out in the public that being effectively used, [xx] is calling it [xx] of surplus. We believe we can take that creative energy and harness it for all kinds of positive outcomes such as this one.

Anne Strainchamps : So that the other game we’re going to look at is virulent. What are we looking at here?

Kurt Squire: This game gives a player a deeper understanding of just of kind of the way a virus infects itself. The steps that it has to through to reproduce itself. And kind of what it does while it’s in the cell. And what actually constitutes an infection.

Susan Millar:  I think it’s deeply engaging. I’ve watched a number of young people play it and they actually get really identified with being a virus. And get upset when they fail to infect the cell and replicate themselves. And I particularly failed when I played it because I couldn’t even get into the cell at first. And then when I got into the cell I got zapped by, what were those things called, They beat me. They sliced me.

Kurt Squire: One thing, if you ever try to learn this in school, One of the real challenges is that you read a text book definition, which you actually have it here on the screen, RNA genomes also need energy to make MRNA and you read that and these are all complicated words like nouns you don’t know, describing these verbs you don’t know. You might get a picture. Whereas in this case you actually get to do it. So you’re actually getting a language connected to what you are actually doing which is the best way to learn. It’s meaningful. It’s in context, relates to what you’re trying to do.

Anne Strainchamps : I can see from just looking at this, it’s like some cool kind of space based game and sort of looks very [xx] in outer space, stars getting around, yes inner space, and this thing Mitochondrial looks like some weird yellow dark station and there’s something else that looks like a purple asteroid. And so I can see suddenly I would have no trouble at all remembering what a Mitochondria is.  

Kurt Squire: That the big old yellow thing.

Anne Strainchamps : So what do virologist thinks of this game?

Kurt Squire: Oh, the virologists love it. For them, part of it is real joy in seeing the work that they do every day. Turned into a video game and put into screen. But then secondarily, they start to think about their own models that they have. As they see it represent , they say that’s really how it happens? So you might have an immunologist and virologist playing together and then having a discussion about what each one thinks happens. If we can build something for them to have a conversation to move forward, then we know we’re doing a good job because we’re pushing the boundaries of our understanding of the systems.

Anne Strainchamps :  So you’ve have got a game here that virologists and immunologists consider and argue about. No that’s not how it works, you know, RNA replicates this way. And at the same time, a 15-year-old Kid might think this is fun to play.

Kurt Squire: Exactly.

Anne Strainchamps :  That’s what we mean by authentic learning. If it’s fun for scientist, it should also be fun for other people. And the way these games are leveled, the first time a player goes in as amateur, they are going to see entirely different things and have entirely different challenges than the virologist were going to see things in  a completely different way.

Kurt Squire: One of my colleagues, during the [xx] said, mouse clicks are kind of the 21st century steam engines. There’s all these people who are playing games and identifying patterns. It’s all kind of going up into the ether. And if we could design games where people were using those mouse clicks as ways to help use people’s natural pattern recognizing ability or a problem solving ability and then use them to further social good, we have a real opportunity for something transformative.


Comments for this interview

I teach with games but (Wkaulbach, 03/31/2012 - 3:38pm)

My games are simulation without technology. The students interact in class but i would love to find out how to make my activities into on line games. How could i do this? Who offers training? Any good WWI or II games.

Thank You (Janet, 03/26/2012 - 10:03pm)

Hey Thank you for the link!

Link (Derick, 03/25/2012 - 2:44pm)

After digging around on the internet, I found a link to the Virulent game here:

Agreed (Libby, 03/25/2012 - 12:49pm)

I would also like to have a link if possible, for use in a biology course. Thanks.

Interesting (Caity, 03/25/2012 - 11:07am)

How is it possible to access this game? I would love to use it in my class.


Very interesting; I'm going to use it in my Training & Development course.

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