“Trauma
Center New Blood”, a surgical
simulation game designed by ATLUS for the Nintendo DS and the Wii, has four
titles released currently in America: Trauma Center: Under the Knife, Trauma
Center: Second Opinion, Trauma Center: Under the Knife 2, and Trauma Center: New
Blood, with a new title, Trauma Team, recently released. This game simulates
the tension and pressures of performing surgeries on patients who have
undergone various traumas or accidents. One such accident encountered in the
early stages of the game involves the hospital director collapsing, and after basic
examinations, it is revealed that the director had several tumors on his lower
stomach and intestinal tracts ("Mahalo: Learn Anything")
To remove the tumors, I used what the game referred to as the Powell Procedure, which is the “Trauma Center” standard procedure for the removal of tumors. This procedure involves first locating the tumors using a small ultrasound, removing the tissue above the tumor, reducing the tumor size by draining the its cytoplasm, and then using a scalpel to excise the tumor from the surrounding tissues. Forceps are then employed to remove the tumor and when it has been successfully removed, a gauze-like synthetic membrane covers and closes the wound so you can move on to the other tumors quickly. Smaller tumors surrounding the main masses are burnt away with a laser.
After
successfully completing the procedure and undergoing copious amounts of stress
as a result (all procedures in the game are timed, and if the Powell procedure
is not completed quickly in the game, more cytoplasm builds up in areas surrounding
the tumors, forcing you to redo the procedure when it does), I began to think
about the feasibility of such a procedure as it relates to the removal of
cancerous tumors. While imaginative and seemingly realistic, the Powell
procedure appears to be a product of the game makers’ imagination as very
little record of the procedure exists in credible sources.
In the
real world, surgery has several functions in
cancer treatment including diagnostic, curative, preventative, palliative,
restorative, and supportive (“wikiCancer”). The type of surgery suggested in
the Wii game is a curative surgery, as it removes a sizable mass from the
infected organ in an attempt to remove or destroy the cancer. More
specifically, “Trauma Center” demonstrates excisional surgery, using a scalpel
to physically remove the entire tumor, and laser surgery, using concentrated
light to burn away infected cells. These categories of surgery are very general,
however, and they are often classified more specific terms to refer to the
organ in question and methods of entry. (For example, spinal
tumors are referred to in different terms than pituitary
tumors).
For the
removal of stomach cancers, a procedure called endoscopic
mucosal resection is often employed. This procedure involves the removal of
tumors from the inside lining of the stomach, and it is often limited by the
size of the tumors and by the extent to which they have grown/ metastasized (“Mayo
Clinic” Stomach Cancer). This type of surgical procedure often involves the
removal of normal, non-cancerous, cells surrounding the tumor in order to
ensure complete removal, but, although thorough removal of a tumor through
surgery can be effective, it is more often not the only tactic employed to
fight cancer.
In the “Trauma
Center” there was no mention of follow up procedures or alternative means of
combatting the tumors, an aspect which surprised me as the removal of the
physical mass may not be sufficient and the lack of follow-up or use of radiation or other
medications may increase likelihood of cancer return. In a 2006 study presented at the Gastrointestinal Cancers Symposium, cancer survivability
and mortality rates show a significant increase when surgical treatments are
combined with chemotherapy and radiation therapy treatments, with a median
survival period of 4.5 years for patients treated with
chemotherapy/radiation/surgery, compared 1.8 years for those treated with
surgery alone in a study comparing 14 patients treated with chemotherapy and
radiation and 17 patients treated with surgery alone. In"Trimodality
therapy is superior to surgery alone in esophageal cancer." researchers
concluded that chemotherapy and radiation therapy prior to surgery appears to
improve survival compared with surgery alone in the treatment of esophageal
cancer (Krasna). Based on the small variable and control populations discussed
in the study (totaling 31 individuals), the study seems limited and the results
may be affected by the small sample population. Previous trials mentioned have
also produced conflicting results, suggesting that further research may be
necessary and that options for treatment are better determined on a patient by
patient basis with personalized treatment.
So, in conclusion, surgery is an
effective means of cancer treatment in most cases, but is suggested to be more
effective when done in conjunction with chemotherapy and radiation treatment.
The “Trauma Center” Wii game, while not a true representation of how tumors are
removed from the stomach and intestinal tracts does promote surgery as an
effective treatment I the removal of cancerous masses. For the aspiring
pre-meds, the game is fast paced and stressful, especially as the patients
vitals begin to crash and the Wii remote refuses to hold still or cut as a real
scalpel would. It is not very realistic in its depiction of treatments or scenarios
for how patients end up in the hospital (ex: pulling a bullet out of someone’s
heart), but it is a fun game to play late at night while waiting for Bronco
delivery.
References:
"Endoscopic mucosal resection." Mayo
Clinic. Mayo Foundation for Medical Education and Research, 02 Aug 2011.
Web. 1 May 2012.
<http://www.mayoclinic.com/health/endoscopic-mucosal-resection/MY00813/>.Krasna, M.. "Trimodality therapy is superior to surgery alone in esophageal cancer." ASCO.org. American Society of Clinical Oncology, 2006. Web. 1 May 2012.
"Stomach Cancer." Mayo Clinic. Mayo Foundation for Medical Education and Research, 02 Aug 2011. Web. 1 May 2012. <http://www.mayoclinic.com/health/stomach-cancer/DS00301/DSECTION=treatments-and-drugs>.
"Trauma Center: New Blood Walkthrough -
Chapter 1 - Northern Lights." Mahalo: Learn Anything. Mahalo.com
incorperated, 2012. Web. 1 May 2012.
<http://www.mahalo.com/trauma-center-new-blood-walkthrough-chapter-1-northern-lights/>.
"Types of Surgery- wikiCancer." wikiCancer.
Wiki, 2012. Web. 1 May 2012. <http://www.wikicancer.org/page/Types of
surgery>.