Icon for arrow pointing top Icon for arrow pointing right Icon for arrow pointing left Icon for arrow pointing bottom Icon for navigation opening Icon for navigation closing Logo of Amsterdam University Of Applied Sciences Logo of Facebook Logo of Twitter Logo of Instagram Logo of LinkedIn Logo of Mirabeau Logo of DDB & Tribal Logo of Fabrique Logo of Woedend Logo of Achtung Logo of Media Monks Logo of Dept Logo of FHV BBDO Logo of Momkai

Terra II

An Uplifting Video Game Narrative for Cancer Patients
  • Client: 
    The Netherlands Cancer Institute & Tilburg University
  • Team: 
  • Disciplines: 
    Visual Design, Storytelling, Game Design
  • Schoolyear: 
    2019 - 2020

The Netherlands Cancer Institute was looking into helping head and neck cancer patients reduce their levels of stress by exercising more. For this project, which was initiated by a previous team at the master’s programme, we were tasked with designing an engaging interactive narrative for a 12-week rehabilitation programme.

The exercise bike game controller and preexisting video game components had been developed by other students at the programme.

Patients would keep themselves entertained with a video game that could only be played while they exercised on a bicycle. The concept had both physical and cognitive benefits.


The Netherlands Cancer Institute was interested in developing the concept further and that is when we came in Our narrative follows Marwin 3001 on his quest to explore new planets in space and bring back this information to his home, Planet X.

First Findings

We began our project with research on topics including therapeutic video games, design methods for interactive story creation, and video game motivation. We discussed with physical therapists at The Netherlands Cancer Institute to understand the needs and abilities of future users of the exercise rehabilitation game. It was clear that our biggest challenge would be to balance a fun and engaging story while maintaining necessary therapeutic benefits.

Exploring New Worlds

We began this project by brainstorming well-loved fables across cultures. We drew inspiration from these stories to help us ideate on engaging and uplifting narratives. We used a narrative design tool to write our story premise, setting and characters. We then added a mission for our story’s protagonist and glued all of the elements together to create a cohesive narrative quest.

We created a setting very unlike planet Earth to give patients a humorous escape from the stress of daily life. Marwin, an alien from Planet X, has been chosen to explore the Terra Solar System the first time. His name is derived from ‘Darwin’ +’ Martian’, as he is an alien on a quest for knowledge. His helper, A.N.N.I.E (Artificial Neural Network Intelligent Entity), is there to support Marwin on his exploration.

Mission Prototyping

Our first prototype of the story was a paper flipbook. We tested this with the bike to see how the narrative held up with the exercise interactions.

Next, we further developed the characters and storyline, creating sketches and diagrams of the story elements. To introduce the story, we created an animation of the story premise to present at the beginning of the game.

Since the game was already partially developed by two previous teams of the master’s programme, we altered the existing Unity game and added new graphic assets to the game-world to match our new narrative.

We developed a working prototype of one branch of the storyline in Unity. To give a larger branching storyline overview, we developed more of the story in Twine (an open source tool for creating interactive fiction).

Challenge Accepted!

While creating this story universe was uplifting, at times it was difficult to know how our story would be perceived by those who would be interacting with our game. We had to keep in mind that there was a need to balance our detailed and humorous story-world with the existing therapeutic elements. It was also necessary to fit our plot and characters into the existing game elements. We overcame these obstacles by incorporating the minigames and intervals into our storyline in a creative and fun way; for example, the patient had to cycle fast to ‘propel Marwin’s spaceship’ during the intense biking interval.

Onto the Next Universe

We learned that a story needs a universe. If characters have detailed backstories you can begin to realise how they will act in particular situations. We built a personality for Marwin 3001 before we gave him a quest in the story. This allowed us to ask “what would Marwin do?” when creating the branching story.

Good stories also include archetypal characters such as the helpful assistant or the hero.

These storyline conventions can be used to help ground your story and make it feel more familiar to audiences. Video game stories add layers of complexity where game mechanics, visuals, audio and animation all add to the story’s meaning. For this project, it was particularly important to strike a balance between conventional and engaging storytelling and therapeutic game elements.

Share this case on: