Cancer, Chemotherapy and Radiotherapy

[I-Knight-I]

A large machine that works like one of the other vitals machines. Treats carcinoma but has some severe side effects. Also has a large power draw and costly build cost.

[I-Knight-I]

Rimworld allows for carcinoma's to be exercised (I think this is the right word) via surgery. Would it be necessary to add this?

[I-Knight-I]

We're going to need to add "Tumours" or other types of cancer for this to make sense. Unless, of course, we change Carcinoma's to only be treated by Radiotherapy?

[ghost]

I don't have too much experience with cancer treatments. It seems that, since Rimworld already allows for surgical treatment and medical treatment (it seems like medical treatment can reverse the cancer), there are already a couple of good ways to address the ailment. To be honest, I've never had carcinoma affect any of my pawns, so I don't know have any gameplay experience with it.

I'm sure it's possible to rework cancer treatments and make them more diverse if you're interested. Surgery IRL works best on localized cancer that hasn't spread, but often radiation or chemotherapy is done afterwards as well just to make sure all of it has been removed. Radiation therapy also is usually used to target a specific area.

Chemotherapy is unique because, as a systemic treatment, it can target cancer cells throughout the body. This is useful if the cancer has spread (metastasized). Of course, chemotherapy can also have uncomfortable side effects like nausea.

If you're interested, I think the best way to expand upon the cancer ailment would be to introduce metastasis. After some time, the cancer would have a risk of spreading to another body part. This would make chemotherapy viable as, unless you have a great surgeon, you might not want to risk doing many surgical procedures to remove all of the tumo(u)rs. Chemotherapy can also incorporate the IV system since chemotherapy treatments can be given intravenously.

[I-Knight-I]

I definitely like the idea of making cancers have a greater effect on gameplay by allowing them to spread. Currently Rimworld offers a simple "Carcinoma" of a single body part that can be excised regardless of where it is. I briefly tested this by giving a pawn a carcinoma in their torso and a surgeon (who wasn't even that great at Medicine IIRC) simply removed it without issue. In reality, the word "cancer" or even "carcinoma" is quite scary so maybe we should portray this better?

I can think of going down one of two routes:

A) Remove carcinoma's and replace it with 'cancer'. This starts as something simple which can spread to adjacent body parts over time if left untreated. Metastasis would be announced to the player via an in-game message (a yellow warning box like the "infection" warning).

B) Leave carcinoma's and their treatments but also add cancer too. Same as the above but, obviously, carcinoma is kept within the game. Could be better for compatibility and would require less patching and mucking around with game code. Might be a good idea to make carcinoma more common (as you said, it seems to be a rare thing) and possible to "catch" or rather develop over time.

Of course expanding on cancer would, as you said, allow us to also add chemotherapy in the form of IV treatment. Not sure how we'd make it refuelable though. What chemical would be used for IV chemotherapy? Would it be possible to manufacture in Rimworld?

[I-Knight-I]

Cancer has been added along with the ability to spread to other vital organs. Now need to work on Chemo/Radiotherapy.

[I-Knight-I]

Going to make a patch that renames "Carcinoma" as "Tumour". Will also remove the ability to excise it so that the player must instead use Radiotherapy. Might add additional hediff to tumours that cause more damage to the pawn whilst it exists.

[I-Knight-I]

Radiotherapy:

Radiotherapy will be done in the form of a 'usable bed'. The same way you right-click on a hospital bed to make the pawn use it is the same way that this'll work. A pawn with a tumour will need to be directed to use the bed and, from there, they will go under treatment by the radiological laser present above it. The longer the pawn is in the bed, the lower the severity of the tumour and lower the damage done by the hediff stages. There will be many hediff stages to visibly show improvements on the pawn's health after treatment for even a small amount of time. After the severity reaches 0 the hediff will be removed.

Chemotherapy:

Chemotherapy will be available through an IV. The IV will only function when a Pawn with Cancer is adjacent AND inside of a bed. Here they'll be made unconscious (not how it works in real life but better for gameplay) and a message will pop-up on the right where "Minor Break Risk", etc... appears saying "X pawn(s) receiving chemotherapy". In order to stop the pawn from receiving treatment and to wake them back up the IV drip itself must be "flicked off" by right-clicking manually and designating for disabling.

What this does is make the player more aware and in control of the treatment used to help pawn's with cancer. In real life, cancer treatment is specific, requires time and effort to setup and needs overseeing regularly to ensure it is beneficial and still viable as a treatment option for the patient. I think it's best we convey this through the mod by adding a tiny bit of micromanagement. Fortunately, only 1-2 pawn's will ever have cancer at once and so the tedium and annoyance of that micromanagement is extremely slim It'll merely be focusing attention on ill colonist's and up to the player to decide how well they're treated for their cancer(s).

[ghost]

I think these are cool implementations that will further encourage people to create late game hospitals with tons of fancy machines.

Regarding the removal of surgically removing tumors (pun not intended), I think it may be interesting to keep the option of surgical removal. This allows early game/low tech colonies to still have a way to treat cancer. However, to keep chemo/radiotherapy viable, perhaps the surgical removal option can be made more risky (i.e. requires a really great doctor). This way, people will use chemotherapy and radiotherapy if they are able to afford it since those higher tech options are less risky and less skill-involved.

[I-Knight-I]

Added "Chemotherapy - Negative Symptoms". Chemo is now dangerous and should only be used on the strongest pawns (those who's vitals are all at 100%) as each stage of Chemo's hediff adds -10% to Breathing/BloodPumping/BloodFiltration/Metabolism/Moving and increases fatigue and hunger by 200%.

If left alone for too long then each of the above capacities will reach 0% and the pawn in question will die. Adds that level of micromanagement I mentioned above earlier. Chemo isn't a nice treatment, unfortunately, and this should display that well. In Rimworld it is, however, very effective reducing the Cancer hediff by 0.000025 every second the Pawn is under its influence (this is like reversing 0.5 days worth of cancer growth).

Players will be warned when the Pawn is severely ill after having taken Chemo for too long - EDIT: They will be warned at 0.7 severity onwards.