The game is an autobiography based on the Greens' experience of raising their son Joel, who was diagnosed with terminal cancer at twelve months old.
That Dragon, Cancer was initially aimed for release as a time-limited exclusive for the Ouya, whose makers helped to fund the game's development.
That Dragon, Cancer bore out from experiences that Ryan and Amy Green had after their third child Joel was diagnosed with an atypical teratoid rhabdoid tumor at twelve months of age.
[1][2] In early 2014, Joel's condition worsened, and the Greens temporarily moved from Colorado to San Francisco to take part in an experimental drug trial.
The new drug failed to relieve the boy's new symptoms, so the Greens, following the advice of the hospice, decided to remove his feeding tube, and he died on March 13, 2014, at the age of five.
[1][3][4] That Dragon, Cancer is played as an exploration game from both third- and first-person perspective through a number of abstracted scenes based on the Greens' experience with raising Joel from learning of his condition through his death.
[6] Alongside the interactivity, the game includes narration from Ryan, Amy, and other family members, as well as recordings such as voicemails that they had made during their time with Joel.
The scenes include cards, letters, and other mementos of support for the Greens, sent by people who had experienced similar losses in their life.
[1] He wanted to relay his experiences of raising Joel to a larger audience, and felt that an interactive video game would be a better medium to express a message of grace.
[9] Ryan Green had been able to secure a deal with funding from Ouya to develop the game, in exchange for a time-limited exclusivity for the micro-console.
[11] The additional funding, though significant, expanded the scope of the game and caused some setbacks, and for some periods, the Greens lived off loans and donations during the development.
[1] To that point the game had been written based on unknowing of Joel's fate, but with his death, the team recognized that much of what they had in place was more focused on the narrative from Ryan and Amy's side, and made it feel more of a selfish work.
[9][13] The Kickstarter was successful, raising more than $100,000 from nearly 3,700 backers, and through it, several funders shared with the Greens their own photos and stories of their losses of their children at young ages due to incurable or inoperable maladies, which would be included within the game.
[18] An audio documentary on the genesis of the game and the family's grief in preparing for Joel's death was produced by Gimlet with interviews by Ryan and Amy Green.
[24] That Dragon, Cancer was highly praised by reviewers on its release, with many favorably commenting on the overwhelming emotional difficulty presented that forces the player to experience and understand what the Greens had gone through with Joel.
[25][26][27][28] Sam Machkevoch of Ars Technica noted that while other games have tried to elicit similar emotions from its players, That Dragon, Cancer was unique in its approach for being "so frank, so nakedly autobiographical, and so imbued with its creators' spiritual identities".