Vivianne Tjan-Heijnen Vivianne Tjan-Heijnen Sacha Ruland

A doctor with a mission

In Body
Written by  Annelotte Huiskes Wednesday, 20 February 2013 15:21
Vivianne Tjan-Heijnen knew from a young age that she wanted to become an oncologist. When she was 16, her grandmother died of bladder cancer without even knowing she was ill. It was simply never discussed: “Only my mother and her brother knew. That’s just the way it was in the early ‘80s. My grandmother lived with us, so it had a big impact on me. I decided then and there to become a doctor to make sure no-one else would ever die of cancer. Naturally that’s what I thought as a teenager.” Now, over 30 years later and the head of the Department of Medical Oncology at the MUMC+, she is committed to providing quality care for cancer patients.
 
Professor Tjan-Heijnen is a doctor with a mission: better treatment and better support for patients. While she was studying internal medicine in Nijmegen, her father developed lung cancer. Before it was finally diagnosed, and also later during his treatment, Tjan-Heijnen experienced first-hand what can go wrong. Initially she specialised in lung cancer, but when a position opened up in the field of breast cancer in Nijmegen she decided to apply. “They weren’t very keen on me because I had no experience in that field. But due to a lack of suitable candidates, I got the job anyway”, she explains with a laugh. For some time she worked with both lung and breast cancer; only when she was appointed in 2006 head of the Department of Medical Oncology in Maastricht did she decide to focus exclusively on breast cancer.
 

Centre of excellence

In 2008, following the MIRROR study, Tjan-Heijnen gained international renown in the field of breast cancer as well. She demonstrated that treating even minor lymph node metastases with medication can increase survival rates by 10%, thus prompting the implementation of revised guidelines for breast cancer treatment in 2010. “The MIRROR study is a great example of how doctors can contribute to clinical research. And it generated quite a few spinoffs: our first publication in the New England Journal of Medicine kicked off a series of other articles and presentations – for example, at the American Society for Clinical Oncology (ASCO) – and major coverage in the international press. During this time, the Maastricht research team was also able to position itself as a centre of excellence for breast cancer treatment in the Netherlands”, she says with pride.


Fertility

Of the 14,000 breast cancer patients diagnosed in the Netherlands each year, 86% are still alive after five years. That is 10% more than ten years ago. According to Tjan-Heijnen, breast cancer treatment is taking great strides. “While surgery is still the cornerstone of treatment, in the future this will increasingly be replaced by medication. For example, hormone and HER2 research is currently being conducted in Maastricht on four very promising new drugs. We’re finding out more and more about the contents of a cell, which means we can develop more targeted and effective medication with fewer side effects.”
 

With improved medication and diagnostics, treatment has unavoidably become more complicated. “You have to take more factors into account. Patients are more informed and face more dilemmas. The combination of breast cancer and fertility is a good example in which sound advice is extremely important. Each year I consult with about 30 young women from around the country. Nowhere in the Netherlands do medical oncologists and gynaecologists work in such close collaboration as they do here in Maastricht. You’re constantly weighing up what the best treatment option is: do you opt for chemotherapy? What are the chances this will trigger menopause? Should they have embryos frozen or only the egg cells? Embryos tend to have a higher success rate. If you give women the opportunity to make their own decisions, it helps them to process things better later on.”
 

Top 5

Tjan-Heijnen is extremely active in the field of quality assurance. “I want to show – not just here in Maastricht, but at other institutions as well – how important communication and teamwork are in offering patients the best possible support during the decision-making process. This mainly concerns the quality of life after treatment. Because when it comes to the actual treatment of the breast cancer itself, we’re doing a very good job in the Netherlands; we’re among the top 5 in the world.”
  

Collaboration

With the Department of Medical Oncology in good order, Tjan-Heijnen is ready to take on a new challenge: Director of Regional Collaboration in Oncology. “I’ve been asked to set up an oncology centre serving the southeastern Netherlands. I want to make sure that all patients in Limburg and in the south of Brabant have access to the same high-quality care, with the same protocols and approach to consultation and discussion, and with a focus on doctor–patient communication. Many protocols have of course already been established at the national level, but there’s always room for improvement. By focusing on quality, by reporting on everything and regularly evaluating it, and by discussing complications and sharing experiences you can look at the same problem from different angles and make any changes as needed. That’s my mission.”
 

Vivanne Tjan-Heijnen (1964) has been head of the Department of Medical Oncology since September 2006 and chair of the Multidisciplinary Oncology Board at the Maastricht University Medical Centre (MUMC+) since January 2008. She also chairs the National Breast Cancer Organisation of the Netherlands (NABON) and until recently chaired the committee for the evaluation of new drugs in oncology (cieBOM) of the Dutch Society of Medical Oncology. On 1 November 2012 she was appointed director of Regional Collaboration in Oncology. 
 

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