‘My motivation is to better understand where cancer comes from’
Interview | Maurice Zandvliet, Specialist in Medical Oncology
Maurice Zandvliet studied Veterinary Medicine because he wanted to mean something for animals. Now, he is a Specialist in Medical Oncology and he treats animals from all over Europe in the UU Animal Cancer Centre in the Academic Veterinary Hospital. ‘We’re the only centre in the whole region that can provide radiotherapy on this level.’
We start the interview while Zandvliet is looking through a microscope. ‘I’m briefly helping out with cell research of biopsies to make diagnoses. But I can easily talk at the same time.’
Are you still happy you chose Veterinary Medicine back then?
Zandvliet looks up and does not return to his microscope anymore. ‘Yes… but as an oncology specialist, I deal with more limitations in veterinary medicine than I would have had in medicine for humans. Oncology is a very technical specialisation in which an awful lot is possible in human medicine. We can also do much with animals, but we do hit the limits earlier. On the other hand, it also seems very difficult to me to have these kinds of conversations with human patients.’
Do you often collaborate with doctors?
‘Not in patient care, but I do in research. Like with researchers from the Hubrecht Institute, UMC Utrecht and the Princess Máxima Center for pediatric oncology. Bone cancer in dogs looks very much like bone cancer in children. For children, the intervention is early and saving the arms or legs is tried as much as possible. For dogs, that almost never works and we amputate faster. So the dog no longer has any pain. We help the doctors with the amputated dog paws. They were wondering: what do we see on MRI scans? Now they can compare an entire paw to a scan of that paw. That provides them with new insights for treating children. And, conversely, we learn from them too.
We also develop tumoroids from bone-tumour material together, and we want to test new medications on those. That’s what I like about this place. It’s the veterinary medicine I love on the one hand, and I get the latest developments from human medicine on the other.’
Is that why you like to work at the Academic Veterinary Hospital?
‘Definitely, I can do research here where medicine for animals and humans intersect. And the patient care is very interesting and challenging. The animal owners who come here want to use all possible treatments that are realistic to help their animals. We are the only centre in the whole region that can provide radiotherapy on this level. The closest after us is in Lille in France. We get animals from all over Europe.
Besides that, I contribute to education, and hope to inspire and teach future vets that an animal with cancer doesn’t have to be euthanised immediately. We can still mean a lot to the animals and their owners.’
The closest other radio-therapeutic centre at this level is in France in Lille
I understood that a new radiation machine was recently installed?
‘That’s right, that’s a new linear accelerator, an instrument that’s also used to irradiate humans. The old machine needed replacing, but that’s an enormous expense. Our charity fund Friends of VetMed helped to fund the installation together with supplier Elekta and a number of other partners. With this machine, we can irradiate tumours very accurately and the animals require fewer radiation sessions. We’re very happy with it!’
Can you tell us something about the treatments you carry out here?
‘In the UU Animal Cancer Centre, we work in a group of colleagues who each have their own expertise. It’s not realistic to think one vet can do the entire treatment track of a cancer patient. The treatments consist of oncological surgery, radiotherapy and medical therapy, such as chemotherapy. Besides that, we can’t do without the colleagues from other departments. You need imaging with X-ray photos, CT and MRI in order to see the tumours. The biopsies, tissue samples, are investigated by Pathology. During radiation sessions, we need Anaesthesiology because the animal mustn’t move.
What are the latest developments?
The latest are resources that inhibit or stimulate the immune system to get a tumour under control. The treatment of hormone-producing tissues in the body is another major development. The research into that lies at the intersection of veterinary medicine and medicine. The genetics of cancer are also fascinating. For instance, some dog breeds have an increased risk of cancer. This is the domain of the Expertise Centre Genetics of Companion Animals. They chart the genetics of companion animals. That makes a big difference for the breeding and health of companion animals in the future.’
Of course, we only resort to treatment if the strain on the animal is acceptable and proportional to the expected gains
The treatments are expensive, how do pet owners pay for them?
‘For oncological treatments, you’re indeed quickly talking along the lines of several thousands of euros. I don’t have the impression that many patients are insured, so people have to pay for it themselves. It’s a lot of money, but pets are often also very important to people. They sacrifice holidays or other big purchases for them. These days, they also occasionally do crowdfunding. For instance, we treated a dog belonging to a lady from Latvia for a brain tumour. That dog had his own Instagram account and his image later became the logo for a coffee manufacturer. Afterwards, I was sent packs of coffee featuring that dog’s head, a big Bullmastiff.’
What’s it like for animals to undergo cancer treatment?
‘That varies per type of tumour, but the side effects are usually not insurmountable. For instance, after radiation, even the more serious side effects heal well after a couple of weeks. Of course, we only resort to treatment if the strain on the animal is acceptable and proportional to the expected gains in lifespan.’ Such a consideration is an ethical dilemma. We do that very methodically based on objective data from science. But emotion also comes into play, of course. You’re dealing with people for whom the animals are important parts of the families. The conversations with owners can sometimes be difficult.’
What inspires you in this line of work?
‘I gain a lot of satisfaction from being able to help both animals and humans. In the research field, my motivation is to gain a better understanding of where cancer comes from. And I still enjoy it if students ask me very smart questions. Because then I think: I hadn’t looked at it like that yet, how am I going to explain that?’
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