Supportive care

About the Supportive Care Department

Care

• Multidisciplinary collaboration

  The department advises the solid tumors, neuro-oncology, hemato-oncology and stem cell transplantation departments on optimal supportive care.

  Supportive care is inherently multidisciplinary. Therefore, we work with a broad supportive care group that includes all relevant disciplines. Parents are also closely involved, as they often raise questions or provide ideas about supportive therapies.

• Guidelines

  We develop and implement clinical guidelines to improve care. This takes place in close collaboration with the Quality department.

  After implementation, we monitor guideline adherence using indicators. If utilization is insufficient, we improve the implementation strategy or adjust the guideline itself.

• Nutrition and dietetics

  Because nutrition is an essential component of supportive care, the dietetics department is part of Supportive Care. Six dietitians work together to optimize the nutritional status of children with cancer. They advise treatment departments and support children and parents where needed.

  For frequently asked questions, we refer to the nutritional guidance available on the website.

  In 2026, a project will start aimed at improving the implementation of blended diet within the Máxima Center, following questions raised by parents.

• Complementary care (integrative medicine)

  Parents regularly ask whether complementary therapies may be used alongside standard treatment. For this reason, the Máxima Center has started implementing complementary care under the leadership of pediatric oncologist Miranda Dierselhuis.

  In 2026 we will begin with:

  • developing a website with a decision aid for parents

  • an inventory of existing complementary interventions

  • implementation of evidence-based complementary interventions

  The goal is to create a structured complementary care program that actively supports parents alongside standard treatment.

• Fertility

  Treatment with certain chemotherapeutic agents can lead to reduced fertility. Therefore, guidelines for fertility care have been developed, including indications for fertility preservation. These guidelines have been implemented at the Máxima Center.

  Irene IJgosse, nurse specialist in fertility, provides counseling and guidance together with colleagues. When possible, they support children in fertility preservation procedures, such as sperm banking or ovarian tissue cryopreservation.

Research Focus Areas

• Onco-infectiology

  This research line consists of two components.

  1. Rapid diagnostics in fever

     We investigate how to quickly determine whether a child with fever has a bacterial or fungal infection. If an infection can be ruled out, the child may be discharged earlier.

  2. Fungal infections

     We work on improving diagnostics, including:

  • measurement of circulating DNA (cfDNA) in blood and bronchoalveolar lavage (BAL) fluid

  • analysis of exhaled breath

  • optimization of radiological diagnostics

• Nutrition and physical activity

  We investigate the relationship between nutritional status (fat mass and fat-free mass) and treatment toxicity. The hypothesis is that both undernutrition and overnutrition are associated with increased toxicity.

  We also study the causes of undernutrition and overnutrition, with the aim of developing interventions that ultimately reduce treatment toxicity.

• Nursing research

  Dr. Aeltsje Brinksma leads the nursing research program. The focus is on improving symptom control through the use of patient-reported outcome measures (PROMs).

• Endocrinology

  Professor Hanneke van Santen leads the endocrinology research program, which focuses on the hormonal effects of childhood cancer and its treatment.

  An important focus area is hypothalamic damage:

  • improving diagnostics

  • prevention where possible (for example through less radical surgery)

  • supporting children and parents when damage occurs

  • symptom relief with medication

• Nausea and vomiting

  Evelien de Vos-Kerkhof leads research into improved preventive treatment for nausea and vomiting.

  She conducts studies on optimizing medication use and develops guidelines to ensure that healthcare professionals have up-to-date knowledge for optimal symptom management.