GOODWILL DIFFERENT VIEW A treatment room at Alexander Monro Hospital Ten years on, the Alexander Monro Hospital in Utrecht, where de Jong is director of the board, is the first dedicated breast-cancer hospital in the Netherlands, and probably the world. It also has among the highest patientsatisfaction score of any Dutch hospital, an impressive 9.5 out of 10. “One out of seven women experiences breast cancer during their lifetime,” continues de Jong. “In the Netherlands, we have 17,000 new breast-cancer cases every year and nine women are dying each day from it,” she says. Globally, the figures are even scarier: according to the American Society of Clinical Oncology, more than 2.26 million new cases of breast cancer were diagnosed in 2020, even when so many doctors’ offices were closed. But caught early and treated effectively, it is survivable and much less traumatic to treat. As the otherwise fit American novelist Elizabeth L Silver wrote earlier this year after her diagnosis, at the age of 42, of a stage-three tumour that even a routine mammogram had failed to pick up, “Early detection is the difference between a small procedure or the loss of your breasts; the difference between a pill every day or months of chemotherapy and radiation with long-term side effects; the difference between a chronic issue that is dealt with using medication, or a life-threatening prognosis.” Named after the eminent 18th-century Scottish surgeon and anatomist Alexander Monro, who studied at the University of Leiden, the hospital offers everything from diagnosis, surgery, chemotherapy, state-ofthe-art nuclear medicine, reconstruction and an in-house tattoo artist who can make the nipple look perfectly realistic after a breast operation to genetic counselling and physiotherapy, all under one roof, where every patient is being treated for the same disease. Not that there isn’t a vast range of pathologies. “In the early days, there were considered only a few types of breast cancer that were known about.” she says. Some main treatment pathways were prescribed. “But now we know so much more extra details of every tumour-type and there are many more possiblities for treatment.” Indeed, of all the second opinions they are asked for – including some from other countries – at the Alexander Monro Hospital, 12 per cent receive a different diagnosis and 28 per cent a different treatment proposal. “By being so specialised, we are getting better and better results. But it’s not just the result of developments in knowledge. It’s also the way we explain to people what their situation is and what the options are,” she says. “We help them choose. It’s important patients feel seen and heard, that they are not overwhelmed and feel they are in control of the choices they are making.” In keeping with the overall ambition to make the experience of being treated here as pleasant and unintimidating as possible, the hospital’s airy bedrooms have been decorated to recall those in a hotel, with tall, buttoned bedheads, art on the walls, crisp white linen, fluffy bathrobes and en-suite bathrooms. ERIK VAN ‘T WOUD 12 NetJets
“ –Marjolein For a long time, we’ve been told to check our breasts monthly for lumps. But there are 11 other signs that you cannot feel but mostly see. de Jong It is important, she says, that they look “hospitable”, not institutional. There is also a kids’ playing area as well, so that the “children of mothers (and fathers) with breast cancer can play games, read, draw or use an iPad, and be close” to their parents while they undergo treatment. This benefits the whole family – “your loved ones are extremely important as your support system,” she stresses – and saves the patient from having to organise childcare. Even the hospital garb has been thought about. “We also provide a gorgeous pink scarf you can wrap around yourself,” she says, something pretty, comforting (and warm) to help preserve the patient’s dignity as she (for, statistically, the hospital’s patients are likelier to be women even if, according to the Centers for Disease Control and Prevention, in the US about one per cent of malignant breast tumours are found in men, who have a 1 in 833 lifetime risk of contracting it) sits anxious and halfundressed waiting for a diagnosis. It comes as no surprise that de Jong has two specialisms: surgical oncology and psychology. Nor that she has been touched emotionally by breast cancer. “I saw it from close up, not in my own family or in myself, but in a close friend, a young woman. I said, ‘OK, this is what I’m going to give my energy to.’ It’s such an enormous problem in the world for women. So I said I will do everything I have in my capability to help to cure the disease and, if not that, to care for them.” In order to fundraise for the hospital and, she hopes, enable it to expand the model, she has also founded a charity, the Breast Care Foundation, as well as being a foundier of Breast Care Netherlands/Europe, a new role model for specialised breast cancer centres. “Our aim is that we spread the word and by doing so to create more breast centres in the Netherlands and abroad. I think we can do much better in breast-cancer care everywhere. And we have a brilliant model that works and that we can share. Though to do that you need good partners.” The foundation also funds research into breast cancer (it has an affiliation with the University Medical Center Utrecht) and runs public-information campaigns in 10 languages, the latest of which – Know Your Breasts – exhorts women to check themselves not just by palpating but also by looking. “For a long time, we’ve been told to check our breasts monthly for lumps. But there are 11 other signs that you cannot feel but you can mostly see. So we teach people the 12 symptoms of possible breast cancer you have to be aware of and look for. The better you know your own breasts, the more you can identify any changes, and when you notice a change, you need to go to your GP [or primary care physician] for mammography or echography, whatever is necessary from their point of view.” (Just for the record, the 12 symptoms she warns of are thick or upright veins, bumps or dents, sores, dimples, changes in the shape or size or skin colour of one breast, orange-peel skin, hot or inflamed skin, the emergence of fluid from a nipple, crusted or inverted nipples, hard or thickened zone – and, of course, a hard lump.) But better detection and treatment of malignancies is going to necessitate greater capacity to treat them, hence the need for more specialised hospitals run on this model. “We have the power and the guts to do something different, to make something new and better,” she says. But to do that, they’re going to need funding. For more information scan the QR code, visit stichtingbreastcarefoundation.com alexandermonro.nl; or contact Marjoleindejong@alexandermonro.nl ISTOCK NetJets 13
