Toine van der Heijden Appointed Professor of Oncological Urology 

Urologist Toine van der Heijden has been appointed Professor of Oncological Urology at Radboud university medical center / Radboud University. His research focuses on improving care for patients with urological cancers, particularly bladder cancer. He explores how this care can be made more efficient, with a strong emphasis on prevention, new diagnostic methods, treatment, and follow-up. 

'Healthcare must become more efficient, because we’re heading toward major shortages! We need to critically assess everything we do,' says oncological urologist Toine van der Heijden. Within the field of urological cancers, especially bladder cancer, he sees many opportunities for smarter, more efficient care without compromising quality. A concrete example: thanks to innovative urine tests, bladder cancer patients now need fewer hospital visits for bladder examinations. 'Patients can easily perform this test at home. This eliminates about 40% of hospital check-ups, without affecting the quality of care. In fact, it’s less burdensome for the patient.' 

Another example is the follow-up of patients with low-risk non-muscle-invasive bladder cancer. Van der Heijden explains: 'We currently monitor these patients for five years with annual internal examinations, even though the risk of recurrence and progression is very low. That’s why we’re launching a ‘less-is-more project’ to revise the Dutch guideline. We’ll follow patients for just one year, provided the disease hasn’t returned. This will save around 7,000 bladder examinations annually in the Netherlands, without reducing care quality.' In the coming years, he aims to initiate more such projects, such as revising frequent PSA checks after radical prostate cancer treatment and the intensive follow-up after radical kidney and bladder cancer treatment, since disease recurrence usually presents through symptoms. 

Lifestyle advice in clinical practice 

Prevention is better than cure, Van der Heijden emphasizes. He is actively involved in integrating lifestyle interventions into hospital care. For example, patients routinely receive four weeks of lifestyle advice on nutrition and exercise prior to bladder or kidney removal surgery. 'We’ve embedded this Fit4Surgery program into the treatment pathway. Because it’s a standard part of care, patients are much more likely to participate than if I simply advise them to quit smoking, exercise more, or live healthier,' says Van der Heijden. 

He acknowledges the challenge of engaging patients in prevention and healthy living. 'I think many initiatives are well-intentioned, but we don’t always reach the right target group. Together with researchers from IKNL and gynecologic oncologists at Radboudumc, we’re exploring how to better approach urological or gynecological patients with low health literacy for lifestyle interventions. As an ambassador for lifestyle-oriented care, I’m committed to making lifestyle care a standard part of daily clinical practice in the coming years.' 

MRI diagnostics

Van der Heijden’s research also focuses on improving and streamlining care. In the large, randomized study BladParadigm, involving eighteen hospitals, he is investigating whether diagnostics for patients with muscle-invasive bladder tumors can be changed. For decades, patients have undergone surgery to remove the tumor through the urethra down to the muscle layer. This procedure may release tumor cells into the bloodstream, potentially contributing to disease spread, although this has never been proven. 'In a recently completed pilot study, we found that 40% of patients with muscle-invasive bladder cancer had no tumor cells in their blood before the diagnostic surgery, but did after,' he explains. 'We believe an MRI scan can effectively replace this surgery. In nearly all other cancers, we assess tumor invasion using imaging—why not here? If the study results are positive, diagnostics will become more efficient: MRI is safer, faster, cheaper, and less burdensome than surgery.' 

Another key question is how to better detect metastases in bladder cancer. 'The five-year survival rate after bladder removal has remained around 50% for years. This means many patients already have metastases that we don’t detect with the current CT or PET scans performed before surgery,' Van der Heijden explains. 'Together with nuclear medicine specialists, chemists, and other researchers, we’re working on developing new radionuclides to detect metastases earlier and more accurately, allowing us to offer more targeted treatment at an earlier stage.' 

Career

Toine van der Heijden studied Medicine in Nijmegen and specialized in Urology at Radboudumc. After an international fellowship, he joined the Urology department staff in 2012. He earned his PhD in 2006 with research on bladder cancer treatment (dissertation title: New treatment strategies for superficial bladder cancer). Collaboration is a central theme in his work. Within Onco Oost, a network of hospitals in Eastern Netherlands focused on cancer care, he chairs the Tumor Type Network for Bladder Cancer. He also chairs the European Guideline Committee for muscle-invasive and metastatic bladder cancer and is actively involved in several leading national and international committees.

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