Ruben van Boxtel works as a group leader at the Princess Máxima Centerand started as an Oncode Investigator at the beginning of 2019. The overall aim of his research is to determine why children can develop cancer and study the genotoxic effects of cancer treatment in normal tissues.

“Knowing more about what happens when children get tumour cells, will most likely increase our knowledge of cancer as a whole, from its precise causes to potential treatments. It doesn’t just feel highly unfair when children get cancer, from a biological viewpoint it’s a paradox. After all, the common explanation for the fact that our risk of getting cancer starts to significantly increase after our forties is that cells gradually accumulate DNA mutations with age. The older a cell, the more mutations it contains which in turn heightens the risk that one occurs that may result in cancer.”

“Childhood cancer not only thwarts this theory, it seems to suggest that instead of age-related mutation accumulation, the tissue context in which malignant cells are able to grow out plays an equally important role.”

“Childhood leukemia in particular seems to offer important clues about the potential role of mutation accumulation and selection in cancer initiation. For instance, 10 - 15 percent of newborns with Down Syndrome show a transient form of leukemia that usually spontaneously disappears within a few months after birth. Although approximately 20 percent of these children will eventually progress to a more malignant form of leukemia, the remaining 80 percent won’t develop cancer. Somehow the body manages to keep the leukemia in check. If we can understand the underlying mechanism causing this, we may be able to improve cancer treatment.”

“Oncode’s goal: ‘Outsmarting cancer, impacting lives’ immediately attracted me. That’s exactly what you hope to achieve as a cancer researcher, after all. But I also like the community aspect: the opportunity of being connected with the best cancer specialists in your field – and vice versa, of you helping others with your particular area of expertise.”

“In that sense, my Oncode membership has already led to a concrete outcome. As part of Oncode’s request to reach out to other Oncode members, I emailed my next-door neighbor Alexander van Oudenaarden at the Hubrecht Institute for Developmental Biology and Stem Cell Research – who is also an Oncode Investigator. Our research interests overlap considerably and we’ve now started a joint project: using mutations in leukemia to try and trace the origin of the cancer and determine when and how it was initiated.”

“Besides this, my Oncode membership is making it easier to get patents, which increases the chance that pharmaceutical companies will pick up on our discoveries and use them to develop or adjust cancer treatments. Veerle Fleskens, who is a business developer at Oncode’s Valorization Team, has kindly started to assess our ideas and results with an eye on obtaining patents and is writing a financial plan for the research in my group for the coming five years. As there is so much pressure to publish, such activities normally often fall through the cracks, so it’s a real luxury to have Veerle around. For instance, we are now researching if certain mutational footprints in the DNA of tumour cells in children can predict how they will respond to a certain cancer treatment.”

“First, I simply love my job. You could say it’s my hobby really. From doing the actual research to mentoring young people. And I am lucky to have a great, excellent team, so what more could one ask for? And of course, I love spending time with my family. So while both areas require time and attention, they also give me loads of energy.”

“From a practical perspective, I am lucky that my wife works part-time. And we moved to live closer to both our parents, who kindly help out where needed. On top of that I have flexible working hours, which mean that I can take the kids to school and pick them up at least once a week.

“What also helps is that my kids are fairly flexible and easy-going, perhaps because they are used to sharing attention, since they are with five. And the older they get, the more independent they become. Three years ago, when my youngest was still a baby and I was doing a post-doc, I sometimes struggled to combine work and family life. Back then, it would have been more difficult to do my current job.”

“Children getting cancer and dying of it is just horrible. Each time my wife and I watch a documentary about the Princess Máxima Center we end up shedding tears. But childhood cancer, no matter how unpalatable, is also a fact of life and the Princess Máxima Center seeks to give the children the best possible care and quality of life. So, I switch into another mode, as it were, at the center. Seeing those sick kids fuels my motivation; they are daily reminders of the importance of my work.”

“Also, even when they are very sick, kids will be kids. The patients can be very playful: you don’t want to know how many times a kid bumped into me in the corridor on his bike or ran me down with her go-kart (laughs). When they are staying positive and doing all they can to get better, then who am I to sit in a corner crying? I am of much more use to them if I simply focus on getting the best job done.”