Prof. dr. Max Witjes

Head and neck surgical oncologist at the UMCG

Replacement and Improvement in the Human Body

Cooperation is the key to unlock “the next level”

Normally Max Witjes knows exactly which of his colleagues in Groningen he needs to get together in order to find the right solution for an idea. But there was one question by a colleague that proved to be quite a conundrum: how do you record chewing movements in an overweight person? After some searching, he found an incredible research lab somewhere in Germany that had all kinds of applications to measure and record exactly this. But surely there must be an easier way to do this. Indeed there was – right around the corner in Groningen. It turned out there was also somebody here that could do that research just fine. “That person might not be as far ahead as the man in Germany, but it is a lot closer to home, so we can start immediately. This example shows that mutual awareness is highly needed.”

“If doctors don’t work together with basic scientists, nothing will change.”

It requires coordination within the hospital and the university. Someone like Max is already easily recognisable within the organisation, since all paths leading to the 3D lab connect to him. It is only logical that he continues in this manner with HTRIC. Working together and learning from one another are the only ways to change healthcare, he thinks. It will be possible to plan surgeries with more precision, more predictability, and without depending on surgeons. His vision is clear: if doctors don’t work together with basic scientists, nothing will change. Within a clinical setting, you will always be held back by the restraints of the available knowledge and expertise.

He gives an example from his own practice, namely replacing the standard plates used to support a bone fracture by patient-specific customised plates. “When you are thinking about something like that, you need to incorporate a calculation of force. How strong does a new design need to be? Can it be made from synthetics? Where does a plate like that need to be able to bend, and where does it need to be rigid? It would be quite interesting to research whether or not you can attach a muscle of mastication to the jawbone. That analysis has never been done in detail before.”

Now that we have all this new technology in-house, there are so many possibilities for new research to be done. But to take that next step, Max needs basic scientists that have a talent for thinking both clinically and practically. “Such as scientists with expertise on biomechanical forces or materials. This way, you could use elements of each other’s findings and applications from previous studies for another, new study. Marleen, for example, was able to develop glues for soft tissue, the skin. Would she have been able to do the same for bone? Those are simple ideas that have a clinical relevance.”

“Ensure that the in-house knowledge does not get stuck in the experimental stage.”

According to Max, working together is the primary building block of HTRIC. The second is sharing practical knowledge. Ensure that the in-house knowledge does not get stuck in the experimental stage. “I am certain that in these past few years basic scientists have developed or tested products for which they did not know how to move it to the next phase and actually get it to the patient. It was a cool idea, but how can you ensure that it is actually safe for the human body? You need specific knowledge about early clinical trials.”

HTRIC should be this knowledge centre to help scientists meet those levels of quality, says Max. What is common practice in the development of medications, is not yet commonplace in developing medical aids and devices. You need a lab space to truly work towards a product that doctors can safely use. There are little to no possibilities to do that now, in part because of the strict regulations. As a doctor in an academic environment you are judged upon the amount of publications or PhD students that you have, whether you were able to bring in money, or whether or not you are internationally active. But writing a technical product file should also be a part of that mix if you are working on product development. It might not be scientifically interesting and it takes up a lot of time, but you need to keep these kinds of trajectories in mind.

Max thinks that attracting new talent is another value that HTRIC offers. Being visible, enticing students of the UG, the technical universities of Twente and Delft, and involving direct commercial partners. If you want people to join you in the process, you have to inspire, he says. “Each and every time that I am talking to people of the Faculty of Science and Engineering, I get a fresh burst of energy. There is so much talent over there. Even now, I can feel that the new generation is eager to get to work. If you work on a problem together, everybody will be motivated to get the job done.”

“Every track should have an example within HTRIC five years from now. One that says: this is what we are aiming for. I hope that HTRIC will become an icon. That scientists come to Groningen because they know that they will have a path forward for their good ideas, so that they can be of importance to our society and healthcare.”

Contact

Prof. dr. Max Witjes is a head and neck surgical oncologist at UMCG. His area of focus is oral surgery and maxillofacial surgery and oncology. He is a member of the treatment teams maxillofacial cancer, melanoma and skull base tumours, as well as a member of the working group Immunotherapy Side Effects and the coordinator of the UMCG 3D lab.