How does a mathematician end up in the medical world? ‘Statistics is incredibly important, especially in cancer research’
Impactmakers image: Prinses Máxima Centrum
Mathematics is essential when doctors are faced with difficult decisions. Professor of Applied Mathematics Marta Fiocco is convinced of this. Building a partnership between the Mathematical Institute and the medical world has not always been easy, but today she is the Netherlands’ leading expert in the field of mathematics and oncology.
Which drug is most suitable, and what is the optimal dose? If a cancer patient receives a lower dose of chemotherapy than usual, what are their chances of survival one, two or five years after starting treatment? And following surgery for bone cancer in children, is radiotherapy or chemotherapy the better option? These are just some of the questions Fiocco works on.
Giving doctors insight
‘Mathematics is incredibly important, especially in cancer research,’ says Fiocco. ‘A randomised controlled trial (in which treatment is assigned by chance, ed.) is not an option here. Obviously, it would be unethical to say: you get chemotherapy and you don’t. But we do have data from previous patients, and we can use these to carry out a statistical analysis. They are still only models, of course, but they provide doctors with valuable insights.’
After completing her PhD in theoretical mathematics, Fiocco wanted to work on more applied problems. She found an opportunity in a medical statistics project at Leiden University Medical Centre (LUMC). ‘I had a job interview in my rather limited Dutch,’ she recalls enthusiastically. ‘I always choose what I enjoy doing. And I got the job!’ That was her first step into the medical world, more than twenty years ago.
Today, she advises doctors on statistics, particularly in the field of cancer. She holds part-time appointments at LUMC and the Princess Máxima Centre for Paediatric Oncology in Utrecht, as well as an honorary appointment at the Netherlands Cancer Institute (NKI) in Amsterdam.
‘You shouldn’t spend endless hours talking about interdisciplinary working. You should just get on with it.’
How do you build collaborations?
The challenge, Fiocco explains, is to establish large collaborative networks. ‘It’s not a given that, as a mathematician, you will find your way into this field. And quite rightly, cancer research funding bodies ask what mathematics can do for doctors and patients.’
A challenging question from a doctor led to Fiocco receiving her first major grant from the Dutch Cancer Society (KWF Kankerbestrijding) in 2017, followed by a second in 2024. Earlier this year, she received a grant from KiKa for the fourth time, to investigate respiratory support for children with cancer. ‘I would never have achieved this within my own little mathematical bubble.’
Building a bridge between two worlds
When working with doctors, you cannot simply turn up with formulas; you need to explain how you can contribute to answering their research questions. Fiocco’s ambition is for doctors to consult a statistician as a matter of course. ‘Doctors sometimes even consult AI now. The analyses it produces are often incorrect,’ she explains. ‘They are not in a position to assess these properly, but I have the expertise to do so.’
‘You have to step outside your comfort zone,’ Fiocco says, reflecting on the process of building a professional network. ‘I enjoy doing that, for example by giving talks at clinical conferences.’ She takes a practical approach to collaboration: ‘You shouldn’t spend endless hours talking about interdisciplinary working. You should just get on with it.’
Fiocco also wants to inspire young researchers to pursue her field. She supervises PhD students at the university’s Mathematical Institute, as well as at LUMC, Princess Máxima Centre and NKI. ‘I had to build everything up myself, but now I can help them make connections. That way, they can take the next step towards bringing mathematicians and medical professionals together to improve cancer treatment.’