What is the LATER outpatient clinic?
Growing numbers of children with cancer recover thanks to improved treatment and care. There are currently more than 12,000 people in the Netherlands who have had cancer as a child. Research shows that survivors are more likely to suffer health problems than their peers. Sometimes these late effects do not occur until years after treatment. Many late effects are treatable, especially if caught early.
That is why you are regularly invited to visit the LATER outpatient clinic. How often you should come depends on your diagnosis and treatment. This can vary from once a year to once every five years.
All knowledge about late effects is amassed in the LATER clinic. Our LATER care is based on scientific research and years of experience. Consequently, you get the care you need.
When do you visit the LATER outpatient clinic?
As from five years after being diagnosed, you will be expected at the LATER outpatient clinic for a check-up. Up to the age of 18, you will see either your own or another pediatric oncologist or LATER pediatrician. Once you turn 18, you will be seen by a LATER doctor for adults, a clinical nurse specialist. Around the time of turning 18, a smooth transfer to the LATER outpatient clinic for adults is arranged, and the check-ups with the pediatric oncologist cease. That can take some getting used to.
During your first meeting, the LATER outpatient clinic and your personal LATER care plan is explained to you. The frequency of your check-ups and which examinations will apply depend on the type of cancer and the treatment you have had. The latter determine the risk of late effects. Your check-ups can continue on an annual basis, but also once every two and a half or five years.
Receiving an invitation
You will receive an invitation for each LATER visit containing the date, time, place and the planned examinations. We strive to conduct all your examinations and your interview on the same day.
If you received treatment at the Princess Máxima Center, we have all your details. If you were registered at another LATER outpatient clinic, your details have been transferred to the Princess Máxima Center. The LATER outpatient clinic of the Princess Máxima Center is in fact a combination of the LATER outpatient clinics of:
- the AMC (Amsterdam)
- the ErasmusMC (Rotterdam)
- the UMCG (Groningen)
- the UMCU (Utrecht)
- the VUMC (Amsterdam)
There are also LATER outpatient clinics in the LUMC (Leiden) and the Radboudumc (Nijmegen). If you go to either one of those clinics for your check-ups, you can address any questions you might have to them.
If you have been waiting for a while for an appointment or if you want to know when you are scheduled, please contact us so we can make an appointment for you if you wish.
Who pays for the LATER check-ups?
Visits to the LATER outpatient clinic are covered by insured care and are reimbursed by your health insurer. If you are 18 years or older, you are subject to the compulsory deductible. When considering increasing your deductible, keep your LATER check-ups in mind.
How to get to the LATER outpatient clinic
If coming by public transport, get off at the Princess Máxima Center (WKZ/Prinses Máxima Centrum stop). If coming by car, you can park in the Princess Máxima Center's parking garage. Your number plate is scanned, so there is no need for a ticket. To pay for your parking, enter your license plate in the parking machine.
You can go straight to the LATER outpatient clinic. It is located on the ground floor, to the left of the espresso bar.
Your visit to the LATER outpatient clinic
How to prepare for your visit. What to take along, where to go. When do you get the results? This information is provided below.
What to take along
Remember to bring your ID with you. If you take medication, it is useful to bring a list of your medicines along. It is also handy to bring something along to keep you busy if you have to wait for a while.
In the waiting area there is a reading table and a cabinet containing information brochures, and you can pour yourself a cup of coffee, tea and/or chocolate milk. If you have to wait a bit longer, you can go to the restaurant, the espresso bar or the gardens.
What is the procedure?
- After entering through the swing doors, first report to the doctor's assistant who checks your identity, address and general practitioner details. Together you go over the place and time of your scheduled check-ups. Your blood pressure, height and weight are then taken in room 1 or 2.
- You meet with the LATER doctor/clinical nurse specialist, you are given a physical examination and, if necessary, additional examinations. During this meeting you can ask questions and discuss any physical complaints and other problems. The LATER doctor/clinical nurse specialist also asks you about your health, studies, work, friends and your thoughts about your treatment period and whether it still affects your life. They also ask what you know about possible late effects, fertility and so on.
- A psychologist, a fertility nurse specialist and physiotherapists are attached to the LATER outpatient clinic and work together with specialists from the UMCU/WKZ, such as a cardiologist (heart), lung specialist, endocrinologist (hormones), gynecologist and rehabilitation specialist. You are informed of who you are to see and why.
Where to go
- You will be collected in the waiting area for the interview, blood taking and examinations, such as a heart ultrasound, lung function examination and hearing test.
- Report to the doctor's assistant after every interview or examination so that they can keep track of your schedule.
- Due to the distance to get to some examinations or because of possible delays, it is not possible to schedule all examinations consecutively. If time allows, you can visit the restaurant, the espresso bar and the gardens.
- Blood is drawn at the LATER outpatient clinic. Let the doctor's assistant know if you are afraid of needles or if you have difficult veins.
- Heart ultrasound, lung function test and hearing test are also conducted at the LATER outpatient clinic, as is the interview with a LATER doctor, clinical nurse specialist, psychologist or physiotherapist.
- Examinations such as an MRI or ultrasound are conducted in the Princess Máxima Center. Other examinations, such as a mammography, MRI or DEXA scan, are done in the UMCU, which is about a 20 minute walk away. The doctor's assistant will give you directions. If this is too far for you or if you don't want to go to the examination alone, the doctor's assistant can arrange for a wheelchair and a volunteer to accompany you.
When do you get the results?
About two weeks after your LATER visit, you have a telephone appointment with the LATER doctor or clinical nurse specialist, who goes through the results with you and answers your questions.
If the results deviate slightly, your doctor can conduct further examinations. Then, if abnormalities are still detected, we usually refer you to a specialist in a hospital in your area. In some instances we refer you to a specialist who has extensive knowledge regarding late effects.
In the event of abnormal results, we sometimes call you up for a LATER check-up at an earlier point in time than usual.
After your LATER visit, we send your GP and any other specialists a letter containing the results and advice.
You are automatically called up for your next visit to the LATER outpatient clinic.
The patient portal
You can view your medical file by logging into the patient portal with your DigiD.
Should you have any questions about the contents of the file, please contact the LATER doctor/clinical nurse specialist.