‘Anyone can manage their fatigue with Untire’

Dr Bram Kuiper and Door Vonk have believed in the Untire app as an effective digital treatment for fatigue and cancer since day one. Door admits that having the app tested by users across the world did cause some nerves. ‘People who don’t know you suddenly have to give their opinion on your product. Fortunately, we received enthusiastic feedback from users straight away. It makes your work so rewarding when people say it’s exactly what they have been looking for.’

The journey to Untire took longer than expected. They have had to brave the necessary hairpin bends, bumps and obstacles along the way but it was all worth it. ‘Ten years ago, we could not have predicted this level of success.’

Their brainchild, Tired of Cancer, is a flourishing company with employees who have expertise in digital healthcare. Cancer patients and survivors are the focus of Tired of Cancer. Untire’s digital treatment programme is now used by thousands of people across the world, and its popularity is increasing. Fatigue is the most common problem among cancer patients and survivors and it has a huge impact on their quality of life.

From Edinburgh Castle to Big Ben

Dr Bram Kuiper translates it into figures. Each year, about 375,000 people across the UK are told they have cancer; that’s around 1000 people every day. ‘80% of cancer patients suffer from fatigue during their first year of treatment. One in three patients experience fatigue symptoms for much longer than that.’

If you lined up every person with cancer related fatigue in the UK and got them to hold hands, that line would extend from Edinburgh Castle right down to the Big Ben in London. ‘Cancer fatigue doesn’t get a lot of attention. Doctors often assume that fatigue is a normal part of living with cancer – at least in the first year – and that little can be done about it. Patients think the same.’

Losing his own father to pancreatic cancer made him realise just how much cancer impacts your life. As a clinical psychologist at VUmc, VU University Medical Center Amsterdam, he has supported many people with their cancer journeys. ‘Cancer affects your identity and the very core of your existence.’ If you struggle with severe fatigue on top of that, your life is severely disrupted. We wanted to use our knowledge and experience to do something about that.’

Bram’s 30 years of experience as a psycho-oncologist gave him the idea to develop an accessible solution to help patients manage their fatigue more effectively. An app seemed to be the obvious way to achieve that.

Dr. Bram Kuiper

Dr Bram Kuiper is a psycho-oncologist, scientific entrepreneur and CEO of Tired of Cancer. He was the Director of the Helen Dowling Institute for over 17 years. With over 30 years of experience in the field of psycho-oncology and writing treatment protocols, he has now dedicated his career to the Untire app in order to help as many people as possible across the world who suffer from cancer fatigue.

Building a house

At the beginning, we received direct support from a leading haematologist and an international patients’ association who believed in us.

Back in 2012, health apps were only just starting to be developed. ‘Our app was pioneering and we learned lots of lessons before finding the right parties to help us design and develop the app,’ adds Bram.

Bram and Door compare building an app with building a house. ‘You gradually discover that as well as a good idea you also need a strong design and a solid foundation before you can build. For that, you need experts such as architects, structural engineers and builders. You need to think about the content and the ‘packaging’: how your house is going to look both on the outside and on the inside. We gradually gained an understanding of the world of apps and learned how everything worked. Now that Untire is here, we are aware of just how well we fit into the world of digital healthcare.’

A grant from the European Union’s Horizon 2020 budget enabled Door and Bram to focus on Untire full-time from the summer of 2017 onwards. ‘That’s when things really accelerated,’ Bram explains. ‘We were able to work on Untire 24/7 and bring in people to help us.’

Door Vonk

Door Vonk is a social entrepreneur and founding partner of Tired of Cancer, where she holds the position of CCO. Having started her career at a bank, Door has accumulated over 20 years of experience in fundraising, financial and communication management of social enterprises, among others at the Ronald McDonald Kinderfonds and the Helen Dowling Institute. She left her own consultancy firm after nine years to dedicate her full attention and skills to Tired of Cancer.

‘We constantly involve patients in what we are doing.’

Since its launch in 2018, Untire is now used by thousands of people across the globe. The programme is a combination of psychology, physiotherapy and relaxation exercises based on proven psychological interventions and exercise methods.

Independent research carried out by UMC Groningen showed that Untire’s digital programme is very effective.

Version 4.0 of the Untire app is now under development. Bram: ‘The next big step is to personalise the app so that all users receive a customised programme – similar to individual therapy. First, patients are asked questions about lots of different things, such as fatigue, other problems, amount of exercise, etc. They then receive targeted, personal advice that guides them through the programme.’

‘The content is also based on the latest scientific information and our own user-based research. It is important to ensure that both the content and the presentation are of a high quality. Which elements ensure that people find your app accessible and meaningful, so that they use it on a regular basis?’

Users are the focus of the new version of the app, which will be released at early 2023. The best kind of app focuses on the user.