- Date of birth: 070853
- Present position: Professor of Palliative Medicine, Faculty of Medicine, NTNU.
- Vice managing director, St. Olavs Hospital, Trondheim University Hospital.
- Director of the European Palliative Care Research Centre, Faculty of Medicine, NTNU.
| Education: | |
|---|---|
| 1980 | Medical doctor, University of Oslo |
| 1989 | Certified specialist in Oncology |
| 1989 | PhD (dr.med.), University of Oslo |
| Work experience: | |
| 1980-81 | Internship in surgery and internal medicine, Notodden Hospital, Norway, |
| 1981 | Internship community practice, Fjaler, Norway |
| 1981-82 | Family Medicine in private practice Bærum, Norway |
| 1983-86 | Junior doctor in medical oncology and radiotherapy, The Norwegian Radium Hospital, Oslo |
| 1986-87 | Research fellow/PhD-student, The Norwegian Cancer Society, Oslo, Norway |
| 1988-89 | Junior doctor internal medicine, Diakonhjemmets Hospital/Lovisenberg Hospital, Oslo, Norway |
| 1990-93 | Consultant medical oncology and radiotherapy, The Norwegian Radium Hospital, Oslo, Norway |
| 1990-94 | Chair of the Board, Institute for Environmental Medicine, Faculty of Medicine, NTNU, Trondheim, Norway |
| 2002-06 | Chair of the Board, Institute for Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, Trondheim, Norway |
| 1993-10 | Director of Palliative Medicine Unit, Trondheim University Hospital, Norway |
| 1993- | Professor of Palliative medicine, Faculty of medicine, NTNU, Norway |
| 2006- 2013 | National Cancer Director, Norwegian Directorate of Health, Oslo, Norway |
| 2009- | Director, European Palliative Care Research Centre, NTNU, Norway |
| 2010- 2013 | Head of the Cancer Clinic, St. Olavs Hospital HF, Trondheim, Norway |
| 2013- | Deputy managing director, St. Olavs Hospital HF, Trondheim, Norway |
| Selected merits/assignments: | |
| 1998-01 | Chair of the Program for Research on Alternative Medicine, The Norwegian Research Council |
| 1999-05 | Member of the Board, Norwegian Association for Palliative Medicine |
| 1999-05 | President of the European Association for Palliative Care, EAPC |
| 2000-05 | Member of the Program Committee for Applied Clinical Research and Alternative Medicine, Norwegian Research Council |
| 1993-07 | Member of the Evaluation Committee for Clinical and Epidemiological Research, The Norwegian Cancer Society |
| 2007-08 | Member of the Program Committee, Patient and Survivor Care, ASCO |
| 2007-08 | Committee Member, Canadian Institutes of Health Research (CIHR) |
| 2007-08 | Reviewer for the “Palliative & End of Life Care” peer review committee, CIHR IRSC, Canada |
| 2007-08 | Section Editor, The Oncologist |
| 2007-09 | Member of the IAEA Group for Palliative Radiotherapy |
| 2007-10 | Chairman, Møbius Research Award, The Norwegian Research Council |
| 2008-09 | Member of the Expert group for the Minister of Health |
| 1993-this date | Professor of Palliative Medicine, Faculty of Medicine, NTNU |
| 1993-this date | Member, European Association for Palliative Care Research Network (EAPC RN) |
| 2005-this date | Editorial board, European Journal of Palliative Care |
| 2006-this date | Co-editor, Palliative Medicine |
| 2007-this date | Co-editor, Oxford Textbook of Palliative Care |
| 2007-this date | Chair, EAPC RN |
| 2007-this date | Member of the Editorial Board of Archives of Medical Science |
| 2007-this date | Member of the Assessment panel for the Australian Government Cancer Clinical Trials. |
| 2008-this date | Reviewer, Wolters Kluwer Health |
| 2008-this date | Board member of International Association of Hospice and Palliative Care, IAHPC |
| 2008-this date | Member, DKNVS Academy (The Royal Norwegian Society of Sciences and Letters) |
| 2009-this date | Chair for European Palliative Care Research Centre (PRC) |
| 2009-this date | Evaluator of proposals for the EU Framework 7 HEALTH-2010 single stage cancer call |
| 2009-this date | Member of the International Advisory Board, Lancet Oncology |
| 2011-this date | Member of the Editorial Board, BMJ Supportive & Palliative Care Journal (SP Care) |
| 2012-this date | Member of the Editorial Board, "The Open Access Journal of Science and Technology" |
| 2012-this date | Editorial Board of Annals of Palliative Medicine (APM |
Cancer Cachexia
Abstract
Cachexia is present in more than 80% of patients with advanced cancer. Cachexia is characterized by loss of appetite and accelerated breakdown of muscle and adipose tissue, reduced immunity, increased treatment toxicity and reduced physical function. Loss of skeletal muscle mass is both a key feature of cachexia and an important side-effect of systemic chemotherapy (1).
Cancer cachexia is a multidimensional syndrome where the interdependence of components indicates that a unimodal treatment approach is unlikely to succeed (2). Inflammation is considered to be fundamental in cancer cachexia pathophysiology and it may reflect an essential difference between simple starvation and cachexia.
Agents with anti-inflammatory properties may down regulate both pro-inflammatory cytokines and the acute phase protein response, and thus improve weight and skeletal muscle mass in cancer patients with cachexia. This effect is probably accompanied with important patient centered aspects such as improved physical performance and self-reported quality of life.(3). Although the evidence of effects of exercise on inflammation and preservation of muscle mass in cachexia is limited, exercise can benefit cancer patients with advanced disease in terms of physical function and muscle strength (4).
Conventional nutritional support in cachectic patients may improve energy balance but has limited impact on preservation of skeletal muscle mass. Even though cachexia cannot be treated with nutrition alone, it is nevertheless mandatory to secure sufficient energy and protein intake and avoid under-nutrition.
The number of new promising drugs, nutritional therapy alternatives and exercise/rehabilitation programs is increasing. Targeted therapies aiming to prevent or reverse wasting might involve a combination of pharmacologic drugs, nutrition and physical exercise working concurrently to enhance muscle protein synthesis and reduce breakdown. Some pharmacological interventions demonstrate the potential to improve muscle mass, but the multimodal interventions seem in greater extent also to demonstrate improvement in physical function (6). Future multimodal treatment may thus hopefully counteract the devastating consequences of this common condition (5).
- 1. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489-95.
- 2. Solheim TS, Laird BJ. Evidence base for multimodal therapy in cachexia. Curr Opin Support Palliat Care. 2012;6(4):424-31.
- 3. Solheim TS, Fearon KC, Blum D, Kaasa S. Non-steroidal anti-inflammatory treatment in cancer cachexia: a systematic literature review. Acta Oncol. 2013;52(1):6-17.
- 4. Oldervoll LM, Loge JH, Lydersen S, Paltiel H, Asp MB, Nygaard UV, et al. Physical exercise for cancer patients with advanced disease: a randomized controlled trial. The oncologist. 2011;16(11):1649-57.
- 5. Solheim T, Laird, BJ, Balstad, TR, Stene, G, Bye, A, Fayers, P, Fearon, C, Kaasa, S. A feasibility study of Multimodal Exercise/Nutrition/Anti-inflammatory treatment for Cachexia – the pre-MENAC study. In prep.
- 6. Balstad T, Kaasa, S, Solheim, TS. Multimodal nutrition / anabolic therapy for wasting conditions Curr Opin Clin Nutr Metab Care. 2014;Accepted for publication
