8. May 2018

A semester with world class cancer researchers

Tormod S. Nilsen was the first of three Norwegian researchers to receive a grant from Aktiv mot kreft and the Kavli Trust, in support of his research on physical activity as a part of cancer treatment. He says his time as a cancer researcher in NYC was both eventful and productive.

After half a year as a visiting researcher at the Memorial Sloan Kettering Cancer Center (MSKCC) in New York City, Tormod S. Nilsen has returned to his job at the Norwegian School of Sport Sciences (NIH).

Tormod S. Nilsen and his family celebrated May 17th, the national day of Norway, in New York last year. Photo: Private

Involved in several projects

In New York, Nilsen worked with the internationally recognised researcher Lee W. Jones and the hospital’s research team for the project “Exercise Oncology”, to map the effect of physical activity in treatment of some types of cancer.

“I was involved in several projects,” he says. “I helped develop the protocol for our part of the MSKCC’s large IMPACT-study, and the data collection was done while I was there.”

The purpose of the IMPACT-study is to uncover different gene alterations in tumours. Tissue samples from the tumours of all the patients treated at MSKCC are sent to a laboratory where the tumours are mapped. The results will among other be used to test new treatment forms targeted at different gene changes.

“Using the same method, we wish to investigate whether the patients’ activity level can affect different kinds of gene changes,” says Tormod S. Nilsen.

“The IMPACT study is very large and is organised by MSKCC centrally. The data collection is therefore handled by designated personnel, and we couldn’t participate actively in this. I was therefore included in other projects that Lee W. Jones and the group were running,” he says.

Reporting exercise doses

They worked a lot on developing new methods to report on work-out doses in scientific studies, and how these methods could be used to dose exercise as if it were medicine. These methods will be useful tools in all future studies, both at MSKCC and in Norway.

“We recently published a paper on this work, where we have adapted terminology from pharmacological studies so that it can be used to report ‘exercise doses’ in the same way as medicine doses,” says Tormod S. Nilsen.

Read the entire article here.

They also used these tools in an intervention study where women with advanced breast cancer were randomly chosen for either exercise or regular follow-up.

“The data collection in the study was finished right before I arrived, and I got to participate in the analyses and the writing,” says Nilsen.

Exercise for patients with breast cancer

In the literature, there are many studies that have looked at the effect of exercise in patients with localised breast cancer, or in patients who receive first time treatment, but there are very few exercise studies done in patients with advanced breast cancer.

“In the paper, we report that exercise was safe for the patients – no serious incidents occurred as a result of the exercise – but that the exercise wasn’t feasible for all patients in the study,” he says.

Most of the patients needed adjustments to the exercise doses, and some patients needed breaks from the exercise due to side effects of the treatment or other reasons.

The patients who managed 70 percent of the planned exercise doses experienced an effect from the exercise in the form of improved oxygen uptake.

You can read the entire study here.

Lee W. Jones. Photo: Helle Aanesen/Aktiv mot kreft

“I was also included in a review article, or an overview article, on the effect of exercise to prevent cardiovascular disease, which are known side-effects from several types of cancer treatment. In the article, we go through the literature on the topic, and discuss the effect of training to reduce the risk of cardiovascular disease in different stages of the cancer treatment,” says Tormod S. Nilsen.

“We also suggest three different approaches to mapping the patients so that we can tailor the exercise for each patient based on their risk profile.”

Read the article here.

Survivors of childhood cancer

Through the autumn and winter, Tormod, alongside the MSKCC team, has worked on two additional articles: another overview article that looks at the effect of exercise on the cardio-respiratory status of cancer patients, and one article where they are investigating the effect of exercise on the survival of adults who have had cancer as a child. Activity data has been collected from a large number of survivors of childhood cancer, who have been followed for a long time after they were diagnosed.

Both articles have been submitted for peer review in two different journals. They hope they will be published before summer.

“Two of the articles we have been working on will also serve as the foundation for a study that we want to carry out in Norway. The goal of this project is to write a protocol in the autumn, and start applying for funding to carry out the project when everything is ready,” says Nilsen.

CEO of Aktiv mot kreft, Helle Aanesen, CEO of the Kavli Trust, Inger Elise Iversen, and researcher Elisabeth Edvardsen, who is the next researcher to receive a grant from Aktiv mot kreft and the Kavli Trust. Photo: Hanne Eide Andersen/The Kavli Trust

Overwhelmed by the research stay

Back in his job as a researcher at NIH, Tormod continues to work on data collection for a study on prostate cancer patients, and for a study on sarcoma patients. He is also responsible for one of NIH’s instructor courses for patients who have been through cancer treatment.

The cancer researcher wasn’t quite sure what to expect ahead of his stay in NYC.

“Today, I’m pretty overwhelmed by everything I got to experience,” he states. “I was included in all the projects the group was working on, both projects where the data collection was finished, projects that were recruiting patients, and projects that will be carried out in the future. It was also a great stay socially, and I left New York having made new friends that I have already been back to visit.

Receiving funding was crucial

“The support from the Kavli Trust was indispensable. I could never have moved myself and my little family to New York without it. That we are now planning new projects in Norway goes to show how useful the research stay was, and how the support from the Kavli Trust has worked as a catalyst for further research,” he says.

“For the feasibility of ‘our part’ of the IMPACT study, the funds from the Kavli Trust were crucial,” he says, and is echoed by Lee W. Jones.

“The data collection actually wouldn’t have happened without the support from the Kavli Trust,” says Jones.

“The results from this project will contribute to new knowledge about potential mechanisms behind how exercise can affect the biology of solid tumours, and/or how the mutation profile of different tumours can affect these mechanisms. In this way, the results from the projects can form new hypotheses to be tested with further work, both in mechanical preclinical studies (animal testing) and clinical studies (with human test subjects),” says Jones.

The work continues in 2018

The recruitment of patients for the IMPACT study will continue throughout 2018. The goal is that 1,500 patients will have been recruited by the end of autumn. When the recruitment has finished, the work on analysing the collected data begins, and the goal is to have a manuscript for the first paper finished by the end of 2018.

“This is, however, dependent on the recruitment process going as planned. The results will be used as a foundation for applying for funding for follow-up studies through national funding schemes in the US (for example the National Institute of Health,” Lee W. Jones finishes.

Researcher Elisabeth Edvardsen from NIH is the next researcher to go to MSKCC with a grant from Aktiv mot kreft and support from the Kavli Trust.

Read more about our support to Aktiv mot kreft and research on exercise in cancer treatment here.