Cancer Cachexia: Assessment & Classification, Cachexia Cohort Study, Decision Support using new Assessment tools, Parenteral Nutrition, Clinical trials with new anti-cachexia drugs (Phase I: ghrelin, scFv-1E8a; proof-of-concept phase II: Lenalidomide, activinin), Clinical trial design
Integrated Oncology and Palliative Care
- Health Services Research on patterns of integrated oncology & palliative care
- Symptomintervention trial: Electronic Monitoring of Symptoms and Syndromes associated with Cancer (SAKK-trial 95/06)
> 1983-1986 Medical School, University of Zürich
Physics, Chemistry, Biology, Morphology, Physiology, Biochemistry, Pathophysiology, Pharmacology, Toxicology, Pathology, Microbiology, Psychosocial Medicine. Participation in a volunteer group for training in medical history taking.
> 1986/87 Working as a nurse aid in a resident house for elderly patients (11.1986 - 3.1987) 1987 Spanish school in Malaga, Spain. Voluntary work (surgery, community work) in a hospital in Los Angeles, Chile. Travelling in South- and Zentralamerica
> 1987-1990 Medical School, University of Zürich. Clinical training in pediatrics, internal medicine, obstetrics, general practician, dermatology and surgery. Participation in a volunteer „Balint“-Group for psychosocial and emotional aspects of patient care
> 1991 Clinic and Policlinic for Radiooncology, University Hospital Zürich (Prof. U. M. Lütolf, MD): 24.4.1992 Thesis: Interaction of interferon alpha and radiation therapy in human squamous-cells in vitro (Prof. Ch. Glanzmann, MD). Work as Emergency Physician in Psychiatry including i.e. drug addicts.
> 9.91-11.92 Division of Clinical Immunology, Universitiy Hospital Zürich (Prof. P. Grob, MD): building up of the routine molecular hepatitis-C-virus diagnosis, AIDS-research-programm. Work at the Swiss Reference Center for Retroviruses Zürich and the Max-von-Pettenkofer-Institute in Munich.
> 1.93-12.93 Division of Infectious Diseases, Universitiy Hospital Zürich (Prof. R. Lüthy, MD): clinical work with HIV-infected outpatients, work on phase II studies, infectious disease hospital counselling service.
> 1.94-2.96 Medical Clinic, Kantonsspital Winterthur (Prof. A. Hany, MD): clinical work in internal medicine including Emergency, ICU and hemodialysis-unit.
> 4.96-7.97 Medical Clinic, University Hospital Zürich (Prof. F. Follath, MD, Prof. A. Schaffner, MD): clinical work in internal medicine and oncology.
> 7.97 – 8.00 Institute of Medical Oncology, Inselspital Bern (Prof. M.F. Fey, MD): clinical work in Medical Oncology and liaison service in radiation oncology. Active Work in a multidisciplinary Palliative Care group providing guidelines for symptom control, establishing a multidisciplinary liaison-service in the hospital and offer education for different professionals. Participation in the pilot workshop „Communication training for Swiss Oncologists“
> 10.00 – 8.02 Department Symptom Control & Palliative Care, The University of Texas MD Anderson Cancer Center, Houston, Texas (Prof. E. Bruera): Clinical fellow Pain, Symptom Control & Palliative Care. Outpatient palliative care and pain clinic including a multidisciplinary clinic, in-hospital palliative care and pain mobile team, Palliative Care Acute Unit, joint bus rounds with local hospices, research. First year supported by: Swiss Cancer Research Grant (BIL KFS 950-09-1999); Second year regular fellow.
> 8.2001 Rotation to the Tertiary Palliative Care Unit Grey Nuns Hospital Edmonton.
> 10.02 – ong Division of Oncology/Hematology, Department of Internal Medicine, Kantonsspital St.Gallen (Prof. Th. Cerny): Assistant Professor (Leitender Arzt) for Oncology and Palliative Medicine. Clinical, Research, and Teaching activities in Palliative Oncology and Palliative Medicine. Participation in inpatient, outpatient, consulting services, and call duties in medical oncology and consulting for head-and-neck.
Development of interdisciplinary outpatient clinics “supportive-palliative” and “nutrition/fatigue”. Participation in the interdisciplinary hospital palliative care mobile team, the inpatient oncological palliative care unit, the palliative care bridge service and call duties for palliative care.
1.06 head of oncological palliative medicine (in- and outpatient, research team), part of the interdepartmental Palliative Care Center.
Swiss Society of Palliative Care (SSPC), member
European Association of Palliative Care (EAPC), Member of the EAPC Research Network, Associated member of the Palliative Research Center
International Association for Hospice & Palliative Care (IAHPC), Board Member
Swiss Society of Medical Oncology (SGMO), member
Swiss Society for Clinical Cancer Research (SAKK), president of the Working Group "Symptom Control & Palliative Cancer Care"
European Society of Medical Oncology (ESMO), Chair of the Palliative Care Working Group
American Society of Clinical Oncology (ASCO), member
Multinational Association for Supportive Care in Cancer (MASCC), Co-Chair of Nutrition Study Group, Member of the Palliative Care, Fatigue, Rehabilitation Study Groups
Swiss Society of Clinical Nutrition (SSCN/GESKES/SSNC), member
European Society of Parenteral and Enteral Nutrition (ESPEN). member
Onco-reha.ch, board member, co-chair research study group
Society of Sarcopenia, Cachexia and Wasting Diseases, Board member
The research group of oncological palliative medicine is part of the department in the section oncology of the department of internal medicine and the palliative care center.
The research focus is on cancer cachexia and on integrated oncology and palliative medicine.
1. Cancer cachexia: Our group is performing systematic work for classification and assessment of cancer cachexia, within the European Palliative Care Research Collaborative, aiming to develop an internationally valid classification system focused on cancer and on the palliative care context, to establish standards in clinical care and clinical trial design.
2. In the field of integrated oncology and palliative medicine, one focus is the development of multidisciplinary outpatient clinics and embedded in that a multilevel assessment package to improve rapid comprehensive clinical judgment and patient centered interventions.
Linked to this project we are developing a comprehensive, but also simple to use, cancer cachexia assessment instrument together with international collaborators.
Further assessment tools are developed in cancer cachexia related suffering (including eating related distress and weight related distress), validation of single item fatigue screening questionnaires and a secondary nutrition impact symptom checklist.
As interventions, we explore pharmacological interventions, such as natural Ghrelin or Lenalidomid and also other drugs in the phase I/II setting including placebo-controlled multicenter trials.
Within the interdisciplinary cachexia outpatient clinic we are developing multi-level assessment strategies and a comprehensive intervention package including nutritional counseling, psychooncological interventions, educational interventions and pharmacological therapies.
As clinical trial we are performing the E-Mosaic study, a multicenter randomized controlled trial evaluating the provision of longitudinal symptom and syndrome data to oncologists. The same technology is now being used in the future in inpatient units to prove monitoring and care appropriateness. Next steps include electronic monitoring of patient reported outcomes to improve decision making and finally also cost outcomes.
The service patterns of integrated oncology and palliative medicine are explored within the palliative care working group ESMO and also in association with the EAPC.