Linda Björkhem-Bergman

Linda Björkhem-Bergman

Professor/Senior Physician
Visiting address: Blickagången 16, 14152 Huddinge
Postal address: H1 Neurobiologi, vårdvetenskap och samhälle, H1 Klinisk geriatrik Björkhem-Bergman, 171 77 Stockholm
Part of:

About me

  • I am MD and Professor in Palliative Medicine.

    I defended my PhD-thesis in Experimental Pathology in 2004 at the Karolinska Institutet. The project involved carcinogenesis studies in animal models and cell-culturing of multi-drug resistant cells with focus on selenium compounds and selenoenzymes. During my post-doc time (2009-2012) at Dept of Clinical Pharmacology I expanded my knowledge about drug metabolism with focus on statins. During my Residency at Clinical Pharmacology (ST-läkare) (2006-2013) I started working with clinical research and with Phase I and II studies at the Clinical Trial Unit. I finished my Specialist Training in Clinical Pharmacology 2012 and I am since 2013 Associate Professor (Docent) in Clinical Pharmacology. Since 2013 I am working in the field of Palliative Medicine and I am Senior Consultant (Överläkare) at Stockholms Sjukhem, Dept of Palliative Medicine. Since 2021 I also have a Specialist degree in Palliative Medicine.

    In 2018 I started up my own research group in Palliative Medicine at the Division of Clinical Geriatrics, NVS, KI. My overall aim is to find new pharmacological and non-pharmacological strategies to improve the quality of life in end-of-life patients. I have a translational approach where I try to combine clinical trials with pre-clinical experiments for mechanistic studies. My main focus during recent years has been on the role of Vitamin D in the immune system and possible beneficial effects of Vitamin D supplementation to cancer patients to improve symptom management, reduce the incidence of infections and improve the quality of life. 

    Today (2024) we are 8 members in my rearsch group, 3 PhD-students and 4 post-docs and one docent (me). We all combine clinical work in palliative care with reserach. We are 6 MDs, 1 reg nurse and 1 reg dietician. 

Research

  • All the reserach in my reserach group involves different topics in palliative medicine and palliative care.

    During recent years my main focus has been the role of Vitamin D in the immune system and possible beneficial effects of Vitamin D supplementation to cancer patients to improve symptom management (pain and fatigue), reduce the incidence of infections and improve the quality of life. Currently my main focus is projects on cancer related fatigue. This involvs both mechanistic studies, with focus on immunology, and treatment options in clinical care including studies on the use of cortisone, vitamin D, methylphenidate and phsyical activity. 

    In the research group we also have projects on nutrition in palliative care, treatment of malignant ascites, the use point of care ultra-sound in palliative home care, studies on the use of CAM (complementary and integrative medicine) in oncology and aspects of aging and immunity.

Teaching

  • Teaching in Palliative Medicine för MD and nurses on advanced level. Course manager for 2 mandatory courses in Palliative Medicine for resident physicians.

    Teaching at basic levels for MDs, physiotherapists and occupational therapist in palliative care.

    Scientific leader at Center of Palliative Care (Palliativt Kunskapscentrum) in Region Stockholm since 2022. This includes teaching on a regular basis for physicians, nurses and other health care professionals  working in palliative care. My main foucs has been symptom managment and end-of-life care.

    Teaching in Clinical Pharmacology at basic and advanced levels for physicians, nurses and biomedical analysts. 

    Teaching in Geriatrics at basic and advanced level for MDs.

    Teaching in Scientific methodology for resident physicians in geriatrics.

    Main supervisor of 11 resident physicians for their Scientific Project (ST-projekt) in Palliative Medicine and Geriatrics.

    Co-ordinator for the Master degree of MDs 2014-2015.

    During 1995-2001  teaching in biochemistry and pathology for MD:s.


    Co-author in three textbooks for MDs and nurses:
    'Palliativ Medicin' in the book Klinisk Geriatrik (Libers förlag 2020),
    'Palliativ Cancervård' i böckerna Klinisk Omvårdnad 1 och 2 (Libers
    förlag, 2021)
    'Vård i livets slut' in the book Boken om Demenssjukdomar (Libers
    förlag 2023)

Articles

All other publications

Grants

  • To live until death - Factors affecting symptom distress, quality of life and survival time in cancer patients in palliative stages. Focus on vitamin D and the immune system.
    Swedish Cancer Society
    1 January 2018
    In palliative care, all treatment aims at alleviating symptoms and maintaining as high a quality of life as possible despite a life-threatening illness. The goal is "to live until you die". Infections, pain and fatigue are common among palliative patients and often lead to lower quality of life during their last life. Vitamin D is a hormone that is important for a healthy immune system and deficiency can lead to increased risk of infections, more pain, fatigue and depression. In a small pilot study, we saw that vitamin D treatment led to reduced pain and fewer infections in our cancer patients without giving any side effects. We now want to do a large clinical trial in which 254 patients with incurable cancer are treated with either vitamin D or placebo for 12 weeks. The purpose is to investigate whether vitamin D can reduce pain, reduce infections and fatigue and improve quality of life. The mechanisms behind vitamin D's effects on pain and inflammation in the body will also be studied. In the study, we also evaluate new and old biomarkers in order to better predict the survival time In a separate study, we will study the immune system's function in the end of life in 100 cancer patients and examine the relationship with immune responses and vitamin D levels. Today, there are no guidelines for supplementation of vitamin D to cancer patients, leaving the field open for thought-provoking and unfounded statements about benefits and risks. Therefore, proper studies are needed, as suggested here. If vitamin D treatment can reduce the burden of infection, fatigue and / or pain in palliative patients, this is of great importance to health care as it can reduce patient suffering, reduce drug treatment and reduce the weight of care. In the event of a negative result, we know that we do not need to treat vitamin D deficiency in our cancer patients, ie even a negative result is important.
  • Can treatment with vitamin D for palliative cancer patients reduce the burden of infection and pain and increase the quality of life?
    Swedish Cancer Society
    1 January 2017
    Infections and pain are a major problem in patients with incurable cancer. In a recent study on palliative cancer patients, we have seen that the patients had very low vitamin D levels. Vitamin D is needed for a healthy immune system. We have previously shown that vitamin D treatment reduced the burden of infection in patients with immunodeficiency disease. In our cancer patients, we also saw a connection between pain medication and vitamin D levels. The lower the vitamin D value, the more pain treatment. Other researchers have shown that low levels of vitamin D are associated with increased pain sensitivity and greater risk of depression. Our goal is to investigate whether we can reduce the burden of infection, reduce pain and improve the quality of life of palliative cancer patients with the help of vitamin D treatment in a gentle and non-adverse manner. We therefore want to do a study in which we treat these patients with vitamin D and follow them for the burden of infection, pain management and self-rated quality of life. A positive result in these studies would mean new opportunities for an almost non-adverse treatment that could improve and perhaps prolong the last time in life for patients with incurable cancer. Even a negative result is interesting as there is currently no knowledge of vitamin D treatment that benefits this patient group.
  • Can treatment with vitamin D for palliative cancer patients reduce the burden of infection and pain and increase the quality of life?
    Swedish Cancer Society
    1 January 2016
    Infections and pain are a major problem in patients with incurable cancer. In a recent study on palliative cancer patients, we have seen that the patients had very low vitamin D levels. Vitamin D is needed for a healthy immune system. We have previously shown that vitamin D treatment reduced the burden of infection in patients with immunodeficiency disease. In our cancer patients, we also saw a connection between pain medication and vitamin D levels. The lower the vitamin D value, the more pain treatment. Other researchers have shown that low levels of vitamin D are associated with increased pain sensitivity and greater risk of depression. Our goal is to investigate whether we can reduce the burden of infection, reduce pain and improve the quality of life of palliative cancer patients with the help of vitamin D treatment in a gentle and non-adverse manner. We therefore want to do a study in which we treat these patients with vitamin D and follow them for the burden of infection, pain management and self-rated quality of life. A positive result in these studies would mean new opportunities for an almost non-adverse treatment that could improve and perhaps prolong the last time in life for patients with incurable cancer. Even a negative result is interesting as there is currently no knowledge of vitamin D treatment that benefits this patient group.
  • Can treatment with vitamin D for palliative cancer patients reduce the burden of infection and pain and increase the quality of life?
    Swedish Cancer Society
    1 January 2015
    Infections and pain are a major problem in patients with incurable cancer. In a recent study on palliative cancer patients, we have seen that the patients had very low vitamin D levels. Vitamin D is needed for a healthy immune system. We have previously shown that vitamin D treatment reduced the burden of infection in patients with immunodeficiency disease. In our cancer patients, we also saw a connection between pain medication and vitamin D levels. The lower the vitamin D value, the more pain treatment. Other researchers have shown that low levels of vitamin D are associated with increased pain sensitivity and greater risk of depression. Our goal is to investigate whether we can reduce the burden of infection, reduce pain and improve the quality of life of palliative cancer patients with the help of vitamin D treatment in a gentle and non-adverse manner. We therefore want to do a study in which we treat these patients with vitamin D and follow them for the burden of infection, pain management and self-rated quality of life. A positive result in these studies would mean new opportunities for an almost non-adverse treatment that could improve and perhaps prolong the last time in life for patients with incurable cancer. Even a negative result is interesting as there is currently no knowledge of vitamin D treatment that benefits this patient group.

Employments

  • Professor/Senior Physician, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 2024-
  • Principal Researcher, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 2022-2024
  • Researcher, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 2018-2022
  • Researcher, Department of Laboratory Medicine, Karolinska Institutet, 2015-2018

Degrees and Education

  • Docent, Karolinska Institutet, 2013
  • Doctor Of Philosophy, Department of Laboratory Medicine, Karolinska Institutet, 2004
  • University Medical Degree, Karolinska Institutet, 2001

News from KI

Events from KI