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Serious Medicine. Extraordinary Care.

Maximum Precision

About two years ago, Timothy Solberg, PhD, an unassuming individual with some big goals, slipped into the lower halls of The Nebraska Medical Center to join his new colleagues in the Department of Radiology. There was not a lot of hoopla, but fellow peers like Charles Enke, M.D., radiation oncologist, who had been “courting” this UCLA physicist for several years, viewed his arrival as quite a triumph — one that would advance the department’s goals in research and technology and elevate the department as one of the leading radiotherapy centers in the country.

That might sound like a lot to hang on one individual. But if you know a little bit about Dr. Solberg’s past accomplishments, you’d understand why. Dr. Solberg, one of the most recognized and sought-out physicists in the country, has become known for his work in developing cutting-edge techniques for the highly-focused delivery of radiotherapy combined with the integration of image-guidance to provide more accuracy and greater cancer-fighting capabilities in this field than ever before.

“Dr. Solberg is recognized by his peers as one of the most forward-thinking medical physicists in practice,” says Dr. Enke.

“Dr. Solberg is recognized by his peers as one of the most forward thinking medical physicists in practice.”
Charles Enke, MD

“He brings a wealth of experience and expertise in the development of new radiotherapy technologies which hold great promise in improving patient outcomes for a variety of cancers. With Dr. Solberg’s guidance, we look forward to developing and refining these and other new technologies at The Nebraska Medical Center as we continue to provide the most cutting-edge radiotherapy technologies in the region.”

If there’s been a common thread that has described Dr. Solberg’s life, it is one that ascribes to pursing his professional and personal interests with passion, adventure, a desire to take on new challenges and a determination to excel. Take for example the time he and a group of friends decided to climb Mount Whitney in California, the highest peak in the continental U.S. Dr. Solberg, an avid hiker, says they completed the 14,500-foot excursion up the mountain and back in one day – a trip many hikers accomplish in two to three days.

Timothy Solberg, MD

A competitive track athlete in college, he continued his enthusiasm for individual competition into his later college and graduate years by taking up running road races and triathlons. At one point, he traveled from city to city competing in some sort of race nearly every weekend. He has competed in more than 30 triathlons to date and has run several marathons and up to 75 5ks and 10ks.

He recalls crazy times, such as when his passion for music led he and a few friends to spend a frigid winter night in Minneapolis outside a ticket sales booth so he could be the first to purchase tickets to a Prince concert. During graduate school he decided to take up guitar lessons, just in case…“What guy doesn’t want to be a rock star at some point in his life?” asks Dr. Solberg.

And oh, by the way, he is also a world traveler, a self-taught photographer, an avid art and wine collector and a collector and restorer of antique radios. In addition, he rides his bike to work regularly both for exercise and conservation and he relishes the family time he spends with his wife and 18-year-old daughter.

“I’ve always been very competitive and very adventurous,” says Dr. Solberg. “My hobbies help fulfill those needs for competition and adventure and help provide balance in my life.”

Timothy Solberg, MD, Professor and Chief
of the Division of Medical Physics

Dr. Solberg, a professor and chief of the division of Medical Physics at The Nebraska Medial Center, was born in Minneapolis but spent most of his childhood growing up in Anchorage, AK, where he developed a deep appreciation for nature and the outdoors. He loved the pristine landscape, cherished the long summer days when it didn’t grow dark until 11 p.m., and spent a lot of time snow skiing and ice skating with his buddies. He and his family often took long weekend excursions to camp and hike the spectacular landscape of Alaska. He learned patience and his affable personality from his father, a hospital chaplain.

Dr. Solberg’s interest in physics was initially sparked at the Oak Ridge National Laboratory outside of Knoxville, Tenn., which he visited in college while preparing for a career in engineering. “We spent a whole month learning about modern physics, relativity, particle acceleration, nuclear fission and fusion, radiation and radioactive materials,” he recalls. “I found it to be very compelling.”

Dr. Solberg went on to complete a bachelor’s degree in physics and mathematics at Augsburg College in Minneapolis, Minn., and continued graduate studies in physics at the University of California at Davis. While there, he became aware of the specialized field of medical physics. He left UC Davis for UCLA to complete his doctoral degree in medical physics. Not only did Dr. Solberg like the scientific aspect of physics, but he savored the opportunity to work with patients and other medical professionals. “Some scientists are very reclusive,” he says. “But this field allows me to interact with patients, physicians as well as other scientists. You can see the impact of your efforts every day. I find that very rewarding.”

After completing his doctoral degree, Dr. Solberg spent the next 10 years at UCLA, where he served as professor and director of Medical Physics and the Department of Radiation Oncology. At UCLA, Dr. Solberg often found himself putting in 12-hour plus workdays. While his professional career flourished, his ability to maintain that “balance” in life suffered.

“At that time, the field was just starting to blossom,” says Dr. Solberg. “The physics group took it upon ourselves to build world- class clinical, research and academics programs at UCLA. We had a great working environment, we really supported each other, worked really hard, and really enjoyed what we did.”

Dr. Solberg says his time at UCLA allowed him to grow as a physicist and pursue cutting edge technology. For instance, through his work at UCLA, Dr. Solberg has become known for his work in integrating some of the most advanced radiation delivery devices with cutting-edge diagnostic imaging to provide greater precision targeting to cancer patients with tumors in traditionally difficult to treat areas such as the lungs, liver and prostate.

Soft-spoken, with an amiable personality, Dr. Solberg is a very approachable individual who is far from pretentious. It is these very attributes that allow Dr. Solberg to rally his peers both in the clinical and research setting toward a common goal. Since coming to The Nebraska Medical Center, Dr. Solberg has essentially picked up where he left off at UCLA. He has helped lead the implementation of two world-class research trials for a new targeting tool to treat prostate cancer and another trial to study the use of image guided technology to refine the treatment of lung cancer. He has other goals as well: he wants to pursue the concept of individualized cancer therapy through studies that integrate physiological and molecular imaging technology into the radiotherapy process. He wants to develop a medical physics PhD program at The Nebraska Medical Center to help reduce the shortage of specialists in this expanding field.

Timothy Solberg with his daughter
Caitlin and wife Judy.

So what brings one of the country’s leading physicists who seemed to have everything he needed right at his fingertips, to The Nebraska Medical Center?  “Like UCLA, I saw a great working environment where everyone worked hard, had great working relationships among their peers and truly enjoyed what they did,” explains Dr. Solberg. “The difference is that at big institutions there is often a significant amount of inertia that can be difficult to overcome.  At The Nebraska Medical Center, I saw an environment more conducive to advancing the field of medicine. The Nebraska Medical Center is hungry, supportive and clearly wants to put itself on the map. The whole culture of the institution is based around building cutting-edge technologies and high quality educational programs. I saw this as a great opportunity for me to take a leadership role in moving the whole field of oncology forward by working with both medical physicists and physicist researchers.”

Since coming to Omaha, Dr. Solberg says he is also starting to find a little more balance in his life. “I love the sense of community and friendliness of the people,” he says. “People on the streets actually walk by and say hello to you whether they know you or not. That’s unheard of in California.” Dr. Solberg says he is also enjoying the many cultural opportunities available in Omaha and is reconnecting with many of his past hobbies such as bicycling, running and swimming, photography, guitar and collecting art.

Dr. Solberg says he sees a promising and growing future for the field of radiotherapy. “Increasingly, radiotherapy is the treatment of choice for many cancers,” he says. “We are treating cancers that have traditionally been treated with more invasive and/or less specific approaches. Radiotherapy delivery technology has reached unparalleled levels of precision and new imaging technology allows us to better see what we need to target. When integrated with molecular imaging, we can create individualized patient roadmaps for predicting and assessing the response to therapy. This has produced better outcomes in shorter treatment times at a lower cost to the patients and healthcare establishment. It is truly a fundamental paradigm shift in the practice of radiation oncology.”

Q&A

How does the field of physics apply to medicine?

Physics deals with the fundamental constituents of the natural world. On the smallest level this involves the study of atoms and their parts – protons and neutrons – and how they interact on an atomic and subatomic level. On a larger level, physics involves the study of our galaxies, how they interact and respond to magnetic forces, how the universe was formed, how it is evolving and expanding.

Medical physics deals with human cells: how cells work, what impacts cells, how we can make them grow and die; and cells on a subcellular level: how collections of cells become tumors and the interaction of radiation with biological matters like cells and tumors.

How has the field of radiotherapy changed over the past 10 years?

The past 10 to 15 years have seen revolutionary advances in radiotherapy that have allowed for more precise and targeted therapy delivery and improvements in imaging. Historically, methods to delivery therapy have been crude. Radiotherapy’s effectiveness was limited by attempts to avoid adjacent structures. Other therapies such as chemotherapy provide a systemic treatment modality which is limited by the fact that doctors must try to find a balance between delivering it in amounts that will kill cancer cells without killing healthy tissue.

Today, radiotherapy is a highly effective and targeted cancer therapy that is used in 70 percent of all cancer patients, either alone or in conjunction with other treatment modalities. In many cases, it is preferred over surgery as it has a shorter recovery time, is less expensive and can be performed on an outpatient basis. Brain cancer is a case in point. In the past, surgery was the procedure of choice to treat tumors in the brain. Today, radiotherapy is the preferred treatment option, providing greater precision and better outcomes.

What have been some of the greatest advances in the field of radiotherapy over the last 10 years?

One of the most significant tools has been the introduction of Novalis® shaped beam surgery, the most advanced radiation delivery system available. The Nebraska Medical Center is the only medical center in the region to acquire Novalis, which delivers a carefully-shaped and highly-precise dose of high-energy radiation to treat tumors in the brain, spinal column and other parts of the body. The radiation beams are shaped to match the exact contour of the tumor or lesion so that even irregularly shaped tumors or lesions can receive doses of radiation while avoiding damage to critical, adjacent structures. Conventional radiation therapy uses beams of uniform intensity, making it extremely difficult to fully treat the tumor without damaging surrounding tissue and organs. Novalis has been successful at treating patients with head and neck cancers, prostate cancer, cancer of the brain and spinal cord and recurrent or inoperable cancers previously treated unsuccessfully.

What kinds of research trials are you pursuing at The Nebraska Medical Center?

The Nebraska Medical Center is one of five testing centers in the country to use a new treatment option for prostate cancer. The procedure uses a targeting tool called Calypso that relies on electromagnetic “beacons” to localize the prostate. This technique provides more exact tracking of the prostate and accounts for slight movements before and during treatment. Working much like a global positioning device, the beacons are implanted into the prostate and emit a low-level radiofrequency signal. The Calypso targeting device reads the signal and allows physicians to triangulate the position of the prostate and monitor it during treatment. If there is movement, treatment can be halted while the patient is repositioned.

The Nebraska Medical Center also recently became one of five centers in the world to begin participating in studies using an innovative technique called respiratory-gated radiotherapy that allows the radiation beam to be turned on and off based on a patient’s respiratory pattern. One of my goals is to refine this technology to assist in the treatment of lung cancer, which are difficult to target because the tumor moves as the patient breathes.

What kinds of advancements do you see in the future of radiotherapy?

The next evolution in radiotherapy imaging is the introduction of sophisticated systems such as 3-D anatomical visualization, that will provide imaging of cancer anatomy as well as the physiologic and biologic processes of cancer. Our goal is to not only improve imaging of the anatomy but also imaging of the actual cancer tumor so that we can be even more exact in our delivery. This is the gold standard of radiosurgery. There are many benefits we can gain from being able to see a patient’s anatomy in the treatment room that will result in even more precision and accuracy. Currently, cancers are treated the same based on how large the tumor is and its stage. This is an individual approach, not an approach based on histology. Every person’s cancer responds to treatment differently and some parts of a tumor may be more aggressive than other parts. Advanced imaging could help physicians understand how the cancer is responding to therapy and allow for customization of dosages for each patient’s individual situation.

What other goals are you pursing at The Nebraska Medical Center?

I am pursuing studies with physiological and molecular imaging technology in conjunction with radiotherapy by incorporating positron emission tomography (PET) and magnetic resonance spectroscopy (MRS) imaging into the radiotherapy process. This type of imaging will provide more detailed information about specific metabolic physiologies such as how rapidly a tumor is growing, its level of oxygenation, (tumors lacking in oxygen are referred to as hypoxic and are more difficult to treat), and angiogenesis – which refers to how new blood vessels are formed and how they grow. Some tumors secrete factors that induce the angiogenesis process. This process is linked very closely to the growth and development of tumors and can provide us with new types of targets to treat with radiotherapy. These are biological processes that will vary in every patient. Being able to mesh and integrate these disciplines and technologies will allow us to get to the most fundamental and basic dynamics of physiology and biology.

To achieve this goal, I would like to see the development of an animal imaging research facility at The Nebraska Medical Center to study systematically these physiologic responses. Development of physiological and molecular technology begins with translational research using basic science. A small animal molecular imaging core is essential to the development of translational programs in humans. A lot can be learned from small animals that you can directly translate to humans. This type of facility would allow us to enhance the basic research in our field in order to understand in greater detail, cancer’s response to radiotherapy individual research.