Annual Report 2017
Department of Palliative Medicine
Toshihiko Doi, Yoshihisa Matsumoto, Tomofumi Miura, Keita Tagami, Kazuhiro Kosugi, Yuko Uehara, Yuki (Sumazaki) Watababe, Yujiro Inoue
Introduction
The purpose of the Department of Palliative Medicine is to improve the quality of life in cancer patients and their family caregivers by the management of irritable symptom burden and establishment of a regional palliative care system. Therefore, we provide three palliative care services: 1) outpatient clinic, 2) supportive care team, and 3) palliative care unit.
Our team and what we do
1. Outpatient clinic
Patients with or without anti-cancer therapy consult our outpatient clinic for the management of their devastating symptoms or for support to decide where and how to spend their lives. The concept of early palliative care gradually spread and the consultations of patients undergoing anti-cancer therapy have been increasing (Table 1).
2. Supportive care team
This team consist of a physician, psycho-oncologist, nurse, dietician, physiotherapist, and speech-language-hearing therapist. Our supportive care team performs a multidisciplinary approach for inpatients with various sufferings in the oncology floor.
3. Palliative care unit
Our palliative care unit is a Japanese version of the acute palliative care unit (APCU). The features of the APCU are the multidimensional assessment, rapid symptom control and intensive psychosocial care with shorter length of stay and a lower death rate than in traditional PCU. Medical social workers greatly contribute to a transition to palliative home care and a transfer to other hospital (Table 2).
Table 1. Number of patients in outpatient clinic
Table 2. Number of patients in PCU
Research activities
The aim of the research in our division is to establish a regional palliative care system and to integrate early palliative care with oncology. Following researches are conducted;
1) A system construction of screening and intervention for symptoms in patients with advanced cancer
2) The development of the integration of early palliative care in metastatic lung cancer
3) The development of the intervention to cancer-related fatigue in advanced cancer patients with palliative care settings
4) A survey about pain, fatigue and anorexia in advanced cancer patients with palliative care settings
5) The registration for Japanese multicenter cohort studies
Clinical trials
1) A multi-centered randomized control trial of the integration of early palliative care in metastatic lung cancer
2) A multi-centered phase II trial of dexamethasone for cancer-related fatigue
Education
The purpose is to promote understanding about palliative care for cancer patients and their families for residents. Residents can train in home palliative care on request. To spread the knowledge of primary palliative care, we held several workshops for medical staff in the National Cancer Center Hospital East (NCCHE) and for regional palliative care staff.
Future prospects
We will continue to advance our activities and develop new researches to improve QOL in cancer patients and their family caregivers.
List of papers published in January 2017 - March 2018
Journal
1. Amano K, Maeda I, Morita T, Baba M, Miura T, Hama T, Mori I, Nakajima N, Nishi T, Sakurai H, Shimoyama S, Shinjo T, Shirayama H, Yamada T, Ono S, Ozawa T, Yamamoto R, Yamamoto N, Shishido H, Kinoshita H. C-reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care. J Cachexia Sarcopenia Muscle, 8:457-465, 2017
2. Matsuo N, Morita T, Matsuda Y, Okamoto K, Matsumoto Y, Kaneishi K, Odagiri T, Sakurai H, Katayama H, Mori I, Yamada H, Watanabe H, Yokoyama T, Yamaguchi T, Nishi T, Shirado A, Hiramoto S, Watanabe T, Kohara H, Shimoyama S, Aruga E, Baba M, Sumita K, Iwase S. Predictors of responses to corticosteroids for anorexia in advanced cancer patients: a multicenter prospective observational study. Support Care Cancer, 25:41-50, 2017
3. Matsuo N, Morita T, Matsuda Y, Okamoto K, Matsumoto Y, Kaneishi K, Odagiri T, Sakurai H, Katayama H, Mori I, Yamada H, Watanabe H, Yokoyama T, Yamaguchi T, Nishi T, Shirado A, Hiramoto S, Watanabe T, Kohara H, Shimoyama S, Aruga E, Baba M, Sumita K, Iwase S. Predictors of Delirium in Corticosteroid-Treated Patients with Advanced Cancer: An Exploratory, Multicenter, Prospective, Observational Study. J Palliat Med, 20:352-359, 2017
4. Mori M, Shirado AN, Morita T, Okamoto K, Matsuda Y, Matsumoto Y, Yamada H, Sakurai H, Aruga E, Kaneishi K, Watanabe H, Yamaguchi T, Odagiri T, Hiramoto S, Kohara H, Matsuo N, Katayama H, Nishi T, Matsui T, Iwase S. Predictors of response to corticosteroids for dyspnea in advanced cancer patients: a preliminary multicenter prospective observational study. Support Care Cancer, 25:1169-1181, 2017
5. Yamada T, Morita T, Maeda I, Inoue S, Ikenaga M, Matsumoto Y, Baba M, Sekine R, Yamaguchi T, Hirohashi T, Tajima T, Tatara R, Watanabe H, Otani H, Takigawa C, Matsuda Y, Ono S, Ozawa T, Yamamoto R, Shishido H, Yamamoto N. A prospective, multicenter cohort study to validate a simple performance status-based survival prediction system for oncologists. Cancer, 123:1442-1452, 2017
6. Kako J, Kobayashi M, Kanno Y, Tagami K. Intranasal Vinegar as an Effective Treatment for Persistent Hiccups in a Patient With Advanced Cancer Undergoing Palliative Care. J Pain Symptom Manage, 54:e2-e4, 2017
7. Naito AS, Sakuma Y, Kinoshita H, Ito T, Mimatsu S, Tarumi A, Kiyohara E, Morita T. Screening using the fifth vital sign in the electronic medical recording system. Jpn J Clin Oncol, 47:430-433, 2017
8. Hirooka K, Otani H, Morita T, Miura T, Fukahori H, Aoyama M, Kizawa Y, Shima Y, Tsuneto S, Miyashita M. End-of-life experiences of family caregivers of deceased patients with cancer: A nation-wide survey. Psychooncology, 27:272-278, 2018
9. Kako J, Morita T, Yamaguchi T, Sekimoto A, Kobayashi M, Kinoshita H, Ogawa A, Zenda S, Uchitomi Y, Inoguchi H, Matsushima E. Evaluation of the Appropriate Washout Period Following Fan Therapy for Dyspnea in Patients With Advanced Cancer: A Pilot Study. Am J Hosp Palliat Care, 35:293-296, 2018