Annual Report 2018
Appearance Support Center
Keiko Nozawa, Naoya Yamazaki (Joint appointment in the Department of Dermatologic Oncology), Emi Noguchi (Joint appointment in the Department of Breast and Medical Oncology), Masao Arikawa (Joint appointment in the Department of Plastic and Reconstructive Surgery), Shoko Toma, Mio Ikeda, Michiko Kato, Masako Imai
Introduction
The Appearance Support Center aims to support patients to be able to 'live in society' and 'live as humans' through clinical research and educational practices regarding patients' physical appearance.
The Team and What We Do
1. Clinical activities
Our team comprises two clinical psychologists (full-time and part-time respectively) specialized in cosmetics, who consult both in- and out-patients as well as their families for questions and concerns regarding physical appearance. Example issues include the side effects of chemotherapy and radiotherapy on skin, nails and hair and scarring and epithesis from surgeries and breast surgery. To expand our practice beyond consultation alone, we are currently developing a new team in collaboration with a dermatologist, plastic surgeon, medical oncologist, pharmacist and nurses.
The outpatient space is open to the public from Monday to Thursday between 12 am and 1 pm, during which time patients can try on different products and consult staff. Despite the limited hours for security reasons, we had 1,174 users from January to December. We also conduct a patient program entitled "Cosmetic Information" every Tuesday and Thursday from 1 pm, the main aim of which is to educate patients through group sessions. We had 99 sessions in which 421 patients participated and we had 25 men participating in the "Men's Consultation Day Sessions" (each one hour ), which were held during the first half of the year.
As for individual new patient consultations, a total of 2,225 consultations were offered to 338 in- and out- patients. Patients' main concerns were coping strategies with specific symptoms, including head and neck cancer. Following last year, consultations including seeking stress relief increased as patients with pediatric cancer increased. There were also consultations on concerns over significant life events such as the shichi-go-san ceremony, the coming-of-age ceremony, weddings and questions regarding mortuary makeup. Additionally, partial components of individual consultations and survey research were conducted at the Patient Support Research and Development Centre.
2. Research activities
Our team mainly conducted research activities focusing on A phase III, open-label, randomized trial evaluating topical corticosteroid therapy for the Facial Acneiform dermatitis by EGFR Inhibitors; supported by a grant from Practical Research for Innovative Cancer Control from the Japan Agency for Medical Research and Development, AMED and research for equalization of appearance to cancer patients and building a leaders' educational program supported by the Health Labor Sciences Research Grant as part of the Comprehensive project promoting cancer control program.
Research outcomes
Our center promoted a phase III, randomized trial evaluating topical corticosteroid therapy for Facial Acneiform dermatitis by EGFR Inhibitors and completed registrations and measurement of all 223 cases of this trials. Furthermore, we created a draft program of Appearance care of cancer patient for Medical staff based on a research survey conducted last year and covering 744 medical staff, 1,034 cancer patients and 1,030 members of the general public.
Education
To support medical staff to practice appearance care, "The Educational Workshop Regarding Appearance Care for Cancer Patients" was held three times in a year (224 participants). We concluded a special contract with Yokohama City and held follow-up training for medical staff working at designated regional cancer centers and hospitals in Yokohama City. We were also actively involved in mentorships for interns and holding monthly lectures for Interns of the Department of Palliative Care.
Future prospects
In the Third stage of the Basic plan to promote Cancer Control Program, revised in March, 2018, various issues regarding changes in appearance for cancer patients emerged. What also emerged was the need for ongoing appearance training for medical staff to further improve QOL for cancer patients. We hope to develop this emerging field based on research.
Conferences
Sponsor: Appearance Support Center (the NCC Hospital)
Conference title: The Educational Workshop on Appearance Care of Cancer Patients for Medical
Staff: Basic course
Date: December 23-24, 2018
Location (prefecture): Tokyo
Sponsor: Appearance Support Center (the NCC Hospital)
Conference title: The Educational Workshop on Appearance Care of Cancer Patients for Medical Staff: Advanced course
Date: October 7, 2018
Location (prefecture): Tokyo
List of papers published in 2018
Journal
1. Kikuchi K, Nozawa K, Yamazaki N, Nakai Y, Higashiyama A, Asano M, Fujiwara Y, Kanda S, Ohe Y, Takashima A, Boku N, Inoue A, Takahashi M, Mori T, Taguchi O, Inoue Y, Mizutani H. Instrumental evaluation sensitively detects subclinical skin changes by the epidermal growth factor receptor inhibitors and risk factors for severe acneiform eruption. J Dermatol, 46:18-25, 2019
2. Watanabe T, Yagata H, Saito M, Okada H, Yajima T, Tamai N, Yoshida Y, Takayama T, Imai H, Nozawa K, Sangai T, Yoshimura A, Hasegawa Y, Yamaguchi T, Shimozuma K, Ohashi Y. A multicenter survey of temporal changes in chemotherapy-induced hair loss in breast cancer patients. PLoS ONE, 14:e0208118, 2019
3. Yamazaki N, Oomuku Y, Mishiro I, Soeda J. Pre-emptive skin treatments to prevent skin toxicity caused by anti-EGFR antibody: the real-world evidence in Japan. Future Oncol, 14:3163- 3174, 2018