Annual Report 2019
Department of Palliative Medicine
Eriko Satomi, Hiroto Ishiki, Daisuke Kiuchi, Masaki Shimizu, Emi Kubo, Sayuri Yokota, Naoki Serizawa, Ken Asaishi, Rebekah Kojima
Introduction
The palliative care service started with a palliative care team of multidisciplinary professionals (palliative care specialists, psycho-oncologists, certified nurses, pharmacists, psychologists, Hospital Play Staff, acupuncturists) in the National Cancer Center Hospital (NCCH) in 1999 and the Department of Palliative Care and Psycho-Oncology was established in 2010 with the reorganization of the NCCH. In 2013, the Department of Palliative Medicine started.
The Team and What We Do
We provide palliative care to patients and their families as members of the palliative care team collaborating with primary doctors, nurses, and other professionals to create an individualized palliative care plan. Our goals are:
- Relieve pain and other physical symptoms
- Focus on patients’ emotional and spiritual concerns, and those of their caregivers
- Coordinate patients’ care
- Improve the quality of life of patients with cancer
- Advance care planning
Research activities
We are participating in and conducting multicenter observational studies and interventional studies for supportive and palliative care, and continuously planning palliative care research for the innovation of palliative care.
Clinical trials
JORTC-PAL08 (Efficacy of duloxetine for cancer patients with neuropathic pain: Double blind, Randomized, Placebo controlled, exploratory trial), PHASE-R (Naldemedine for opioid-induced constipation: observational study), J-SUPPORT 1603 (Nurse-led, screening-triggered early specialized palliative care intervention program for advanced lung cancer patients randomized controlled trial), EASED (East-Asian collaborative Study to Elucidate the Dying process), JORTC-PAL16 (A Phase III, international, multi-centre, double-blind, dose increment, parallel-arm, randomised controlled trial of duloxetine versus pregabalin over 14 days for opioid unresponsive cancer-related neuropathic pain), EORTC-QOL study (EORTC PATSAT-C33, EORTC OUT-PATSAT7, EORTC COMU26, Development of a module to supplement the EORTC Core instruments for assessment of Health Related Quality of Life in patients with Metastatic Breast Cancer (Phase I-III)), etc.
Education
We have two training courses for doctors who will be palliative care specialists and for residents to learn primary palliative care. All the surgical and medical oncology residents in the NCCH need the knowledge and skills about primary supportive and palliative care in oncology. They participate in our team for four weeks and undergo on-the-job training for palliative medicine. It includes an opportunity to attend home hospice rounds in cooperation with the Chuo-ku Medical Association. A total of 16 residents finished the four-week palliative medicine course in 2019. Two short-term residents and 2 chief residents registered for the specialized palliative care education course. They learned specialist palliative care in oncology including physical, psychosocial, and spiritual supportive care during anti-cancer therapy as well as end-of-life care, and support for patients’ decision making and advance care planning.
Future prospects
We will continue to provide qualified palliative cancer care with an integrated palliative care model in clinical practice throughout the continuum of a person’s disease, regardless of whether it is early or later in the course of the disease. In addition, we will enhance our palliative care education program for specialists and oncologists. We also continuously conduct high-level palliative care research in order to strengthen evidence to improve palliative care practice.
List of papers published in 2019
Journal
1. Matsuoka H, Iwase S, Miyaji T, Kawaguchi T, Ariyoshi K, Oyamada S, Satomi E, Ishiki H, Hasuo H, Sakuma H, Tokoro A, Matsuda Y, Tahara K, Otani H, Ohtake Y, Tsukuura H, Matsumoto Y, Hasegawa Y, Kataoka Y, Otsuka M, Sakai K, Nakura M, Morita T, Yamaguchi T, Koyama A. Predictors of duloxetine response in patients with neuropathic cancer pain: a secondary analysis of a randomized controlled trial-JORTC-PAL08 (DIRECT) study. Support Care Cancer, 28:2931-2939, 2020
2. Tanaka T, Ishiki H, Kubo E, Yokota S, Shimizu M, Kiuchi D, Satomi E. Is Gefitinib Combined With Platinum-Doublet Chemotherapy a Counterpart to Osimertinib Monotherapy in Advanced EGFR-Mutated Non-Small-Cell Lung Cancer in the First-Line Setting? J Clin Oncol, 38:843-844, 2020
3. Mori M, Fujimori M, Ishiki H, Nishi T, Hamano J, Otani H, Uneno Y, Oba A, Morita T, Uchitomi Y. Adding a Wider Range and “Hope for the Best, and Prepare for the Worst” Statement: Preferences of Patients with Cancer for Prognostic Communication. Oncologist, 24:e943-e952, 2019
4. Mori M, Fujimori M, Ishiki H, Nishi T, Hamano J, Otani H, Uneno Y, Oba A, Morita T, Uchitomi Y. The Effects of Adding Reassurance Statements: Cancer Patients' Preferences for Phrases in End-of-Life Discussions. J Pain Symptom Manage, 57:1121-1129, 2019
5. Matsuoka H, Iwase S, Miyaji T, Kawaguchi T, Ariyoshi K, Oyamada S, Satomi E, Ishiki H, Hasuo H, Sakuma H, Tokoro A, Shinomiya T, Otani H, Ohtake Y, Tsukuura H, Matsumoto Y, Hasegawa Y, Kataoka Y, Otsuka M, Sakai K, Matsuda Y, Morita T, Koyama A, Yamaguchi T. Additive Duloxetine for Cancer-Related Neuropathic Pain Nonresponsive or Intolerant to Opioid-Pregabalin Therapy: A Randomized Controlled Trial (JORTC-PAL08). J Pain Symptom Manage, 58:645-653, 2019
6. Osaka I, Ishiki H, Yokota T, Tada Y, Sato H, Okamoto M, Satomi E. Safety and efficacy of naldemedine in cancer patients with opioid-induced constipation: a pooled, subgroup analysis of two randomised controlled studies. ESMO Open, 4:e000527, 2019
7. Kanai Y, Ishiki H, Maeda I, Iwase S. A survey of practice in management of malignancy-related ascites in Japan. PLoS One, 14:e0220869, 2019
8. Ishiki H, Satomi E, Shimizu K. Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness. N Engl J Med, 380:1779, 2019
9. Masuda K, Ishiki H, Oyamada S, Shimizu M, Kiuchi D, Satomi E. Questions Regarding the Randomized Phase II Trial of Defactinib as Maintenance Therapy in Malignant Pleural Mesothelioma. J Clin Oncol, 37:2293-2294, 2019
10. Kako J, Ishiki H, Kajiwara K. Biofeedback or loperamide for faecal incontinence in women. Lancet Gastroenterol Hepatol, 4:903-904, 2019