Annual Report 2022
Department of Rehabilitation Medicine
Nanako Hijikata, Junya Ueno, Yoshie Ino, Yu Koishihara, Tsuyoshi Harada, Nobuko Konishi, Keiko Sato, Kanako Miyazaki, Motoki Tanaka, Takumi Yanagisawa
Introduction
The Department of Musculoskeletal Oncology and Rehabilitation at NCCHE was established in 2012 as a team consisting of a panel of orthopedic surgeons and rehabilitation specialists. In 2021, a board-certified physiatrist joined the team to expand our rehabilitation delivery system, which led to a shift in our advocacy to “the Department of Rehabilitation Medicine.” Consequently, our rehabilitation delivery system for cancer patients has been further improved. We strive to provide specialized interdisciplinary care for a variety of tumors and offer comprehensive rehabilitation services. Currently, one physiatrist and a team of nine rehabilitation staff members, consisting of five physical therapists, three speech-language pathologists, and one occupational therapist, are involved in the treatment of a variety of patients with the help of other medical staff at NCCHE.
The Team and What We Do
We provide preoperative and postoperative rehabilitation treatment for cancer patients scheduled to undergo surgery to reduce perioperative complications. We also offer rehabilitation treatment for patients with advanced cancer undergoing chemotherapy and/or radiation therapy, regardless of cancer type, to preserve functionality and capability. We are actively engaged in providing rehabilitation treatment to support for return to home for advanced, terminal or end-stage cancer patients. The demand for rehabilitation therapy has been increasing every year, and the number of patients referred to the Department of Rehabilitation Medicine in 2022 was 3,281 (Table 1).
Table 1. Number of patients enrolled for rehabilitation.
Research Activities
We are engaged in research to demonstrate the effects of rehabilitation therapy on cancer patients who undergo surgery and patients with advanced cancer who receive chemotherapy and/or radiation therapy, in collaboration with physicians and paramedical teams from various departments. We have been involved in research on sarcopenia in oncology and have analyzed the effects of surgery and preoperative adjuvant chemotherapy on physical functionality and skeletal muscle mass in perioperative esophageal cancer patients. The findings were compiled into an original paper and submitted to international journals to demonstrate research results. In addition, a review article about physical frailty and rehabilitation therapy in elderly patients with cancer was published. Rehabilitation staff members were encouraged to present the effects of rehabilitation therapy at national and international conferences on cancer treatment. We supported paramedical staff members to apply for research funding, and a physical therapist acquired a research grant in 2022.
Education
In 2022, our hospital applied for and newly obtained the accreditation certificate for educational institution for respiratory physiotherapy. We now offer a clinical curriculum to training physical therapists for board certification. In addition, we accepted undergraduate students from the Department of Physical Therapy, Faculty of Health Science, Juntendo University, for clinical training as an affiliated hospital.
Future Prospects
According to the Fourth Basic Plan to Promote Cancer Control Programs, "promotion of effective and continuous cancer rehabilitation in outpatient settings (in addition to hospitalization)" was identified as an issue to be addressed in advancing cancer medicine. Along with the shift of cancer treatment to outpatient setting, the number of patients who visit hospitals to receive outpatient chemotherapy and/or radiotherapy is increasing, and thus we intend to conduct rehabilitation treatment and research with the aim of standardizing and establishing of outpatient cancer rehabilitation programs. Specifically, we plan to expand the screening and support system for patients undergoing chemotherapy in clinical setting, and we aim to verify the effectiveness of preoperative and postoperative outpatient rehabilitation treatment in research fields.
List of papers published in 2022
Journal
1. Hijikata N, Ishikawa A, Matsuda S, Kawakami M, Muraoka K, Ando M, Mayanagi S, Irino T, Kawakubo H, Kitagawa Y, Tsuji T. Effect of Postoperative Oral Intake Status on Sarcopenia Six Months After Esophageal Cancer Surgery. Dysphagia, 38:340-350, 2023
2. Harada T, Tatematsu N, Ueno J, Koishihara Y, Konishi N, Fukushima T, Fujiwara H, Fujita T, Hijikata N, Wada A, Ishikawa A, Tsuji T. Impact of early postoperative factors on changes in skeletal muscle mass after esophagectomy in older patients with esophageal cancer. European geriatric medicine, 14:203-210, 2023
3. Harada T, Tatematsu N, Ueno J, Koishihara Y, Konishi N, Hijikata N, Ishikawa A, Tsuji T, Fujiwara H, Fujita T. Prognostic Impact of Postoperative Loss of Skeletal Muscle Mass in Patients Aged 70 Years or Older with Esophageal Cancer. Annals of surgical oncology, 29:5638-5645, 2022
4. Harada T, Tsuji T, Fujita T. ASO Author Reflections: Significance of Postoperative Loss of Skeletal Muscle Mass in Older Patients with Esophageal Cancer. Annals of surgical oncology, 29:5646-5647, 2022
5. Harada T, Tsuji T, Fujita T. ASO Author Reflections: Significance of Loss of Skeletal Muscle Mass During Neoadjuvant Chemotherapy in Older Patients with Esophageal Cancer. Annals of surgical oncology, 29:8140-8141, 2022
6. Harada T, Tsuji T, Ueno J, Koishihara Y, Konishi N, Hijikata N, Ishikawa A, Kotani D, Kojima T, Fujiwara H, Fujita T. Prognostic Impact of the Loss of Skeletal Muscle Mass During Neoadjuvant Chemotherapy on Older Patients with Esophageal Cancer. Annals of surgical oncology, 29:8131-8139, 2022