Annual Report 2023
Department of Rehabilitation Medicine
Nanako Hijikata, Junya Ueno, Tsuyoshi Harada, Nobuko Konishi, Keiko Sato, Kanako Miyazaki, Motoki Tanaka, Takumi Yanagisawa, Daiyu Kobayashi, Koki Nakashima
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 9 rehabilitation staff members, consisting of 6 physical therapists, 2 speech-language pathologists, and 1 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 2023 was 3,486 (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. We also investigate the priority of activities of daily living (ADL) among vulnerable older patients with cancer. The results were summarized as an original paper and submitted to international journals to demonstrate research findings. 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 2023.
Education
We have offered a clinical curriculum to training physical therapists for board certification and accepted therapists since our hospital acquired the accreditation certificate for educational institution for respiratory physiotherapy in 2022. 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 settings, and we plan to verify the effectiveness of preoperative and postoperative outpatient rehabilitation treatment in research fields.
List of papers published in 2023
Journal
1. Ikeda T, Toyama S, Harada T, Noma K, Hamada M, Kitagawa T. Effectiveness of prehabilitation during neoadjuvant therapy for patients with esophageal or gastroesophageal junction cancer: a systematic review . Esophagus, 21:283-297 , 2024
2. Harada T, Tsuji T, Yanagisawa T, Ueno J, Hijikata N, Ishikawa A, Hiroshige K, Kotani D, Kojima T, Fujita T. Skeletal muscle mass recovery after oesophagectomy and neoadjuvant chemotherapy in oesophageal cancer: retrospective cohort study. BMJ supportive & palliative care, spcare-2023-004245, 2023
3. Harada T, Tsuji T, Ueno J, Hijikata N, Ishikawa A, Kotani D, Kojima T, Fujita T. Association of sarcopenia with relative dose intensity of neoadjuvant chemotherapy in older patients with locally advanced esophageal cancer: A retrospective cohort study. Journal of geriatric oncology, 14:101580, 2023
4. Harada T, Tsuji T, Tatematsu N, Ueno J, Koishihara Y, Konishi N, Yanagisawa T, Hijikata N, Ishikawa A, Fujita T. The Postoperative Recovery Course of Skeletal Muscle Mass in Older Esophageal Cancer Patients . European Journal of Cancer Care, 6655999 , 2023
5. Harada T, Tsuji T, Tanaka M, Konishi N, Yanagisawa T, Koishihara Y, Ueno J, Mizutani T, Nishiyama N, Soeda R, Hijikata N, Ishikawa A, Hayashi R. Priority of the basic and instrumental activities of daily living in older patients with cancer prescribed rehabilitation: a cross-sectional survey . Supportive care in cancer, 31:503 , 2023
6. Masui A, Harada T, Noda Y, Soeda R, Kida H, Tsuji T. Retrospective study on the trajectories of lower limb volume after outpatient-based complex decongestive therapy in post-operative gynecological cancer patients with lymphedema . Supportive care in cancer, 31:318 , 2023