Annual Report 2023
Department of Palliative Medicine
Tomofumi Miura, Kazuhiro Kosugi, Emi Kubo, Yujiro Inoue, Keisuke Ishizuka, Mariko Harada, Ayaka Ishida, Sakiho Noda, Masato Hayashi
Introduction
The purpose of our department is to improve the quality of life of cancer patients and their family caregivers by managing the irritable symptom burden and establishing a regional palliative care system. For that purpose, we provide 3 palliative care services: (1) outpatient clinic, (2) palliative care unit, and (3) supportive care team.
Additionally, the National Cancer Center Hospital East was certified as an ESMO designated center of integrated oncology and palliative care in 2018.
The Team and What We Do
1. Outpatient clinic
Patients with or without anti-cancer therapy consult our outpatient clinic about management of their symptoms or support to decide where and how to spend their lives (Table 1).
Table 1. Number of patients in the outpatient clinic
2. Palliative care unit
Our palliative care unit is the Japanese version of an acute palliative care unit (APCU). The features of APCUs are multidimensional assessment, rapid symptom control, and intensive psychosocial care with a shorter length of stay and lower death rate than in a traditional PCU. Medical social workers greatly contribute to the transition to palliative home care and transfers to other hospitals (Table 2).
Table 2. Number of patients in the PCU
3. Supportive care team
This team consists of physicians, psycho-oncologists, nurses, dieticians, physiotherapists, and speech-language-hearing therapists. In the oncology section, our supportive care team takes a multidisciplinary approach for inpatients with various illnesses (Table 3).
Table 3. Number of patients treated by the supportive care team
Research Activities
1) Development of a support system for cancer patients at home using AI-based monitoring.
2) Research on the establishment of a support system for cancer patients with minor children using an online peer support system.
3) Research on the efficacy of specialized rehabilitation for cancer patients hospitalized in palliative care units.
4) Research on psychological distress among cancer patients with minor children during the COVID-19 pandemic.
5) Participation in multicenter observational studies, interventional studies, and surveys of bereaved families.
Clinical Trials
A double-blind randomized controlled trial to relief the distress from chemotherapy-induced peripheral neuropathy using magnetic fields.
Education
The purpose is to promote our residents’ understanding of palliative care for cancer patients and their families. Residents can train in home palliative care on request. To disseminate knowledge about primary palliative care, we held several online lectures for patients, caregivers and medical staff across the country.
Future Prospects
Our department will continue the above activities and develop new treatments and medical instruments to improve the QOL of cancer patients and their family caregivers.
List of papers published in 2023
Journal
1. Kadono T, Ishiki H, Yokomichi N, Ito T, Maeda I, Hatano Y, Miura T, Hamano J, Yamaguchi T, Ishikawa A, Suzuki Y, Arakawa S, Amano K, Satomi E, Mori M. Malignancy-related ascites in palliative care units: prognostic factor analysis. BMJ supportive & palliative care, 13:e1292-e1299, 2024
2. Tagami K, Chiu SW, Kosugi K, Ishiki H, Hiratsuka Y, Shimizu M, Mori M, Kubo E, Ikari T, Arakawa S, Eto T, Shimoda M, Hirayama H, Nishijima K, Ouchi K, Shimoi T, Shigeno T, Yamaguchi T, Miyashita M, Morita T, Inoue A, Satomi E. Cancer Pain Management in Patients Receiving Inpatient Specialized Palliative Care Services. Journal of pain and symptom management, 67:27-38.e1, 2024
3. Tsuno T, Kawaguchi T, Yanaizumi R, Kondo J, Kojima K, Igarashi T, Inoue M, Miura T, Miyasato A, Azuma K, Hamada H, Saeki T, Mawatari H, Ogura H, Kotani A, Yamaguchi T, Hakamata H. Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study. Palliative medicine reports, 5:43-52, 2024
4. Noda S, Yamaguchi J, Kosugi K, Ishida A, Harada M, Ishizuka K, Inoue Y, Kubo E, Miura T. Peppermint Inhalation Therapy for Persistent Hiccups in Terminally Ill Cancer Patient: A Case Study. Journal of pain and symptom management, 67:e503-e505, 2024
5. Amano K, Baracos VE, Mori N, Okamura S, Yamada T, Miura T, Tatara R, Kessoku T, Matsuda Y, Tagami K, Otani H, Mori M, Taniyama T, Nakajima N, Nakanishi E, Kako J, Morita T, Miyashita M. Associations of nutrition impact symptoms with dietary intake and eating-related distress in patients with advanced cancer. Clinical nutrition ESPEN, 60:313-319, 2024
6. Ishida A, Inokuchi Y, Hirata M, Narimatsu H, Yoshioka E, Washimi K, Machida N, Maeda S. A case of an unreported point mutation in promoter 1B of the adenomatous polyposis coli gene, which is responsible for gastric adenocarcinoma and proximal polyposis of the stomach. Clinical journal of gastroenterology, 2024
7. Shiraishi R, Kizawa Y, Mori M, Maeda I, Hatano Y, Ishiki H, Miura T, Yokomichi N, Kodama M, Inoue K, Otomo S, Yamaguchi T, Hamano J. Comparison of Symptom Severity and Progression in Advanced Cancer Patients Among Different Care Settings: A Secondary Analysis. Palliative medicine reports, 4:139-149, 2023
8. Hiratsuka Y, Tagami K, Inoue A, Sato M, Matsuda Y, Kosugi K, Kubo E, Natsume M, Ishiki H, Arakawa S, Shimizu M, Yokomichi N, Chiu SW, Shimoda M, Hirayama H, Nishijima K, Ouchi K, Shimoi T, Shigeno T, Yamaguchi T, Miyashita M, Morita T, Satomi E. Prevalence of opioid-induced adverse events across opioids commonly used for analgesic treatment in Japan: a multicenter prospective longitudinal study. Supportive care in cancer, 31:632, 2023
9. Amano K, Morita T, Miura T, Mori N, Tatara R, Kessoku T, Matsuda Y, Tagami K, Otani H, Mori M, Taniyama T, Nakajima N, Nakanishi E, Kako J, Ishiki H, Matsuoka H, Satomi E, Hopkinson JB, Baracos VE, Miyashita M. Development and validation of questionnaires for eating-related distress among advanced cancer patients and families. Journal of cachexia, sarcopenia and muscle, 14:310-325, 2023
10. Otani H, Amano K, Morita T, Miura T, Mori N, Tatara R, Kessoku T, Tokoro A, Tagami K, Mori M, Taniyama T, Nakajima N, Nakanishi E, Kako J, Miyashita M. Difficulty swallowing and food bolus obstruction in advanced cancer: association with the cachexia-related quality of life. Annals of palliative medicine, 12:717-728, 2023
11. Kubo E, Harada M, Ishizuka K, Umetsu K, Inoue Y, Kosugi K, Miura T. Letter to the Editor: Three Cases of Pain Treatment in Cancer Patients Using an Alternating Magnetic Field Therapy Device. Journal of palliative medicine, 26:1444-1445, 2023