Annual Report 2023
Department of Palliative Medicine
Eriko Satomi, Hiroto Ishiki, Sayaka Arakawa, Naruaki Kawasaki, Ayaka Ishikawa, Takako Ikegami, Naho Matsubara, 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
Patient demography in the outpatient clinic and palliative care team (Table 1)
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
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)), ACT-1 (Phase II study of the efficacy and safety of acupuncture for CIPN), ABC-1 (Phase II study of the efficacy and safety of acupuncture in Breast Cancer Survivors with Post-Mastectomy Pain Syndrome, PAL20 (Exploratory trial of preventive Olanzapine for opioid induced nausea and vomiting), PhaseR-Methadone, MARC study (Phase II study of the efficacy and safety of additive methadone on other opioid for intractable cancer pain), Screening Distress and Supportive Care Needs of Adolescents and Young Adults with Cancer, Effectiveness of the educational program for healthcare professionals to support cancer patients with minor children, Pilot study of web consultation on specialized cancer pain, etc.
Education
We have three training courses for doctors who will be palliative care specialists and for residents to learn primary palliative care. Three residents took a training course in specialized palliative medicine. All the medical oncology residents in the NCCH need to acquire the knowledge and skills in primary supportive and palliative care in oncology. They can participate in our team for four weeks and undergo on-the-job training for palliative medicine. A total of 16 residents, 2 chief residents and 3 interns finished the four-week palliative medicine course in 2023. 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. We also organized the PEACE Palliative Care Training Seminar, a basic training in palliative care set by the Ministry of Health, Labour and Welfare. Twelve people, including four physicians, completed the one-day training, which included small group discussions and role-playing workshops.
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 its course. In addition, we will enhance our palliative care education program for specialists and oncologists. We will also continuously conduct high-level palliative care research in order to strengthen evidence to improve palliative care practice.
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. Hirayama T, Ishiki H, Yanai Y, Horiguchi S, Sugisawa A, Sato J, Kojima R, Sato K, Mizuta T, Kojima R, Udagawa R, Kojima Y, Satomi E. Feasibility of an Electronic Patient-Reported Outcome Tool for Screening Distress and Supportive Care Needs of Adolescents and Young Adults with Cancer. Journal of adolescent and young adult oncology, 13:138-146, 2024
3. Takamizawa S, Ishiki H, Oyamada S, Takeda Y, Kiuchi D, Amano K, Matsuda Y, Yokomichi N, Kohara H, Suzuki K, Satomi E, Mori M. Psychological symptom burden associated with malignant wounds: Secondary analysis of a prospective cohort study. Palliative & supportive care, 22:396-403, 2024
4. Hirayama T, Kojima R, Udagawa R, Mashiko Y, Matsumoto K, Ogata K, Shindo A, Mizuta T, Ogawa Y, Kayano A, Yanai Y, Ishiki H, Satomi E. Preliminary Effectiveness of an In-Hospital Peer Support Program, Adolescent and Young Adult Hiroba, on Anxiety in Adolescent and Young Adult Patients with Cancer. Journal of adolescent and young adult oncology, 13:224-232, 2024
5. 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
6. Sanomachi T, Ishiki H. Classifying and grading liposarcoma by CT. The Lancet. Oncology, 25:e53, 2024
7. Kawashima N, Yokomichi N, Morita T, Yabuki R, Hisanaga T, Imai K, Hirose Y, Shimokawa M, Miwa S, Yamauchi T, Okamoto S, Satomi E. Comparison of Pharmacological Treatments for Agitated Delirium in the Last Days of Life. Journal of pain and symptom management, 67:441-452.e3, 2024
8. Amano K, Okamura S, Baracos V, Mori N, Sakaguchi T, Uneno Y, Hiratsuka Y, Hamano J, Miura T, Ishiki H, Yokomichi N, Hatano Y, Morita T, Mori M. Fluid retention and weight loss in refractory cancer cachexia. BMJ supportive & palliative care, spcare-2024-004820, 2024
9. Satomi E, Kobayashi T, Ishikawa A, Arakawa S, Ishiki H, Amano K, Sakiyama N, Ariyoshi K, Kihara K, Oyamada S, Mizushima A. Investigating the efficacy and safety of olanzapine prophylaxis for opioid-induced nausea and vomiting (JORTC-PAL20): a study protocol for an open-label, single-arm exploratory study. BMJ open, 14:e076575, 2024
10. Amano K, Koshimoto S, Arakawa S, Oyamada S, Ishiki H, Morita T, Takeuchi T, Satomi E, Mori N. Factors associated with multimodal care practices for cancer cachexia among registered dietitians. Supportive care in cancer, 32:213, 2024
11. Hirayama T, Fujimori M, Yanai Y, Ishiki H, Shindo A, Tanaka M, Kobayashi T, Kojima R, Satomi E. Development and evaluation of the feasibility, validity, and reliability of a screening tool for determining distress and supportive care needs of adolescents and young adults with cancer in Japan. Palliative & supportive care, 21:677-687, 2023
12. Toda Y, Ishiki H, Machida T, Kawasaki N, Kobayashi E. Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery. Annals of internal medicine, 176:eL220366, 2023
13. Imai K, Morita T, Mori M, Kiuchi D, Yokomichi N, Miwa S, Okamoto S, Yamauchi T, Naito AS, Matsuda Y, Maeda I, Sugano K, Ikenaga M, Inoue S, Satomi E. Visualizing How to Use Antipsychotics for Agitated Delirium in the Last Days of Life. Journal of pain and symptom management, 65:479-489, 2023
14. Mori M, Yamaguchi T, Suzuki K, Matsuda Y, Matsunuma R, Watanabe H, Ikari T, Matsumoto Y, Imai K, Yokomichi N, Miwa S, Yamauchi T, Okamoto S, Inoue S, Inoue A, Hui D, Morita T, Satomi E. Do Types of Opioids Matter for Terminal Cancer Dyspnea? A Preliminary Multicenter Cohort Study. Journal of pain and symptom management, 66:e177-e184, 2023
15. Amano K, Arakawa S, Hopkinson JB, Baracos VE, Oyamada S, Koshimoto S, Mori N, Ishiki H, Morita T, Takeuchi T, Satomi E. Factors Associated With Practice of Multimodal Care for Cancer Cachexia Among Physicians and Nurses Engaging in Cancer Care. JCO oncology practice, 19:602-609, 2023
16. Maeda S, Morita T, Yokomichi N, Imai K, Tsuneto S, Maeda I, Miura T, Ishiki H, Otani H, Hatano Y, Mori M. Continuous Deep Sedation for Psycho-Existential Suffering: A Multicenter Nationwide Study. Journal of palliative medicine, 26:1501-1509, 2023
17. 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
18. Hirayama H, Satomi E, Kizawa Y, Miyazaki M, Tagami K, Sekine R, Suzuki K, Yotani N, Sugano K, Abo H, Sakashita A, Sato K, Nakagawa S, Nakazawa Y, Hamano J, Miyashita M. The effect of palliative care team intervention and symptom improvement using patient-reported outcomes: a multicenter prospective observational study. Supportive care in cancer, 31:439, 2023
19. 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
20. Amano K, Baracos V, Okamura S, Yamada T, Maeda I, Otani H, Ishiki H, Miura T, Hamano J, Hatano Y, Morita T, Mori M. Low serum creatinine as a prognostic marker in advanced cancer. BMJ supportive & palliative care, spcare-2023-004646, 2023
21. Takeda Y, Ishiki H, Oyamada S, Otani H, Maeda I, Yamaguchi T, Hamano J, Mori M, Morita T. Symptoms and Prognoses of Patients With Breast Cancer and Malignant Wounds in Palliative Care Units: The Multicenter, Prospective, Observational EASED Study. The American journal of hospice & palliative care, 10499091231219855, 2023