COVER STORY:Life Innovation
Cancer Checkups and Care for All
With cancer the leading cause of death in Japan, the government is promoting a policy of “Maintaining Designated Cancer Hospitals” so that everyone in Japan can receive the same level of medical care regardless of where they live. The Japan Journal’s Osamu Sawaji talks to Dr. Tadao Kakizoe, president emeritus of the National Cancer Center, who has played a central role in formulating Japan’s policies for combating cancer.
Dr. Tadao Kakizoe
Credit: THE JAPAN JOURNAL
According to statistics from the Ministry of Health, Labor and Welfare, approximately 340,000 people died of cancer during 2009, roughly 30% of deaths from all causes. In 2007, the Cabinet approved a Basic Plan to Promote Cancer Control Programs, which aim to lower the death rate due to cancer. The Plans focus on the following three issues: (1) promoting radiotherapy and chemotherapy and training specialists in these therapies, (2) implementing palliative care from the early stages of medical treatment, and (3) implementing “cancer registration” to collect information about cancer patients. The overall goals for the next ten years are to reduce the rate of age-adjusted deaths from cancer by 20%, to reduce the suffering of cancer patients and their families, and to improve the quality of life during treatment. One of the main measures for reaching these goals is to establish and maintain Designated Cancer Hospitals.
Equal Access Nationwide
Behind this move to develop designated hospitals is a discrepancy in the cancer treatments that are available in different parts of Japan. Although new methods for treating cancer continue to be developed from time to time, the hospitals with the facilities and specialists to treat cancer tend to be concentrated in major cities, with relatively few in regional areas.
“The goal of maintaining designated hospitals as bases for treating cancer in regional areas is to ‘equalize access’ to cancer treatment. By allowing everyone in Japan to receive at least a certain level of cancer treatment regardless of where they live, it is hoped that the rate of age adjusted deaths from cancer will be reduced by 4.6% over ten years,” explains Dr. Tadao Kakizoe, president emeritus of the National Cancer Center.
Being able to receive treatment near their home would significantly reduce the burden on elderly patients and patients who need to attend hospital regularly as an outpatient in order to receive chemotherapy.
Designated hospitals have systems that allow multidisciplinary therapy that combines surgery, radiotherapy and chemotherapy for the five most common cancers in Japan (lung cancer, stomach cancer, liver cancer, colon cancer and breast cancer). These designated hospitals also provide palliative care for patients who are difficult to care for, and for patients suffering from serious side effects or after effects of treatment.
The National Cancer Center in Tokyo plays an important role both in collecting and disseminating information to and from designated hospitals in the regions.
Credit: THE JAPAN JOURNAL
At general hospitals, only patients who are receiving cancer diagnosis or surgery (and their family members) have the opportunity to discuss their case with a specialist. However, designated hospitals have consultation support centers where ordinary members of the public or patients from other hospitals can come in and have a free consultation where they can ask about all kinds of issues relating to cancer. Designated hospitals are also expected to play a guiding role, acting as regional centers by receiving consultations and diagnosis requests from doctors in other regional hospitals, and by accepting patients from other hospitals.
“The involvement of patients and their families in the process of creating the Basic Plan to Promote Cancer Control Programs has been one of the major reasons for the focus in the plans on having designated hospitals improve the quality of life of patients and their families,” says Dr. Kakizoe.
Expanding the Programs
As of April 1, 2010, at least two hospitals have been designated in all forty-seven prefectures, with a total of 377 designated hospitals around the country.
“By maintaining designated hospitals in each region, we have been able to establish a system that covers the entire country. It is now possible to receive intensive cancer treatment even in regional areas a long way from major cities,” says Dr. Kakizoe. “The next challenge will be to improve the level of treatment in each hospital. There are still differences between hospitals in terms of the numbers of experienced doctors and nurses. In the future we need to improve the quality of each hospital even further, starting by training even more skilled workers.”