Oncology In Japan Research Articles

"Present status and future perspectives on geriatric oncology in Japan" for special edition

"Present status and future perspectives on geriatric oncology in Japan" for special edition

Practical management of older adults with cancer: geriatric oncology in Japan.

Japan has the highest proportion of older adults globally, and the average life expectancy of the Japanese population has increased in recent decades. Given that the incidence of cancer increases with age, it is a major health concern for older adults. However, geriatric oncology is a relatively new field and collaboration between oncologists and geriatricians in Japan is limited. Hence, oncologists and other healthcare professionals engaged in cancer care have not been able to adequately understand geriatric care, and information and experience are insufficient for this specific population. Thus, they may struggle with the assessment and management of older adults with cancer. Recently, several Japanese academic societies for cancer have developed practical guidelines and research policy with regard to geriatric research in older adults with cancer, in addition to organizing symposia and workshops focusing especially on geriatric oncology. Furthermore, because the Japan Geriatrics Society established a discipline committee on cancer, close collaboration between oncologists and geriatricians has grown steadily. Geriatric oncology is currently recognized as an important field of cancer care in Japan. The integration of oncology and geriatric care is anticipated in the near future. However, understanding the aspects of geriatric care and meanings of technical jargons used in geriatric oncology is difficult. Accordingly, this article provides an overview of the current knowledge and recent advancements in geriatric oncology. In addition, it outlines the current status and problems of geriatric oncology in Japan.

Japanese structure survey of radiation oncology in 2015.

This article describes the ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From May 2016 to August 2018, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2015. Data were analyzed based on the institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 225 000 and 271 000, respectively. Additionally, the estimated cancer incidence was 891 445 cases with approximately 25.2% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (linac; n = 936), Gamma Knife (n = 43), 60Co remote afterloading system (RALS; n = 21), and 192Ir RALS (n = 129). The linac system used dual-energy functions in 754 units, 3D conformal radiotherapy functions in 867, and intensity-modulated radiotherapy (IMRT) functions in 628. There were 899 Japan Radiological Society/Japanese Society for Radiation Oncology-certified radiation oncologists (RO), 1213.9 full-time equivalent (FTE) ROs, 2394.2 FTE radiotherapy technologists (RTT), 295.7 FTE medical physicists, 210.2 FTE radiotherapy quality managers, and 906.1 FTE nurses. The frequency of IMRT use significantly increased during this time. In conclusion, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility although there was a shortage of personnel in 2015.

Current status of medical oncology in Japan and changes over the most recent 7-year period: results of a questionnaire sent to designated cancer care hospitals.

BackgroundAccording to a questionnaire sent to Designated Cancer Care Hospitals in Japan in 2013, only 39.4% of the institutes had medical oncology departments. Furthermore, most of these medical oncology departments were primarily responsible for the treatment of limited disease categories and the administration of newly developed therapeutic modalities, including molecular-targeted therapy. The aim of the present study was to update these previous findings and to clarify the changes over the intervening 7-year period.MethodsThe questionnaire was sent to all 393 Designated Cancer Care Hospitals on 13 March 2020. Similar to the previous questionnaires, questions were asked regarding the presence of a medical oncology department, the number of physicians in the department and the degrees of responsibility for drug therapies provided by medical oncologists to adult patients with solid cancers.ResultsIn total, 270 institutions (68.7%) responded. Overall, 145 of these 270 institutions (53.7%) had medical oncology departments, representing a significant increase compared with the results of the previous study (P < 0.01). Among the institutions with a medical oncology department, these departments were responsible for the administration of over 30% of all cytotoxic and molecular-targeted drug therapies for extragonadal germ cell tumors, cancers of unknown primary site, soft tissues, head and neck, esophagus, stomach, colon and rectum, and pancreas as well as the administration of immune checkpoint inhibitors (ICI) for microsatellite instability-high tumors, cancers of the stomach, esophagus and head and neck, and melanoma.ConclusionThe proportion of institutes with medical oncology departments in Japan has increased. In addition, the responsibility of medical oncology departments has expanded to include newly emerging drugs, such as ICIs.

SJS-2 Approaches to geriatric oncology in Japan

By 2025, the baby boomers' generation in Japan will most likely consists of elderly at the age of 75, which meant that one in four people in this country is expected to be within such age range or older. Cancer is the leading cause of death in Japan, and it is estimated that one in two people will develop cancer during their lifetime. Furthermore, by 2025, one in five people over the age of 65 will be expected to have dementia that requires someone's attention. Based on these findings, the Ministry of Health, Labor and Welfare recommended the establishment of treatment methods and medical treatment guidelines that are appropriate for older patients with cancer, including the enhancement of their quality of life.

MO28-1 Change in status of medical oncology in Japan over a seven-year period

MO28-1 Change in status of medical oncology in Japan over a seven-year period

Japanese structure survey of radiation oncology in 2013.

ABSTRACTThis paper describes the ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From December 2014 to July 2017, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2013. Data were analyzed based on institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 216 000 and 257 000, respectively. Additionally, the estimated cancer incidence was 862 452 cases with ~25.0% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (LINAC; n = 880), Gamma Knife (n = 45), 60Co remote afterloading system (RALS; n = 23) and 192Ir RALS (n = 128). The LINAC system used dual-energy functions in 675 units, 3D conformal radiotherapy functions in 785 and intensity-modulated radiotherapy (IMRT) functions in 494. There were 831 Japan Radiological Society/Japanese Society for Radiation Oncology-certified radiation oncologists, 1130.6 full-time equivalent (FTE) radiation oncologists, 2214.6 FTE radiotherapy technologists, 196.6 FTE medical physicists, 183.8 FTE radiotherapy quality managers and 856.7 FTE nurses. The frequency of IMRT use significantly increased during this time. In conclusion, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility although there was a shortage of personnel in 2013.

Japanese structure survey of radiation oncology in 2012.

ABSTRACTThis paper describes the ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From March 2013 to August 2016, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2012. Data were analyzed based on the institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 213 000 and 251 000, respectively. Additionally, the estimated cancer incidence was 865 238 cases with ~24.6% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (LINAC; n = 864), telecobalt (n = 0), Gamma Knife (n = 44), 60Co remote afterloading system (RALS; n = 23) and 192Ir RALS (n = 130). The LINAC system used dual-energy functions in 651 units, 3D conformal radiotherapy functions in 759 and intensity-modulated radiotherapy (IMRT) functions in 466. There were 792 Japan Radiological Society/Japanese Society for Radiation Oncology-certified radiation oncologists, 1061.6 full-time equivalent (FTE) radiation oncologists, 2124.2 FTE radiotherapy technologists, 181.3 FTE medical physicists, 170.9 FTE radiotherapy quality managers and 841.5 FTE nurses. The frequency of IMRT use significantly increased during this time. In conclusion, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility although there was a shortage of personnel in 2012.

Precision Oncology and the Universal Health Coverage System in Japan.

Although precision oncology is transforming clinical management of patients with cancer, many hospitals face challenges to effectively implement precision oncology. In addition, the cost and time exerted for genomic profiling needs to be balanced with expectations of benefit for each patient. This article summarizes the effort to implement precision oncology in Japan. The most promising development is that tests to profile the genomes of select cancers are now fully covered by the national health insurance system. In May 2019, two gene panels were approved with reimbursement: FoundationOne CDx Cancer Genomic Profile and OncoGuide NCC Oncopanel System, the latter of which was developed in Japan. To make better use of scarce resources, the reimbursement is restricted to patients with solid tumors that have progressed on standard chemotherapy, rare tumors, or tumors of unknown primary. To centralize Japanese precision oncology, the government designated approximately 170 hospitals and stratified them to three layers on the basis of their roles. In addition, Japan’s National Cancer Center launched a Center for Cancer Genomics and Advanced Therapeutics (C-CAT) that collects genomic information and clinical characteristics of patients who received genomic profiling tests. C-CAT is expected to be the central data repository, to match patients with clinical trials, and to assist translational research. The centralized system under the national health insurance system could be a double-edged sword. Although tight regulation may make it hard to keep up with the rapid development of precision oncology, a federated ecosystem for sharing clinical and genomic data will be a precious asset and allow for shared access to data. Access to unapproved drugs and administrative support from C-CAT will be keys for Japanese precision oncology to meet its full potential.

Japanese Structure Survey of Radiation Oncology in 2011.

ABSTRACTWe evaluated the evolving structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From March 2012 to August 2015, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2011. Data were analyzed based on the institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 211 000 and 250 000, respectively. Additionally, the estimated cancer incidence was 851 537 cases with approximately 24.8% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (LINAC; n = 836), telecobalt (n = 3), Gamma Knife (n = 46), 60Co remote afterloading system (RALS; n = 24), and 192Ir RALS (n = 125). The LINAC system used dual-energy functions in 619 units, 3D conformal radiotherapy functions in 719 and intensity-modulated radiotherapy (IMRT) functions in 412. There were 756 JRS or JASTRO-certified radiation oncologists, 1018.5 full-time equivalent (FTE) radiation oncologists, 2026.7 FTE radiotherapy technologists, 149.1 FTE medical physicists, 141.5 FTE radiotherapy quality managers and 716.3 FTE nurses. The frequency of IMRT use significantly increased during this time. To conclude, although there was a shortage of personnel in 2011, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility.

Perspectives and attitudes toward the integration of oncology and palliative care in Japan: Qualitative analysis of a nationwide survey.

96 Background: The integration of oncology and palliative care (IOP) is an emerging issue that has been encouraged by several agencies, including the American Society of Clinical Oncology. Despite such efforts, clinical implementation of IOP is evolving slowly. One key barrier to implementation is the lack of institutional support; however, recognition of IOP by the heads of hospitals has rarely been investigated. Methods: This was a secondary qualitative analysis of a nationwide survey, which was performed in November 2017 to clarify the current status of IOP in Japan. The questionnaires were distributed to all designated cancer hospitals (DCHs) (n = 399) and randomly sampled non-DCHs (n = 478). This survey included a free text query asking executives or directors of oncology departments at cancer hospitals to describe their opinions about encouragement of IOP in Japan (i.e., importance or challenges of IOP). In total, 174 hospitals (20.2%) responded to the free text query (106 DCHs and 68 non-DCHs). Contents analysis was performed using the free text data. Results: Three major categories emerged from the descriptive data: (1) perceptions and attitudes toward IOP, (2) perceived barriers to IOP, and (3) perceived facilitators of IOP, which possessed two, nine, and eight minor categories, respectively. Of these minor categories, there were both affirmative and contradictory opinions toward IOP. Reluctant attitudes of patients, caregivers, health care professionals, and hospital heads; limited clinical resources, process, and political support; and specific clinical circumstances in Japan were identified as perceived barriers. Education, improvement of clinical resources and process, and political initiatives were identified as perceived facilitators. Conclusions: Comprehensive perceptions, attitudes, challenges, and solutions regarding IOP were proposed. Such data may provide healthcare professionals and policymakers with greater understanding of how to encourage IOP in Japan.

SJS-3 - Geriatric oncology in Japan

In Japan, the field of geriatric oncology has not long history of development yet. The cancer control act was amended in Dec. 2016, and The Basic Plan to Promote Cancer Control Programs (the 3rd term) was decided by the Cabinet in Oct. 2017. In the 3rd term Basic Plan, the measures of improving cancer care for the elderly are included. JSMO working group of geriatric oncology was set up in 2016 to improve cancer care for elderly. Making guidelines of systemic therapy for elderly, we carried out a systematic review of geriatric assessment and 5 diseases; lung cancer, colorectal cancer, gastric cancer, breast cancer and hematologic malignancies. This is based on a search method using appropriate clinical questions and keywords. We are now formulating guidelines with a Grading of Recommendations Assessment, Development and Evaluation system advocated by Minds2014. Minds (Medical Information Network Distribution Service) is an information service provided by the Japan Council for Quality Health Care (JCQHC), a public interest incorporated foundation. The MINDS project has been financially supported by the Ministry of Health, Labor and Welfare of Japan. JSMO working group also improves education for all health-care providers cooperating with SIOG. In April 2018, a working group under a Health and Labor Sciences Research Grant will promote the establishment of geriatric oncology in Japan. This working group has 3 missions: (1) To make a practical guidelines for cancer elderly, (2) To encourage and disseminate geriatric oncology in terms of collaboration with oncology and geriatrics, (3) To improve information for the regular population and all health-care providers. Japanese society is moving forward to cope with an increasing number of elderly cancer patients by a team with broad sense consisting of cancer professionals, other health-care providers and government.

SJS-5 - The educational system about geriatric oncology in Japan

SJS-5 - The educational system about geriatric oncology in Japan

Japanese structure survey of radiation oncology in 2010.

We evaluated the evolving structure of radiation oncology in Japan in terms of equipment, personnel, patient load, and geographic distribution to identify and overcome any existing limitations. From March 2011 to June 2013, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2010. Data were analyzed based on the institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 211 000 and 251 000, respectively. Additionally, the estimated cancer incidence was 805 236 cases, with ~26.2% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (LINAC; n = 829), telecobalt (n = 9), Gamma Knife (n = 46), 60Co remote afterloading system (RALS; n = 28), and 192Ir RALS (n = 131). The LINAC system used dual-energy functions in 586 units, three-dimensional conformal radiotherapy functions in 663, and intensity-modulated radiotherapy (IMRT) functions in 337. There were 564 JASTRO-certified radiation oncologists, 959.2 full-time equivalent (FTE) radiation oncologists, 1841.3 FTE radiotherapy technologists, 131.3 FTE medical physicists, 121.5 FTE radiotherapy quality managers, and 649.6 FTE nurses. The frequency of IMRT use significantly increased during this year. To conclude, although there was a shortage of personnel in 2010, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility.

ES 10.04 Carbon-ion Therapy

ES 10.04 Carbon-ion Therapy

SUN-P229: Nutritional Status of Cancer Patients Seen from Nutritionday Oncology in Japan 2015

SUN-P229: Nutritional Status of Cancer Patients Seen from Nutritionday Oncology in Japan 2015

SC03.03 Carbon-Ion Therapy of Lung Cancer

SC03.03 Carbon-Ion Therapy of Lung Cancer

Highlights for ESMO 40: celebration review for lifetime achievement awards

My work, my crucial achievement, has been in the management of the transition of the conduct of cancer research/management from basic researchers/surgeons to medical oncologists (figure 1). Figure 1 The Flower of Hope—the ESMO Lifetime Achievement Award. This transition can be divided into four categories: 1. The development, progression and consolidation of global Medical Oncology in Asian countries, especially in Japan. 2. Building a close collaboration with European Society of Medical Oncology (ESMO) and receiving strong support from ESMO, through (A) Adaptation of the ESMO/ASCO Core Curriculum in Medical Oncology,1 (B) Mutual ESMO/ Japanese Society of Medical Oncology (JSMO) joint symposia during their respective meetings, (C) making Annals of Oncology JSMO's official scientific publication,2 along with (D) my own work as an Associate Editor of Annals of Oncology (2011–2014), (E) my work as ESMO's National/Regional Representative and Membership Committee member (2005–2011). 3. Leadership of clinical research in Japan as a key opinion leader and primary investigator in IND (investigational new drug) trials and a chairman of the Japanese Clinical Oncology Group (JCOG; 2000–2009), organising a governmental clinical trial group; and the development of new gold standards in the treatment of malignant diseases, especially in thoracic malignancy by investigator-initiated randomised controlled clinical trials. 4. Encouraging translational research and the publication of numerous articles, especially in the area of the identification of molecular targets for anticancer drugs, as Chief of the Pharmacology Division in the National Cancer Center Research Institute. When I began my training in Medical Oncology, cancer research, including translational research, was conducted by basic researchers, and cancer treatment, including chemotherapy, was conducted by surgeons. There was no place for medical oncologists to play an active part in cancer research and treatment. ESMO was established 40 years ago and now has more than 10 000 professionals as members, and medical oncology has been recognised as …

Current status of medical oncology in Japan--reality gleaned from a questionnaire sent to designated cancer care hospitals.

Medical oncology in Japan has a relatively short history, with specialist certification starting in 2006, resulting in 867 certified medical oncologists as of 2014. Although the national government has appointed 397 Designated Cancer Care Hospitals, little is known about the actual situations of medical oncology services at these institutions. Questionnaires regarding the presence of a medical oncology department, the number of physicians in the department, the presence of certified medical oncologists and the degree of the medical oncologists' responsibilities for drug therapies in adults with solid cancers were sent to all 397 institutions between 21 January and 1 May 2013. The response rate was 68.0%. Among the responses, 39.4% of the institutions had medical oncology departments with a median of three physicians. Most of the medical oncology departments were primarily responsible, as evaluated according to patient number, for the treatment of limited disease categories. The medical oncologists were significantly more responsible for molecular-targeted therapy than for chemotherapy in head and neck cancer or for cytokine therapy in renal cell carcinoma. The wide variety of adverse events associated with molecular-targeted therapy might have enhanced the roles of medical oncologists. As the proportion of hospitals with a medical oncology department increased according to the number of certified medical oncologists working at the institution, cultivating medical oncologists seems to be an urgent task for advancing medical oncology in Japan. The present study provides fundamental data for the future development of medical oncology in Japan. The present study is to uncover the current situation of medical oncology in Japan.

PSY2-4 - Education of Medical Oncology at Cancer Centers and Universities in Japan

ABSTRACT There is a constructional difference in opportunities of learning medical oncology between cancer centers and university hospitals in Japan. The university is the only institution to provide oncology education for all medical students including those who will make a specialty of fields other than oncology. Since palliative and terminal care as well as primary and secondary cancer prevention have become more important recently, students who wish to become a primary physician need to learn medical oncology. The university plays a role in education for doctors in early postgraduate training. Whether they will have an interest in medical oncology depends entirely on the results of the education. The education for doctors in late postgraduate training is conducted at both cancer centers and university hospitals. The cancer centers have an enriched on-the-job training program (resident program), while such program has not been established in many university hospitals. This is partly because assignment of roles between a newly organized medical oncology department and traditional organ-specified departments remains in a chaotic state. Knowledge and insight on cancer biology have been even more essential for medical oncologists than before, but no chance to learn basic medical science is given to doctors in training, except for postgraduate students in universities and senior residents in cancer centers. There is a lot of argument about the identity of medical oncology in Japan. It should not be defined in a hurry, but it is being gradually established as medical oncologists will grow up to be the support and driving force of future medical oncology in Japan.