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国立がん研究センター 中央病院

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Appearance Support Center

Keiko Nozawa, Naoya Yamazaki (Joint appointment in the Department of Onco-Dermatology), Chikako Shimizu (Joint appointment in the Department of Breast and Medical Oncology), Masahide Fujiki (Joint appointment in the Department of Plastic Surgery), Shoko Toma, Kazuko Aoki, Atsuko Ito, Eriko Takahashi

Introduction

The Appearance Support Center aims to support patients to be able to 'live in society' and to 'live as a human' through clinical research and educational practices regarding patients' physical appearance.

Clinical activities

Our team consists of two clinical psychologists (one full-time and one part-time) specialized in cosmetics, and they consult both in- and out-patients as well as their families for questions and concerns regarding physical appearance. Examples of issues are side effects of chemotherapy and radiotherapy on skin, nails, and hair, scarring and epithesis from surgeries, and breast surgery. In order to expand our practice beyond solely consultation, we are currently developing a new team in collaboration with a dermatologist, plastic surgeon, medical oncologist, pharmacist, and nurses.

The outpatient space is open to the public from Monday to Thursday between 12 am and 1 pm during which patients can try on different products and consult staff. Despite limited hours for security reasons, we had 894 users from January to December. Additionally, we conduct a patient support program titled “Cosmetic Information” every Tuesday and Thursday from 2 pm. Its main aim is to provide information to patients through group sessions. We had 99 sessions in which 438 patients participated. 40 men participated in “Men's Consultation Day” held on the fourth Wednesday of every month from 1 to 3 pm. In addition, we offered long-term inpatients a special program at the transplantation ward four times this year, and a total of 17 men and women participated.

As for individual consultations for new patients, there were a total of 1,696 consultations offered to 250 in- and out- patients. Patients' main concerns were coping strategies with specific symptoms. Following last year, consultations including seeking stress relief increased as patients with pediatric cancer increased. There were also consultations of concerns over significant life events such as the coming-of-age ceremony, weddings, and questions regarding mortuary makeup.

Research activities

Our center conducts research actively due to the lack of evidence regarding physical appearance. Current research projects are: the establishment of guidelines for support of cancer patients' appearance problems, the development of assessments and care methods for dermatological changes due to cancer treatment, the examination of distress by changes in physical appearance in male cancer patients and support by information provision, and the development of a program for an educational workshop on appearance care of cancer patients for cosmeticians.

Research outcomes

We instructed patients for treatments and care of side effects on physical appearance and developed a guideline that should guide medical staff (provisional). We also found that it was possible to evaluate skin symptoms by a device prior to grading by eyes. In addition, we investigated the effects of an appearance-related group program, and reported at the Annual Meeting of Japan Society of Clinical Oncology.

Education

In order to support medical staff to practice appearance care, “The Educational Workshop Regarding Appearance Care for Cancer Patients” was held three times in a year (237 participants) for medical staff working at designated regional cancer centers and hospitals. Additionally, we welcomed visitors of our hospital and held a special educational workshop to offer the same program conducted at Kobe University Hospital. We also held "The Educational Workshop on Appearance Care of Cancer Patients for Cosmeticians" once a year (30 participants).

Future prospects

We anticipate the emergence of patient needs of support for physical appearance as the variety of treatment drugs increases, longer-survival rates increase, and so on. Although responding to all patient needs is difficult as fulltime workers are scarce, we hope to expand human resources and develop this emerging field based on research.

Conferences

Sponsor: The Appearance Support Center (Center Hospital)
Conference title: The Educational Workshop on Appearance Care of Cancer Patients for Medical Staff: Basic course
Date: November 8th - December 20th, 2015
Location (prefecture): Tokyo
Sponsor: The Appearance Support Center (Center Hospital)
Conference title: The Educational Workshop on Appearance Care of Cancer Patients for Medical Staff: Advanced course
Date: October 11th, 2015
Location (prefecture): Tokyo
Sponsor: The Appearance Support Center (Center Hospital)
Conference title: The Educational Workshop on Appearance Care of Cancer Patients for Cosmeticians
Date: January 31st, 2016
Location (prefecture): Tokyo

List of papers published in 2015

Journal

  1. Nozawa K, Ichimura M, Oshima A, Tokunaga E, Masuda N, Kitano A, Fukuuchi A, Shinji O. The present state and perception of young women with breast cancer towards breast reconstructive surgery. Int J Clin Oncol, 20:324-331, 2015