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Department of Palliative Medicine

Hiroya Kinoshita, Yoshihisa Matsumoto, Tomofumi Miura, Keita Tagami, Hanako Iwamoto, Yuki Sumazaki

Introduction

The purpose of our Department is to improve the quality of life for cancer patients and their family caregivers by management of irritable symptom burdens and establishment of a regional palliative care system. Therefore, we provide three palliative care services: 1) an outpatient clinic, 2) a supportive care team and 3) a palliative care unit.

Routine activities

Outpatient clinic

Patients with or without anti-cancer therapy consult our outpatient clinic for management of their symptoms or for support to decide where and how to spend their lives. The concept of early palliative care has gradually spread and consultations for patients undergoing anti-cancer therapy have been increasing.

 

Supportive care team

This team consist of a physician, psychooncologist, nurse, dietician, physiotherapist and speech-language-hearing therapist. Our supportive care team perform a multidisciplinary approach for inpatients with various sufferings in the oncology floor.

 

Palliative care unit

Our palliative care unit is the Japanese version of an acute palliative care unit (APCU). The features of APCU are multidimensional assessment, rapid symptom control and intensive psychosocial care with a shorter length of stay and lower death rate than in traditional PCU. Medical social workers greatly contribute to a transition to palliative home care and transfer to other hospitals.

 

 

Research activities

The aim of the research in our division is to establish a regional palliative care system and to integrate early palliative care with oncology. The following research is conducted:

  1. System construction of screening and intervention for symptoms in patients with advanced cancer.
  2. Development of the integration of early palliative care in metastatic lung cancer.
  3. Surveys for patients about opioids adherence and for bereaved family members about opioids administration.
  4. Registration for Japanese multicenter cohort studies and international multicenter projects.

Education

The purpose is to promote understanding about palliative care in cancer patients and their families for residents. Residents can train in home palliative care on request. To disseminate knowledge about primary palliative care, we held several workshops for medical staff in the National Cancer Center Hospital East (NCCHE) and for regional palliative care staff.

Future prospects

Our Department will continue the above activities and develop new research to improve quality of life (QOL) for cancer patients and their family caregivers.

List of papers published in 2015

Journal

  1. Baba M, Maeda I, Morita T, Inoue S, Ikenaga M, Matsumoto Y, Sekine R, Yamaguchi T, Hirohashi T, Tajima T, Tatara R, Watanabe H, Otani H, Takigawa C, Matsuda Y, Nagaoka H, Mori M, Tei Y, Hiramoto S, Suga A, Kinoshita H. Survival prediction for advanced cancer patients in the real world: A comparison of the Palliative Prognostic Score, Delirium-Palliative Prognostic Score, Palliative Prognostic Index and modified Prognosis in Palliative Care Study predictor model. Eur J Cancer, 51:1618-1629, 2015
  2. Hamano J, Morita T, Inoue S, Ikenaga M, Matsumoto Y, Sekine R, Yamaguchi T, Hirohashi T, Tajima T, Tatara R, Watanabe H, Otani H, Takigawa C, Matsuda Y, Nagaoka H, Mori M, Yamamoto N, Shimizu M, Sasara T, Kinoshita H. Surprise Questions for Survival Prediction in Patients With Advanced Cancer: A Multicenter Prospective Cohort Study. Oncologist, 20:839-844, 2015
  3. Hamano J, Morita T, Ozawa T, Shishido H, Kawahara M, Aoki S, Demizu A, Goshima M, Goto K, Gyoda Y, Hashimoto K, Otomo S, Sekimoto M, Shibata T, Sugimoto Y, Matsunaga M, Takeda Y, Nagayama J, Kinoshita H. Validation of the Simplified Palliative Prognostic Index Using a Single Item From the Communication Capacity Scale. J Pain Symptom Manage, 50:542-547.e4, 2015
  4. Maeda I, Morita T, Kinoshita H. Reply to H. Nakayama et al. J Clin Oncol, 33:2228-2229, 2015
  5. Kizawa Y, Morita T, Miyashita M, Shinjo T, Yamagishi A, Suzuki S, Kinoshita H, Shirahige Y, Yamaguchi T, Eguchi K. Improvements in Physicians' Knowledge, Difficulties, and Self-Reported Practice After a Regional Palliative Care Program. J Pain Symptom Manage, 50:232-240, 2015
  6. Miura T, Matsumoto Y, Hama T, Amano K, Tei Y, Kikuchi A, Suga A, Hisanaga T, Ishihara T, Abe M, Kaneishi K, Kawagoe S, Kuriyama T, Maeda T, Mori I, Nakajima N, Nishi T, Sakurai H, Morita T, Kinoshita H. Glasgow prognostic score predicts prognosis for cancer patients in palliative settings: a subanalysis of the Japan-prognostic assessment tools validation (J-ProVal) study. Support Care Cancer, 23:3149-3156, 2015
  7. Umezawa S, Fujimori M, Matsushima E, Kinoshita H, Uchitomi Y. Preferences of advanced cancer patients for communication on anticancer treatment cessation and the transition to palliative care. Cancer, 121:4240-4249, 2015
  8. Miura T, Mitsunaga S, Ikeda M, Shimizu S, Ohno I, Takahashi H, Furuse J, Inagaki M, Higashi S, Kato H, Terao K, Ochiai A. Characterization of patients with advanced pancreatic cancer and high serum interleukin-6 levels. Pancreas, 44:756-763, 2015
  9. Igarashi T, Abe K, Miura T, Tagami K, Motonaga S, Ichida Y, Hasuo H, Matsumoto Y, Saito S, Kinoshita H. Oxycodone frequently induced nausea and vomiting in oxycodone-naïve patients with hepatic dysfunction. J Palliat Med, 18:399, 2015
  10. Kinoshita H, Maeda I, Morita T, Miyashita M, Yamagishi A, Shirahige Y, Takebayashi T, Yamaguchi T, Igarashi A, Eguchi K. Place of death and the differences in patient quality of death and dying and caregiver burden. J Clin Oncol, 33:357-363, 2015