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国立がん研究センター 中央病院

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Department of Palliative Medicine

Eriko Satomi, Kaoru Nishijima, Daisuke Kiuchi

Introduction

The palliative care service started with a palliative care team of multidisciplinary professionals (palliative care specialists, psychooncologists, certified nurses, pharmacists, psychologists, Hospital Play Staff, an acupuncturist) in the National Cancer Center Hospital (NCCH) in 1999 and the Department of Palliative Care and Psychooncology was established in 2010 with the reorganization of the NCCH. In 2013, the Department of Palliative Medicine started. We provide palliative care to patients and families as members of the palliative care team with leading doctors, nurses and other professionals to create an individualized palliative care plan. Our goals are:

  • Relieve pain and other physical symptoms
  • Focus 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

Routine activities

Our missions are:

  • Manage cancer-related pain and symptoms
  • Collaborate with other medical professionals and establish care plans
  • Support patients' decision making and advance care planning
  • Teach basic skills in supportive and palliative medicine to resident doctors
  • Research about new treatment of supportive and palliative medicine

For hospitalized patients

We work as a palliative care team and provide consulting and follow-up services to hospitalized patients throughout the NCCH. A consultation request is made by a physician (doctor in charge) or the medical staff. We provide support to the primary team. We follow up about 25 to 30 patients every day.

For outpatients

Our outpatient clinic for palliative medicine is open from Monday through Friday. It is possible for us to see patients on demand.

Research activities

We have just started the group J-SUPPORT (Japanese Supportive, Palliative and Psychosocial Oncology Group) for clinical trials in supportive and palliative care

Clinical trials

JORTC-PAL08, PASQoL, PHASE-R (Olanzapine for nausea and vomiting: observational study), etc.

Education

We have two training courses for doctors who will be palliative care specialists and for residents to learn primary palliative care. All the surgical and medical oncologist residents in the NCCH need knowledge and skill about primary supportive and palliative care in oncology. They participate in our team for 4 weeks and undergo on-the-job training for palliative medicine. This includes an opportunity to attend home hospice rounds in cooperation with Chuo-ku medical association. A total of 20 residents finished the 4-week palliative medicine course in 2015. On the three-month course for palliative care specialists, two participants enrolled. They learned specialist palliative care in oncology including physical, psychosocial and spiritual supportive care during anti-cancer therapy, end-of-life care, support for decision making and advanced care planning.

Table 1. Number of patients Table 2. Clinical stage Table 3. Primary site of cancer Table 4. Symptoms

List of papers published in 2015

Journal

  1. Inoue I, Higashi T, Iwamoto M, Heiney SP, Tamaki T, Osawa K, Inoue M, Shiraishi K, Kojima R, Matoba M. A national profile of the impact of parental cancer on their children in Japan. Cancer Epidemiol, 39:838-841, 2015