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Annual Report 2017

Appearance Support Center

Keiko Nozawa, Naoya Yamazaki (Joint appointment in the Department of Dermatologic Oncology), Chikako Shimizu (Joint appointment in the Department of Breast and Medical Oncology), Masaki Arikawa (Joint appointment in the Department of Plastic and Reconstructive Surgery), Shoko Toma, Mio Ikeda, Michiko Kato and Masako Imai

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.

1. Clinical activities

 Our team consists of two clinical psychologists (one full-time and one part-time) specialized in cosmetics, and they are consulted by 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 12:00 p.m. and 1:00 p.m. during which patients can try on different products and consult staff. Despite limited hours for security reasons, we had 1,335 users from January to December. Additionally, we conduct a patient program titled "Cosmetic Information" every Tuesday and Thursday from 1:00 p.m. Its main aim is to provide information to patients through group sessions. We had 121 sessions in which 533 patients participated. Forty-seven men participated in "Men's Consultation Day" held on the fourth Wednesday of every month from 1:00 to 3:00 p.m.

 As for individual consultations for new patients, there were a total of 2,782 consultations offered to 409 in- and out- patients. Patients' main concerns were coping strategies with specific symptoms. Following last year, consultations which include the seeking of 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. Additionally, partial components of individual consultations and survey research were conducted at the Supportive Care Development Center.

2. Research activities

 Our team mainly conducted research activities focusing on the research on establishment of standard treatment for the Facial Acneiform dermatitis by EGFR Inhibitors supported by a grant from Practical Research for Innovative Cancer Control program of the Japan Agency for Medical Research and Development (AMED), and "the research for equalization of appearance to cancer patients and building a leader education program" supported by a grant from Health Labor Sciences Research Grant in Comprehensive project promoting cancer control program.

Research outcomes

 Our center promoted "a phase III, randomized trial evaluating topical corticosteroid therapy for Facial Acneiform dermatitis by EGFR Inhibitors" and focused on accumulating the number of case series of this trial. Furthermore, in order to construct the program of "Appearance Care of Cancer Patient for Medical Staff", we collected fundamental data of this trial and conducted a research survey on 744 medical staff, 1,034 cancer patients, and 1,030 general people.

Education

 In order to support medical staff to practice appearance care, "The Educational Workshop on Appearance Care of Cancer Patients for Medical Staff" was held four times in a year (483 participants) including special training for medical staff working at designated regional cancer centers and hospitals. We had a special contract with Yokohama city and held continuing appearance trainings three times for 26 medical staff working at designated regional cancer centers and hospitals in Yokohama city. Additionally, we were actively involved in mentorship for interns, and held monthly lectures for residents of the Department of Palliative Medicine.

Future prospects

 In the third phase of "The Basic Plan to Promote Cancer Control Programs" revised in March, 2018, various issues of changes in appearance for cancer patients were picked up. Additionally it is mentioned that continuous appearance training for medical staff is needed in order to improve QOL for cancer patients. Although responding to all patients' needs is difficult due to the fact that full time staff were scarce, we hope to expand human resource and develop this emerging field based on research.

Conferences

Sponsor: The Appearance Support Center (NCC Hospital)

Conference title: The Educational Workshop on Appearance Care of Cancer Patients for Medical Staff: Special course

Date: January 14th, 2017

Location (prefecture): Tokyo

Sponsor: The Appearance Support Center (NCC Hospital)

Conference title: The Educational Workshop on Appearance Care of Cancer Patients for Medical Staff: Basic course

Date: December 16th - 17th, 2017

Location (prefecture): Tokyo

Sponsor: The Appearance Support Center (NCC Hospital)

Conference title: The Educational Workshop on Appearance Care of Cancer Patients for Medical Staff: Advanced course

Date: November 4th, 2017

Location (prefecture): Tokyo

List of papers published in January 2017 - March 2018

Journal

1. Nozawa K, Tomita M, Takahashi E, Toma S, Arai Y, Takahashi M. Distress from changes in physical appearance and support through information provision in male cancer patients. Jpn J Clin Oncol, 47:720-727, 2017