Japanese journal of clinical oncology
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Jpn. J. Clin. Oncol. · Dec 2012
ReviewRecent developments in the management of cancer pain in Japan: education, clinical guidelines and basic research.
The Cancer Control Act of Japan came into effect in 2007. Most physicians, however, have not yet had sufficient opportunity to learn about pain management and other clinical palliative care practices. In an attempt to rectify this situation, the Japanese Society for Palliative Medicine has initiated the Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education project. ⋯ In an attempt to remedy this situation, therefore, Japanese basic researchers are cooperatively involved in conducting high-quality basic research to answer clinical questions in palliative care. They have demonstrated to the world, for the first time, that (i) chronic pain dramatically attenuates the reward effects of opioids and that (ii) atypical antipsychotics, such as olanzapine, can suppress morphine-induced emesis and alleviate the sleep dysregulation associated with neuropathic pain in animals. Thus, we are working in close collaboration to establish new strategies for palliative care in Japan.
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Jpn. J. Clin. Oncol. · Jun 2011
ReviewImportance of rehabilitation in cancer treatment and palliative medicine.
Although rehabilitation for cancer patients is being practiced in clinical settings, it has not been very well recognized in cancer care. However, interest has been turning to cancer rehabilitation in recent years in association with advances in palliative care and the increasing numbers of patients who survive for long periods, while enduring symptoms caused by cancer or adverse effects associated with treatment. ⋯ Rehabilitation can be applied throughout the entire phase from the time of diagnosis to the terminal stage, and it is an approach that can involve psychosocial aspects as well as physical aspects. Although its effectiveness has not been adequately demonstrated, especially in the area of palliative medicine, rehabilitation for cancer patients is expected to be an important means of supporting the hopes of patients and their families, and attempting to maintain and improve patients' quality of life.
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Jpn. J. Clin. Oncol. · Sep 2010
ReviewDevelopment of palliative medicine for cancer patients in Japan: from isolated voluntary effort to integrated multidisciplinary network.
The paradigm of palliative care in cancer medicine has shifted from only care of terminally ill patients to earlier intervention for them in the recent 15 years. The concept of palliative medicine was founded in Japan in the 1970s. ⋯ According to the aim of the Cancer Control Act established in Japan (2006), patients and their families will be able to access easily integrated high-quality cancer care wherever they live at the time of 2016. Systematic and continuous education for medical staff is mandatory, and a major breakthrough for achieving this purpose would be to increase the number of courses and faculties in palliative medicine at most universities in Japan.
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Jpn. J. Clin. Oncol. · Mar 2010
ReviewCurrent status and problems in development of molecular target agents for gastrointestinal malignancy in Japan.
Since late 1990s, many molecular target agents have been introduced to clinical trials for various kinds of tumors, and some of them showing significant benefits have been approved. However, these global trials were mainly conducted outside Japan, and the 'drag lag' has been a serious problem in Japan recently. Nowadays, Japanese institutions have been participating in some global trials, and the drug lags are getting shorter. ⋯ For all gastrointestinal malignancies, molecular target agents have made a progress in their treatments. In the near future, Japanese institutions will participate in more and more global trials and should play a specific role in worldwide drug development. Furthermore, the optimal use of these new drugs, molecular target agents, based on the daily practice should also be explored in Japan.
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Jpn. J. Clin. Oncol. · May 2004
ReviewRobotic surgery and cancer: the present state, problems and future vision.
In the 1990s, laparoscopic surgery entirely changed the traditional style of surgical operations. Laparoscopic cholecystectomy has spread rapidly and is now established as the standard treatment. However, besides cholecystectomy, endoscopic procedures are still not applied so widely to a variety of surgical operations. ⋯ We point out that there are several problems to be solved for robot surgery: i) price of surgical robots, ii) training systems for surgeon, iii) coverage by medical insurance, iv) downsizing and v) navigation system. In conclusion, we believe that, in the near future as robotic technology continues to develop, almost all kinds of endoscopic surgery will be performed by this technology. It will replace traditional surgery not only in the treatment of benign diseases but also in malignant illnesses.