Japanese journal of clinical oncology
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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. · Sep 2010
Changes and current state of diagnosis of lung cancer after development of the flexible bronchofiberscope.
The flexible bronchofiberscope developed by Ikeda et al. has brought about revolutionary changes in the diagnosis and treatment of lung cancer. Advances in this device are continuing to emerge and lesions even smaller than those visible to the naked eye can now be visualized. In addition, the use of ultrasound now enables diagnosis of extramural bronchial lesions. ⋯ Computed tomography imaging has made remarkable advances, and computed tomography now plays a central role in chest imaging, including early detection of lesions by low-dose computed tomography, qualitative diagnosis by high-resolution computed tomography and diagnosis of disease progression by contrast computed tomography. Ikeda et al. introduced the concept of personal health data recording system to manage these various images but the technology was not mature enough at that time for implementation. With modern advances in information technology, this is likely to be realized using an electronic health record system.
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Gastric cancer is the second most common cancer in Asia, more than half of the world's gastric cancer cases arise in Eastern Asia, and the majority of Asia's cases still occur in the distal part of the stomach. ⋯ As chemotherapy for gastric cancer, fluorouracils plus platinum are the most widely accepted first-line regimens, whereas taxanes or irinotecan are mostly used in second- and third-line settings. Differences in the approval and medical insurance systems may influence the status of these regimens. Trastuzumab in combination with fluorouracils/platinum will be a standard regimen for HER2-positive gastric cancer. Many new targeting agents are currently under investigation, and Asian countries are playing important roles in investigation and development of new and better treatments for this malignancy.