Yosuke Uchitomi

National Cancer Center, Japan | ncc · Innovation Center for Supportive, Palliative and Psychosocial Care

702 Background: There is an increasing awareness of the importance of pt-centricity in cancer treatments. To achieve pt-centricity in mRCC treatment, it is important to clarify the differences of preferences between pts and physicians in terms of efficacy, safety, quality of life, and healthcare economics. However, these data are currently lacking...

Objective Even though vaccines have become widespread, there is an explosion of infection due to the emergence of new mutant strains, and support for healthcare providers’ mental health is necessary. The aims of this study were to explore factors associated with the psychological distress, and to determine the degree of association between moral di...

Background Transcatheter arterial embolization (TAE) has long been used for hemostasis of traumatic or postoperative hemorrhage and embolization of tumors. Previous retrospective studies of TAE for painful bone metastases showed 60%–80% pain reduction with a median time to response of 1–2 days. Compared with radiotherapy and bisphosphonates, time t...

Psycho-Oncology in Palliative and End-of-Life Care provides consensus expert advice and clinical management guidelines on the impact of advanced cancer and its treatment on the life and well-being of a patient as they move into palliative care and toward the end of their life. Employing a practical toolkit format, this volume addresses a variety of...

Introduction In patients with incurable advanced cancer, preferences about treatment and how to spend their final days are not adequately discussed. This process of discussion is called advanced care planning (ACP), and timely intervention is recommended. As the communication attitude of healthcare providers is a critical factor in ACP facilitation...

Purpose: Several studies have investigated good communication practices with adult patients receiving bad news about cancer. However, while communication preferences may differ between adults and adolescent and young adult (AYA) patients, these preferences have not been determined for AYA patients. The primary endpoint of this study was to describe...

Purpose: Fear of cancer recurrence (FCR) is a common distressing condition. We investigated the efficacy of smartphone problem-solving therapy and behavioral activation applications in breast cancer survivors. Methods: This was a decentralized randomized trial. Participants were disease-free breast cancer survivors age 20-49 years who were rando...

Introduction Workplace programs to prevent non-communicable diseases (NCDs) in the workplace can help prevent the incidence of chronic diseases among employees, provide health benefits, and reduce the risk of financial loss. Nevertheless, these programs are not fully implemented, particularly in small- and medium-sized enterprises (SMEs). The purpo...

Introduction: Elderly cancer patients often have ageing-related physical and psychosocial problems that should be fully shared with their oncologists. Geriatric assessment (GA) can assess these ageing-related problems and guide management. Communication support might also facilitate implementation of GA-guided management. We will conduct a multice...

Background: In Japan, little is known of the severity of and factors associated with psychological distress among caregivers of patients with advanced or recurrent cancer who die. Methods: This prospective cohort study of cancer patients at the National Cancer Center Hospital East, Japan, and their caregivers followed the participants from the i...

Background: This study aimed to investigate the risk of death by suicide, other externally caused injuries (ECIs), or cardiovascular disease for patients with cancer. Methods: We used data from the National Cancer Registry, which include the entire population in Japan. Patients diagnosed with cancer from January 1 to December 31, 2016 were inclu...

Objective Preventing postoperative delirium with agitation is vital in the older population. We examined the preventive effect of yokukansan on postoperative delirium with agitation in older adult patients undergoing highly invasive cancer resection. Methods We performed a secondary per-protocol analysis of 149 patients’ data from a previous clini...

Introduction Chemotherapy-induced nausea and vomiting (CINV) decrease patients’ quality of life and negatively impact treatment outcomes. Although standard prophylactic antiemetic therapy for acute CINV recommended by guidelines is effective, poor guideline implementation is a worldwide problem. In Japan, prophylactic antiemetic therapy is relative...

Background: Oral mucositis is one of the main areas of research in supportive and palliative care of cancer patients. However, the methodology of prospective clinical trials on oral mucositis has not been established, despite its uniqueness. Here, we propose a novel research policy on oral mucositis, including an implementable set of recommendatio...

Objectives We examined the efficacy of case management (CM) interventions to encourage participation in colorectal cancer screening for patients with schizophrenia. This study aimed to clarify patients’ acceptability of the intervention and the helpful components of the intervention. Simultaneously, the study aimed to determine the acceptability, a...

Objectives: To reduce cancer care disparities, this study aimed to clarify the difficulties in cancer care for people with mental disorders as perceived by cancer care providers. Methods: Cancer care providers at 17 designated cancer hospitals in Japan were surveyed using mail questionnaires. Respondents were asked to rate 29 items related to di...

The usefulness of depression scales for patients with cancer based on item response theory (IRT) and computer adaptive testing (CAT) has not yet been fully explored. This study thus aimed to develop an IRT-based tool for measuring depression in patients with cancer. We analyzed data from 393 patients with cancer from four tertiary centers in Japan...

Purpose: Several studies have investigated good communication practices with adult patients receiving bad news about cancer. However, communication preferences differ between adult and adolescent and young adult (AYA) patients. These preferences have not been determined for AYA patients. The primary endpoint of this study was to describe the commun...

In Japan, risk behaviors for cancer remain inadequately controlled, often due to a lack of necessary information and support to guide consumers in cancer control decisions. The use of strategic health communication efforts based on social marketing has substantial potential to provide groups of consumers who are underinformed or misinformed with re...

Background: Cancer patients experience various forms of psychological distress. Their distress, mainly in the form of depression and anxiety, leads to poor quality of life, increased medical spending due to frequent visits, and decrease in treatment adherence. It is estimated that 30-50% among them would require support from mental health professio...

Background There is an immense difference between large companies and small and medium-sized enterprises (SMEs) in implementation of evidence-based interventions (EBIs). Previous literature reveals various barriers that SMEs face during implementation, such as a lack of time, accessibility, and resources. However, few studies have comprehensively e...

Objectives Adolescent and young adult (AYA) cancer patients may be at high risk of experiencing psychological distress because their diagnosis came during a key time of consolidation of identity and social growth. This study aimed (1) to examine the prevalence of psychological distress among AYA cancer patients within a year of diagnosis to long-te...

Background: Strategies to implement early specialized palliative care have not yet been established. The present study investigated the feasibility of a nurse-led, screening-triggered early specialized palliative care intervention programme and obtained data to design a randomized controlled trial. Methods: Patients with metastatic lung cancer u...

Objective Early integration of palliative and cancer care improves the quality of life and is facilitated by discussions about the end of life after cessation of active cancer treatment between patients with advanced cancer and their physicians. However, both patients and physicians find end-of-life discussions challenging. The aim of this study wa...

Background: It is reasonable to target small and medium-sized enterprises (SMEs) as a workplace to promote the implementation of evidence-based interventions (EBIs) for reducing health inequalities. Previous literature reveals various barriers that SMEs face during implementation, such as a lack of time, accessibility, and resources. However, few s...

Objective: We examined the efficacy of a case management approach to improve participation in colorectal cancer screening among people with schizophrenia. Methods: This was a randomized, parallel group trial. We recruited outpatients with schizophrenia aged 40 years or over from two psychiatric hospitals in Japan. Participants were randomly assi...

Objective The purpose of this study was to investigate the validity and reliability of the Japanese version of the Peace, Equanimity, and Acceptance in the Cancer Experience questionnaire (PEACE-J) and to evaluate the association between the PEACE subscales and Japanese patient characteristics. Methods A cross-sectional web-based survey was conduc...

It is necessary to assess functional impairment when treating schizophrenia. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) has been adopted as a measure of functional disability in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This study was a secondary analysis from a cross-sectional stud...

Purpose: Radiation dermatitis is one of the most common acute toxicities induced by chemoradiotherapy (CRT) for head and neck cancer (HNC). The benefit of topical steroids in the management of radiation dermatitis is still unclear. This phase 3, multi-institutional, randomized, double-blind, placebo-controlled trial evaluated the efficacy and safet...

12097 Background: The integration of palliative care into standard cancer treatment during the early phase of the disease can improve cancer patients’ quality of life (QOL). The current study examined the effectiveness of a nurse-led, screening-triggered, early specialized palliative care intervention program for patients (pts) with advanced lung c...

12012 Background: Geriatric assessment (GA) is recommended in various guidelines for older adults with cancer, but is not widely used in daily practice. This study aims to identify multi-level barriers and facilitators of GA implementation in daily oncology practice, based on a theoretical implementation framework. Methods: We conducted 20 semi-str...

12119 Background: Communication is an essential aspect of care for patients with progressive serious illnesses. Earlier discussion about patients’ values and priorities may lead to empathic communication and more goal-concordant care, and improved quality of life (QOL). This study aims to evaluate the efficacy of a newly developed integrated commun...

Background: While several small groups in Japan have attempted to conduct prospective studies in the field of supportive and palliative care, development of exploratory research into multicentre confirmatory studies has been difficult. The main reason for this is the difference in clinical research methodology in supportive and palliative care com...

Objective: To conduct the first national population-based study in Japan to characterize risks of death by suicide, other externally caused injuries and cardiovascular diseases within 6 months of cancer diagnosis. Methods: Cancer patients diagnosed between 1 January and 30 June 2016 and registered in the National Cancer Registry in Japan were fo...

Background Young adult cancer patients often face unique challenges and have potential unmet needs. This study aimed (1) to describe unmet supportive care needs among young adults with cancer in Japan, and (2) to identify its associated factors. Methods In a cross-sectional web-based survey, 206 young adults with cancer were assessed for supportiv...

A protocol for nurse-led early palliative care intervention.

Introduction: Although topical use of moisturisers is slightly effective for the prevention and avoiding the aggravation of hand-foot syndrome induced by multikinase inhibitors, there is still room for improvement. Hydrocolloid dressing is a type of wound dressing often used for wounds such as decubitus ulcers. The purpose of this study is to veri...

Introduction: Communication is an essential aspect of care for patients with progressive serious illnesses. This study aims to evaluate the efficacy of a new, integrated communication support program for oncologists, patients with rapidly progressing advanced cancer and their caregivers. Methods and analysis: The proposed integrated communicatio...

Context No standard preventive or therapeutic methods have been established for preoperative anxiety and postoperative delirium in cancer patients. Objectives To clarify the therapeutic effect of yokukansan for perioperative psychiatric symptoms in cancer patients, as well as to confirm its safety profile. Methods This is a randomized, double-bli...

Purpose To develop consensus-based components used in the first evidence-based cancer survivorship guidelines in Japan. Methods Purposive sampling was used to recruit a panel of experts in oncology clinical practice, nursing, health science, epidemiology, and patient advocacy. The panel engaged in a modified Delphi process to (1) generate consensu...

To determine whether the downward trend in the smoking rate over time in Japan differs between individuals with and without serious psychological distress (SPD), we used nationally representative data sets from the 2007, 2010, 2013, and 2016 Comprehensive Survey of Living Conditions of Japan. SPD was defined as a score ≥ 13 on the six-item Kessler...

Background: The Japanese Psycho-Oncology Society and Japanese Association of Supportive Care in Cancer recently launched the clinical practice guidelines for delirium in adult cancer patients. The aim of the guidelines was to provide evidence-based recommendations for the clinical assessment and management of delirium in cancer patients. This arti...

Background: Young adult cancer patients often face unique challenges and have potential unmet needs. This study aimed (1) to describe unmet supportive care needs among young adults with cancer in Japan, and (2) to identify its associated factors. Methods: In a cross-sectional web-based survey, 206 young adults with cancer were assessed for supporti...

Background: Young adult cancer patients often face unique challenges and have potential unmet needs. This study aimed (1) to describe unmet supportive care needs among young adults with cancer in Japan, and (2) to identify its associated factors. Methods: In a cross-sectional web-based survey, 206 young adults with cancer were assessed for supporti...

Background: Young adult cancer patients often face unique challenges and have potential unmet needs. This study aimed (1) to describe unmet supportive care needs among young adults with cancer in Japan, and (2) to identify its associated factors. Methods: In a cross-sectional web-based survey, 206 young adults with cancer were assessed for supporti...

Background: Olanzapine 10 mg added to standard antiemetic therapy including aprepitant, palonosetron, and dexamethasone has been recommended for the prevention of chemotherapy-induced nausea and vomiting. Guidelines suggest that a dose reduction to 5 mg should be considered to prevent sedation. In several phase 2 studies, olanzapine 5 mg has shown...

Background: We performed a follow up study about willingness and behaviors to quit smoking among smokers with schizophrenia in Japan. Methods: Participants were outpatients with schizophrenia aged 20-69 years who had been visiting the hospital for ≥1 year as of April 1, 2016, and had visited the hospital more than once in the previous 6 months....

Introduction One of the reasons for the high mortality rate from cancer in people with schizophrenia is delay in diagnosis. Many studies have shown lower cancer screening rates in people with schizophrenia; however, there are no interventions for people with schizophrenia to increase cancer screening. Therefore, we developed a case management (CM)...

Background Olanzapine (OLZ) 10 mg added to standard antiemetic therapy including aprepitant (APR), palonosetron (PALO), and dexamethasone (DEX) has been recommended for the prevention of chemotherapy-induced nausea and vomiting (CINV) caused by cisplatin. Guidelines suggest that OLZ at a dose of 5 mg should be taken into consideration in patients a...

Introduction A growing body of literature has demonstrated that cancer patients have a higher risk of suicide and cardiovascular mortality compared with the general population, especially immediately after a cancer diagnosis. Using data from the National Cancer Registry in Japan launched in January 2016, we will conduct the first nationwide populat...

Background: Nondisclosure of a poor prognosis to patients with advanced cancer remains a typical practice in Asia. Although the importance of prognostic communication has increasingly been recognized worldwide, little is known about whether explicit prognostic disclosure positively affects Asian patients with advanced cancer. The objective of this...

Background In medical practice, a patient’s loss of competency is a major obstacle when choosing a treatment and a starting treatment program smoothly. A large number of studies have revealed the lack of medical competency in patients with dementia. However, there have been only a few reports focusing on the capacity of patients with mild cognitive...

11503 Background: Olanzapine (OLZ) 10 mg added to standard antiemetic therapy including aprepitant (APR), palonosetron (PALO), and dexamethasone (DEX) has been recommended for the prevention of chemotherapy-induced nausea and vomiting (CINV) caused by highly emetogenic chemotherapy (HEC). Guidelines suggest that a dose of 5 mg should be taken into...

Background: Optimal cancer survivorship care needs its comprehensive guidelines. We aimed to identify English and Japanese guidelines that include cancer survivorship in their title, the issues highlighted in such guidelines, and any existing oncology practice guidelines in Japan that address these issues. Methods: This literature review was per...

Introduction: Although various phrases to communicate prognoses based on a certain concept have been proposed, no study has systematically investigated preferences of patients with cancer for actual phrases. We investigated whether phrases with a wider range and additional "hope for the best, and prepare for the worst" (hope/prepare) statement wou...

Background Preoperative anxiety and postoperative delirium affect both short- and long-term prognoses in patients with cancer; therefore, these conditions require early prevention and treatment. However, no standard preventive or therapeutic methods have been established for them. Yokukansan, a Japanese herbal medicine for the treatment of insomnia...

Context: When discussing end-of-life issues with cancer patients, the addition of reassurance statements is considered helpful. However, patients' preferences for such statements have not been systematically demonstrated. Objectives: The objectives of this study were to clarify if phrases with additional reassurance statements would be more pref...

Introduction One of the most common distressing conditions experienced by breast cancer survivors is fear of cancer recurrence (FCR). There is, however, no standard intervention for ameliorating FCR. Our clinical experience and previous studies have suggested the potential benefits of problem-solving therapy (PST) and behavioural activation (BA). G...

Background: To date, the clinical benefit of topical steroid use has only been demonstrated for radiation dermatitis induced by 50-60 Gy irradiation in breast cancer. However, these agents are also often used clinically for the control of radiation dermatitis induced by high-dose (>60Gy) irradiation with chemotherapy in head and neck cancer. Despi...

Background The mechanisms underlying cognitive decline after radiotherapy not directed at brain areas remains unclear. We previously suggested that adjuvant breast radiotherapy in breast conservation therapy could lower memory function soon after therapy, and that the process might be partially mediated by plasma interleukin (IL)-6 levels. The pres...

Background Postoperative delirium is a common and important complication in cancer patients. We need to identify patients at high risk of postoperative delirium such that it can be prevented preoperatively or in early postoperative phase. The aim of this study was to investigate whether preoperative anxiety predicted onset of postoperative delirium...

The Guidelines of the Japan Society of Clinical Oncology recommend standard triple antiemetic therapy with aprepitant, a 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone for patients receiving highly emetogenic chemotherapy. Recently, a Phase III study demonstrated the significance of adding of olanzapine (10 mg) to standard triple...

Purpose: To investigate if physicians' intrapersonal empathy increased after a communication skills training (CST) workshop. Method: Participants were oncologists from across Japan with three or more years of clinical experience in oncology. They were recruited through the Internet and via direct contact by the workshop organizers. Participants...

Context: Dyspnea is a common distressing symptom among patients with advanced cancer. Objective: To determine the effect of fan therapy on dyspnea in terminally ill cancer patients. Methods: This parallel arm, randomized controlled trial included 40 patients with advanced cancer from a palliative care unit at the National Cancer Center Hospita...

Background: Smoking behavior among people with serious psychological distress (SPD) has not been fully investigated in Asia, although smoking has become a public health concern worldwide. Many Western population-based studies indicate that people with psychological distress are more likely to smoke. Methods: This study used a national representa...