Cancer

Hurdles remain in government's anticancer programs Yoshiaki Takeuchi and Satoshi Yamada / Yomiuri Shimbun Staff Writers The government's outline of measures to prevent and fight cancer was recently revised for the first time since 2007, but many problems still remain, including gaps in the quality of medical service available in different regions, a shortage of doctors specializing in cancer treatment, and insufficient percentages of people being tested. The government was required by the 2007 basic law for anticancer measures to create the anticancer outline and set a goal of reducing the death rate from cancer among people under 75 by 20 percent in 10 years. The numerical goal was based on changes in population in age groups in the nation. The Health, Labor and Welfare Ministry's Anticancer Measures Promotion Council on Thursday approved the revised outline for anticancer measures from fiscal 2012. Ministries concerned will hold meetings with an eye to obtaining Cabinet approval in May. A 54-year-old woman in Buzen, Fukuoka Prefecture, regularly visits Nakatsu Municipal Hospital in the nearby city of Nakatsu, Oita Prefecture, to receive radiation therapy for her breast cancer. She has visited the hospital five days a week for the past five weeks. In January she underwent surgery at another hospital in Kitakyushu, a 1-1/2-hour drive from her home, but the hospital in Nakatsu is just 15 minutes away. The woman said, "It's a big help to be able to receive treatment at a nearby hospital." Last year, Nakatsu Municipal Hospital was designated by the government as a core hospital for cancer treatment. To be a core hospital, a facility must fulfill such criteria as having enough medical practitioners and equipment. Last summer, Nakatsu Municipal Hospital introduced a cutting-edge radiation therapy machine called a linac. It also opened new departments for outpatients undergoing pain management and consultation services for cancer patients. Some of the hospital's nurses have obtained certificates as nurses specializing in chemical treatments for cancer. Hospital Director Masahito Ikeda said, "The level of our care has surely risen." But problems remain. Although the linac machine provides intensity modulated radiotherapy (IMRT), an advanced treatment for prostate and other types of cancer, the hospital cannot use it because of a staff shortage. The hospital has also been unable to find full-time doctors specializing in anticancer and psychosomatic medicine. Cancer is the top cause of death among Japanese, with 350,000 fatalities annually. It is estimated that 50 percent of Japanese will develop cancer in their lifetime. The government set a goal of improving anticancer core hospitals in the previous outline made in 2007, and the number of core hospitals increased by more than 100 from 286 at that time. But practical concerns have not kept up with this progress, such as a shortage of specialist doctors. For example, the number of doctors specializing in anticancer medicine and treatment using such drugs has gradually increased, but the number is still only 585 nationwide. In Oita Prefecture, there are six. Even some core anticancer hospitals do not have specialists. Japan Cancer Society President Tadao Kakizoe said, "Measures to foster more specialist doctors, such as establishing courses specializing in cancer in universities' medical departments, are urgently needed." Medical examinations are a pillar of measures to prevent cancer. In the previous outline, the government set a goal of having at least 50 percent of the population tested. Forty-nine percent of people aged 40 to 44 received checks for cervical cancer, and 46 percent of people aged 45 to 49 were checked for breast cancer in the past two years. These figures, and those for some other types of cancer, have improved. The government believes the increased testing for cervical and breast cancer was the result of free coupons for health checks that the health ministry began to distribute in fiscal 2009. The government therefore added large intestine cancer to the examinations covered by the coupons. However, some medical experts said the coupons' effect was limited. Orie Ninokura, chief medical technician of the Chiba prefectural government's office for healthy diet and anticancer measures, said, "Testing rates for breast cancer and cervical cancer rose just after the coupons' distribution started, but the rates have not risen remarkably since then." Testing for all types of cancer has been from 20 percent to 30 percent, far below the government's goal. In the latest revision, the government has lowered its present goals for stomach, large intestine and lung cancer testing to 40 percent. Keiichi Nakagawa, head of the University of Tokyo Hospital's Department of Palliative Medicine, said, "To make people understand the necessity of these medical examinations, it's necessary to educate them about cancer from childhood." The latest revision to the outline includes promotion of such education. Another pillar of anticancer measures is steps against smoking. The revised outline set for the first time a numerical goal of lowering the percentage of smokers among adults to 12 percent or lower in 10 years. Resistance from the tobacco industry was strong when the previous outline was made and regarding the latest revisions. But the government pushed the measure through. The government also set a specific goal of improving core hospitals for juvenile cancer, a subject on which measures had been delayed. The new outline further contains measures to assist cancer patients and people who have recovered from cancer in finding jobs and continuing to work http://www.yomiuri.co.jp/dy/national/T120304004051.htm