President Messages
Japan Association of Supportive Care in Cancer Toshiaki Saeki, President
Japan Association of Supportive Care in Cancer (JASCC) was established and fostered by Dr. Kazuo Tamura, the first President, to promote the studies, practices and dissemination of supportive care in Japan. The society has now over 1,000 members and is expanding the activities for dissemination of cancer care responding to diverse requirements among cancer patients throughout the nation, in cooperation with the officers and members. Focusing our attention only on the patients’ requirements may include some risks. Seeing the patients suffering from adverse reactions and distress, who may grasp a straw, we may feel compelled to do anything possible for them. However, we must be careful in providing customary cares with poor evidences. The supportive care must be supported by evidences, complementary to the evidence-based medicine, and developed considering the Japanese culture and life style. Medical practitioners must sincerely listen to patients and understand them to create a new story in treating them to solve their problems through dialogues. As the society grows, members of the board, committees and study groups are now in the second stage. We have rejuvenated the board members adding the members since 2020 and renewed our web site. Taking this opportunity, here below, I would like to present our activities in the past and to move forward.
Finally, with the support from Dr. K. Tamura as a consultant, we would like to invite skilled and highly motivated persons in various professions to join us and lead the society as board members. We highly appreciate your kind and continuous supports to us.
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Operations
Differently from other societies, our society is operated by study groups (SGs) for individual therapeutic fields. Starting from 16 SGs, Kampo Medicine SG was added to make 17. Additionally, four working groups (WGs) have been set up for Onco-cardiology, Onco-nephrology, Patient Reported Outcome (PRO), Integration of Oncology and Supportive/Palliative Care, rarely discussed in the past.
As the activities of the SGs are expanded to create evidences and to prepare practice guidelines, a committee has been established as Guideline Committee (chaired by Dr. Kosuke Uchitomi) to review and verify them. For enhancing our international activities, International Affairs Committee has been established (chaired by Dr. Mitsue Saito). The existing committees also have been reorganized and changed their names to Election Administration Committee, Education Committee, New Medical Information Committee, etc. to better represent their actual missions.
As plans for coming five years, Election Administration Committee has been set up for election of board members by the members and Future Conception Committee is planning to implement Recognition System for Cancer Supportive Care Specialists (preliminary). At present the society has 12 committees, 17 SGs, and four working groups.
Members
The members are smoothly increasing yearly, including not only physicians but also pharmacists and nurses, in particular. It is a multi-disciplinary society with no educational system for specialists but the increase of the members suggests that our vision is supported by considerable persons. We expect further increase of the members.
Annual meetings
Our first annual meeting in 2016 (president: Dr. Keisuke Aiba, at Jikei University, Tokyo) had 340 participants and the 2nd meeting in 2017 (president: Dr. T. Saeki, at Saitama) had 647. In 2018, Dr. K. Tamura, the first president, organized the 3rd meeting in Fukuoka, enhancing the cooperation with the Multinational Association of Supportive Care in Cancer (MASCC). The 4th meeting chaired by Dr. Atsushi Sato had over 1,000 participants including many from Tohoku region. The 5th meeting was held in conjunction with the Japan Society for Palliative Medicine and Japan Psycho-Oncology Society. President of the JASCC meeting was Dr. Takao Takahashi and the joint meeting was chaired by Dr. Yosuke Naito, JASCC board member. It was held on the web due to COVID-19 pandemic but was an epoch-making meeting including live lectures with many participants. In 2021, with Dr. Akihiko Osaki as the president, we have started preparation for the meeting completely on the web. In 2022, Dr. Tadashi Uwagawa will take the chair, and in 2023, with Dr. Mitsue Saito as the president we are preparing for a joint meeting with MASCC.
Clinical studies in supportive and palliative cares
In the Project 5 of the six projects by Japan Agency for Medical Research and Development (AMED) to promote practical application of innovative cancer care, for the first time, “Studies on the development of evidence-based cancer supportive/palliative cares” have been included. The studies are already ongoing led by the study group of our society. In the field with poor evidences where study policy has not been established yet, the group leader and the members are working for preparation of the protocol and operation. In development of the study guidelines for supportive/palliative cares, the project by Dr. Sadamoto Zenda (vice-chairperson of General Affairs Committee) was adopted at the second public submission in 2017.
Additionally, we are supporting clinical studies in supportive care in cooperation with J-SUPPORT at National Cancer Center Japan.
Clinical studies lead by our committees (as of August 2020)
Development of the standard therapy for cancer associated cachexia.
Kyoto Prefectural University of Medicine KOICHI TAKAYAMA
Research on development of rehabilitation program for cancer patients in the outpatient setting.
Keio University School of medicine TETSUYA TSUJI
The project of making clinical research policy of supportive and palliative care
National Cancer Center SADAMOTO ZENDA
Guidelines published
Series of JASCC supportive care
Clinical Guide of Management for Chemotherapy-Induced Peripheral Neuropathy
(Neurological Disorder Sturdy Group:YASUO HIRAYAMA/YOICHIRO YOSHIDA)
The atlas and management for skin toxicities induced by anticancer drug therapy
(Onco-dermatology Sturdy Group:NAOYA YAMAZAKI/SATOSHI HIRAKAWA)
Learn through Q & A Treatment of lymphedema
(Lymphedema Sturdy Group: HIROMI SAKUDA/YOSHIHIRO OGAWA)
Clinical Guide of Management for Mucositis to Cancer Therapy
(Mucositis Sturdy Group : DAICHI CHIKAZU/KUMIKO KARASAWA)
Edited by Japanese Association of Supportive Care in Cancer
Japanese Association of Oral Supportive Care in Cancer
Cancer cachexia handbook
Supervised by KOICHI TAKAYAMA、TATEAKI NAITO、KAZUO TAMURA
Current Geriatric Oncology in Japanーoverview
Health and Labor Sciences Research Grant ”Geriatric Oncology Guideline-establishing (GOGGLE) Study”
Japanese Association of Supportive Care in Cancer・Geriatric Oncology Guideline-establishing (GOGGLE) Study Group・Japanese Association of Geriatric Oncology(JAGO)(PDF only)
Series of guidebooks translated by JASCC
European Oral Care in Cancer Group Oral Care Guidance and Support – Japanese edition
(Mucositis Sturdy Group : DAICHI CHIKAZU/KUMIKO KARASAWA)
Cancer cachexia: mechanism and progress in treatment- Japanese edition
(Cachexia Sturdy Group:KOICHI TAKAYAMA/TAKASHI HIGASHIGUCHI)
Guideline series of JPOS mental care in cancer care
Delirium in Cancer Patients :JPOS-JASCC Clinical Practice Guidelines
Edited by Japan Psycho Oncology Society・Japanese Association of Supportive Care in Cancer
Basic researches in supportive/palliative medicine – precision medicine
Basic researches for elucidation of pathology in supportive/palliative medicine are crucial for development of new medical products and devices as well as the cancer care. Newly set up New Medical Information Committee (chaired by Dr. Ikuo Sekine) is collecting accurate information focusing on immune-related adverse events, cancer genomic medicine, and novel medicines to share the information widely among the members. Supportive/palliative care also should move on to the era of precision medicine not only in cancer care but also in supportive care. For that, training of basic researchers and investments in studies are needed in this field.
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Definition of terms in supportive/palliative care
– For dissemination of “supportive care”
The National Cancer Control Plan Phase II and later phases include “palliative care after diagnosis of cancer” as a key strategy. What is the “palliative care”? It is questionable as a medical term because it is ambiguous and confused with “terminal care.”
We include the words “supportive care” in the prospectus of the society saying “through education, researches and clinical practices of comprehensive supportive care in cancer care (hereinafter referred to as supportive care) … .” We cannot find any appropriate Japanese translation for Supportive Care (SC). However, we consider that the care intends “comprehensive supportive care responding to the requirements in cancer patients.” Therefore, we would like to further spread the word ”supportive care” confronting “palliative care.” Actually, at the joint meeting with Japan Society for Palliative Medicine, we could appeal the features of JASCC, presenting the difference between the activities of JASCC and those of JSPM. The societies are cooperating under global conception of similarities and differences of the palliative care and the supportive care. JASCC considers the supportive care as the “medical care supporting patients and their families at every stage (trajectory) of cancer” in line with the concept of ESMO (Cherny NI et al., Ann. Oncol. 2003; 14: 1335 – 1337), whereas the palliative care (PC) as the “supports at the stage where no cure is expected.” Of course, there are overwraps and it is difficult to distinguish them clearly. Therefore, in treating cancer, we believe it adequate to use the terms “cancer treatment” targeting cancer, and “supportive/palliative care” supporting the former. Actually, Western societies concerning cancer including MASCC use “supportive/palliative care” at their meetings. In “Palliative care after diagnosis of cancer” in the National Cancer Control Plan Phase II, we consider that the above mentioned “supportive/palliative care” is the most appropriate because the palliative care should be the care involving medical institutions and authorities (for nursing care and welfare) rather than a wide meaning of “care.” We have a working group for integration of oncology and palliative care (lead by Dr. Takako Nakajima), where this issue will be defined as the main tasks for our future activities.
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Moving for internationalization
Since 2016, during the scientific meeting of MASCC, we are holding the “JASCC Seminar” for participants from Japan. Also, from 2017, we are holding a joint meeting MASCC-JASCC within the program of the MASCC meeting (Washington DC). From JASCC, International Affairs Committee is participating in program planning and in contact with the office for the MASCC general meeting every year. Additionally, we are planning a symposium with an inspiring theme at the joint general meeting of the MASCC-JASCC in 2023.
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Issues and perspectives
Following the great contribution of Dr. K. Tamura, the first president, not only continued efforts in the society’s activities but also recruitment of excellent human resources is necessary for further development. Fortunately, we have many researchers and practitioners in various professions in the members but we think that the patients’ diverse needs are not fully met by medical care yet. Main players of our society are individual SGs but some of them are not fully achieving their own tasks. In addition to activation of individual SGs, coordination among them is necessary. All SGs should achieve the following:
1) To prepare a handbook or guidelines in their fields
2) To establish research systems for individual problems in the fields with poor evidences in cooperation with other societies and concerned parties
3) To dispatch accurate information to public and medical workers.
4) To increase fellows interested in supportive/palliative care and support them to create a system based on the designated cancer hospitals so that cancer care and supportive/palliative care can be started concurrently at the diagnosis of cancer and medical facilities be prepared for it according to their resources.