Clinics & Departments

Palliative Care Center

Department of Palliative Care & Pain ManagementDepartment of Counseling & SupportDepartment of Regional Care Network & AllianceDoctors and Staff

Department of Palliative Care & Pain Management

Division of Palliative Therapy

In addition to surgery, endoscopy, radiotherapy and chemotherapy, palliative therapy and care play an important role in cancer treatment. At the division of Palliative Therapy, we provide long-term treatments, from the beginning of the treatment until when the patient’s life is lost, and grief care for his/her family members. The purposes of palliative therapy and care are to eliminate painful symptoms caused by cancer, and to enable a patient and their family to live enjoyable and relaxed lives.

We perceive physical, mental, social, and spiritual pain associated with cancer as “total pain”, and thereby we work as a team consisting of physicians and nurses specializing in palliative therapy and care, dietitians, physical therapists, clinical psychologists and medical social workers in order to treat these pains. We practice medical care aiming at ‘zero’ cancer pain without giving up throughout the process of disease. We provide such treatments in the outpatient clinic of the Division of the Palliative Therapy and the palliative care ward in cooperation with other hospitals and clinics.

At the same time, we conduct researches on the establishment of multidisciplinary cancer pain treatment, the analysis of the pathogenesis of cancer cachexia and development of its treatment, appropriate use of antipsychotics in the palliative field, and so on.

Division of Cancer Pain Service

The Division of Cancer Pain Service provides specialized treatment for cancer pain, which prevents cancer treatment and palliative care (treatment of symptoms).

Many types of pain, such as pain caused by cancer itself, pain at the sites of metastasis, and pain associated with the treatment, are involved in cancer pain. In addition, it includes visceral pain (such as abdominal pain and lower abdominal pain), somatic pain (such as hand pain, foot pain, lower back pain, and pain associated with movement), and neuropathic pain (such as tingling pain, smarting pain, and electric shock-like pain). There is also psychogenic pain associated with anxiety and a depressed mood.

If such pain is untreated, patients’ daily life will be interfered with and, furthermore, cancer treatment itself may also be affected due to the decrease of physical strength. We use medical skills of pain clinic to reduce pain, when analgesics prescribed by the physician in charge cannot smoothly reduce pain, when pain-killing injections have to be used, or when it is considered difficult to control pain with oral drugs or medical patches.

  1. Adjustment of General Analgesics
    If the cancer pain is mild, oral drugs (such as non-steroidal analgesics and acetaminophen) are prescribed. If these drugs cannot relieve the pain well, we will detect the problems and advise on the timing and the frequency of taking the drugs.
  2. Adjustment of Opioid Analgesics
    Opioid analgesic is the technical term for a narcotic analgesic. Opioids are used when the pain is not relieved by general analgesics. Its dose can be adjusted according to the level of pain, thus it can manage a strong pain. Opioids have side effects such as constipation, transient nausea and sleepiness, but do not affect the stomach, kidney, or liver. The sudden discontinuation of opioid analgesics causes withdrawal symptoms including cold sweats and anxiety. Therefore, if they are no longer necessary, we gradually reduce their amount and eventually discontinue them. We ensure that patients do not become addicted or dependent, if these drugs are used for pain management properly.
    In addition to general drugs, we use opioid analgesics to reduce the pain. We select the appropriate drugs, adjust their doses, and prescribe therapeutic drugs for side effects such as nausea and constipation, in consideration of the lifestyle and disease condition of patients.
  3. Control with Injections
    We often use analgesic injections for inpatients. These injections are used when the patient cannot take drugs orally due to examination, surgery, or gastrointestinal problems, and when we determine the analgesic dose required to control pain.
  4. Nerve Block Therapy (Neurodestruction)
    Nerve block therapy (neurodestruction) is available in cases where oral analgesics or analgesic patches alone cannot sufficiently reduce pain. Neurodestruction is a method that paralyzes the nerves transmitting the pain to prevent feeling excessive pain stimulation. This method allows significant reduction in the amount of analgesics for about 50% of the patients. In addition, the reduction in the amount of oral analgesics by nerve block therapy decreases associated side effects.
    Since nerve block therapy cannot be applied to every patients, its use will be discussed with the doctor in charge.
  5. Spinal Analgesia
    Spinal analgesia is a method in which a catheter is inserted near the spinal cord to directly inject analgesics. A small percentage of the amount required for oral administration produces better analgesic effects. This method is selected when the pain is not relieved by oral drugs and medical patches, or when nerve block cannot be applied. We also perform surgery to implant a catheter in the body to prevent accidental catheter removal and infection.
    This analgesic method contributes to reducing pain in many patients, although it has the disadvantage that patients have to carry a pump to inject the drug through the catheter in their daily lives.
  6. Activities as the Palliative Care Team
    Members of the Division of Cancer Pain Service also work as Palliative Care Team. We support patients who need pain treatment from the time of cancer diagnosis together with nurses and pharmacists.

What is the palliative care team?

The palliative care team of our hospital manages symptoms in cancer patients at any time during and after the treatments. The team consists of pain clinic specialists, oncology certified nurse specialists, board certified pharmacists in palliative pharmacy, psycho-oncologists, and other staffs.

Cancer patients need the holistic treatment for not only pain and suffering caused by cancer itself, but also pain and side effects associated with treatment, psychosocial anxiety, and complications due to the concurrent use of many drugs. In addition, during recuperation after the treatment, it is necessary to return the patients to normal life as much as possible without painful symptoms. To solve these many problems multidirectionally, it is necessary for us to work as a team and to provide holistic medical care for patients. We provide services to eliminate painful symptoms of the patients in the general wards in cooperation with physicians and nurses in charge. We immediately provide such services when physicians or nurses in charge feel the need our cooperation.

Division of Psycho-Oncology

The Division of Psycho-Oncology provides diagnosis of psychiatric disorders in patients receiving outpatient treatment or inpatient chemotherapy and their families. We also offer treatment including drug therapy and counseling.

We think it is very important to relieve mental pain for undergoing cancer treatment and living well with the disease. We accept patients through their doctors whenever patients need our support: when they are receiving the detailed examination, diagnosis, specific treatment, or rehabilitation, as well as when they are in the recurrence or advanced stages.

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Department of Counseling & Support

Cancer Counseling & Support Center

In the Cancer Counseling & Support Center, nurse specialists, certified nurses, and medical social workers (MSWs) provide face-to-face or telephone counseling on cancer treatment and life with treatment. In particular, we answer the following inquiries:

  • I feel much anxiety, and I don’t know what to do.
  • I want to know more about cancer and its treatment.
  • I received an explanation from my doctor, but it was too difficult for me to understand.
  • I cannot decide which treatment to undergo.
  • Side effects may be severe, so I worry about whether I can get through the treatment.
  • I am troubled by painful symptoms.
  • I worry about whether I can continue to work.
  • I worry about how to tell my parents, children, friends, and colleagues about my disease and treatment.
  • I cannot decide the way and the place of my recuperation in the future.
  • I am worried about how I can support my family member suffering from cancer.

WOC Support Room

In the WOC Support Room, certified wound, ostomy, and continence nurses provide support, guidance, and counseling for a patient having problems associated with an artificial anus, artificial bladder, pressure ulcer, and incontinence, in cooperation with nurses working in the wards.

In particular, patients with an artificial anus or bladder feel distress at the decline in physical function and the limit of social life caused by the difficulty in urinating that is a basic human need. Thereby we make an effort to relieve them from pain, to provide nursing care for restoration of their will to live, and to provide adequate support. We start the support before surgery and it lasts until after they are discharged.

For wound care, we thoroughly perform management to prevent pressure ulcers during hospitalization. For incontinence, we also support patients with dysuria, dyschezia and related health problems, and provide professional skin care.

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Department of Regional Care Network & Alliance

The Department of Regional Care Network & Alliance supports creating a cooperative system with the local medical institutions in an area (in Japan) where our patients and their family live, so that they can live without anxiety. We offer the counseling on the following situations:

  • I was recommended to be discharged, but I feel uneasy. I don’t know what to prepare for.
  • I was recommended to be hospitalized, but I want to stay home.
  • I want a doctor or nurse to visit my home.
    * Our hospital does not provide visiting medical care and visiting nursing.
  • I want to prepare for sudden deterioration and make it possible to be treated at a nearby hospital in preparation.
  • I want to find a hospital for the recuperation.
  • I want to find a hospital good at pain management.
  • I also want to use long-term care and welfare services.

In addition, we also provide counseling on drip infusion management, home oxygen therapy, the use of various catheters, medical devices, welfare devices, and so on.

How to Support

A nurse or a MSW in charge directly sees the patients and their family to offer counseling. The staff finds medical institutions together with them in consideration of their request and the services of medical institutions, and helps them go through the specific procedures.

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