[The Overview of Two Programs to Support Cancer Survivor's Advocacy by CancerNet Japan].

In 2016, the Cancer Control Act was revised, with emphasis on support for people living with cancer, the public's understanding of cancer patients, continuation of employment of cancer patients and cancer education, etc, was added. In order to make policies effective, it is necessary for society to listen to the voices of cancer survivor and to know the current situation of issues they face on. We, CancerNet Japan have been supporting cancer patients through the 2 projects "Breast cancer Experienced Coordinator(BEC)Training Course", started in 2007 and "Over Cancer Together(OCT)Campaign", started in 2013. We have educated the knowledge and skills that are required for cancer survivor to utilize their experiences. There are more than 400 graduates who have completed each 2 courses. Some engaged in consultation support activities as a peer supporter in hospitals and areas, other serve as local cancer promotion committee members, and give lecture activities. These 2 projects that have supported cancer survivorship were to support the process of enhancing advocacy, cancer survivor gaining correct knowledge, standing with their own power, disseminating their own experiences and issues based on it, and taking actions to resolve.

The importance of good death components among cancer patients, the general population, oncologists, and oncology nurses in Japan: patients prefer "fighting against cancer".

BACKGROUND: The objectives of this study were to compare the importance of components of a good death among cancer patients, the general population, oncologists, and oncology nurses, and explore which patients preferred "fighting against cancer." METHODS: We conducted a cross-sectional anonymous self-reported survey of cancer patients who visited a radiation oncology outpatient clinic, oncologists, and oncology nurses at the Tokyo University Hospital and a random sample of the general population in the Tokyo metropolitan area. The outcomes were 18 previously developed components of a good death in Japanese cancer care consisting of 57 attributes. RESULTS: Three hundred ten patients, 353 subjects from the general population, 109 oncologists, and 366 oncology nurses participated. The desire to "fight against cancer" was highly significantly different between patients and oncologists (effect size [ES] = -1.40; P = 0.001) and patients and oncology nurses (ES = -1.12; P = 0.001). "Physical and cognitive control" was, similarly, highly significantly different between patients and oncologists (ES = -1.30; P = 0.001) and patients and oncology nurses (ES = -1.06; P = 0.001). Patients who emphasized "maintaining hope and pleasure" (P = 0.0001), "unawareness of death" (P = 0.0001), and "good relationship with family" (P = 0.004) favored "fighting against cancer." The patients, however, who emphasized "physical and psychological comfort" did not significantly favor "fighting against cancer" (P = 0.004). CONCLUSION: The importance of good death components differed between groups. Medical professionals should be aware of the diversity of values surrounding death and assess the patient's values and discuss them to support his or her quality of life. In addition, the development of care and a medical/social system to maintain hope and pleasure after failure of anticancer treatment is necessary.

Views on death with regard to end-of-life care preferences among cancer patients at a Japanese university hospital.

OBJECTIVE: This study investigates the views on death among cancer patients in Japan and examines how these views are related to age, sex, and physical condition. We also investigate how these views are related to where patients would like to spend their final days and whether or not they would like to be told how long they have left to live. METHOD: We targeted 450 cancer patients receiving outpatient treatment in the radiology department at the University of Tokyo Hospital. We used the Death Attitudes Inventory (DAI) developed by Hirai to measure attitudes about death. RESULTS: Of the 450 patients approached, we received responses from 310 (69% collection rate). The results of the t test and one-way ANOVA showed that, in terms of "death anxiety/fear," the under-65 group (17.73 ± 6.69) scored significantly higher than the 65-and-over group (15.43 ± 7.69, t = 2.685, df = 280, p < 0.01); the group with KPS scores 70 or above (16.88 ± 7.21) scored higher than the group with KPS scores below 70 (12.73 ± 7.09, t = 2.168, df = 280, p = 0.03); and no significant difference was found for sex, metastasis, or treatment stage. SIGNIFICANCE OF RESULTS: Our results demonstrate that, although views on death among cancer patients may differ according to sex, age, and physical condition, taking these factors into account when understanding such views can be useful in predicting where patients may wish to spend their final days.

[Agenda for dissemination of peer support by cancer survivors].

The 2012 revision of the Basic Plan to Promote Cancer Control Programs explicitly recommends the enhancement of peer support. As of October 2013, only 20% of all designated regional and prefectural core hospitals and centers for cancer care formally promote peer support. Accordingly, the national government has been organizing training courses on peer support. Even so, peer support is not readily available. CancerNet Japan, a non-profit organization, has organized a peer support system at four designated cancer care hospitals in the Kanagawa prefecture, in association with the government. Peer supporters are breast cancer survivors who have completed the"Breast Cancer Survivor Coordinator Training Program,a course organized by CancerNet Japan since 2007, and have been officially certified as coordinators after course completion. These peer supporters have not only learned from their own experience but have also studied scientific medical information on cancer. The manner in which supportive activities are conducted in these four hospitals varies according to environment; for example, a dedicated booth may be set up or a standby coordinator may be stationed in a dedicated support room. The most common issue dealt with was the fear expressed by patients or their families, and supporter responses were primarily to attentively listen to them. In this paper, we review our activities with regard to the following three areas of interest:(1) intra-institutional coordination within each hospital, (2) supporter-related issues, and (3) financial resources for efforts involved in the proposed structured peer support system to be adopted at a large number of hospitals nationwide.

The inter-rater reliability of the Japanese version of the Inventory of Depressive Symptomatology, clinician version.

The Inventory of Depressive Symptomatology, clinician version (IDS­C), was developed by Rush et al. to evaluate the severity of major depressive episodes. The aim of the present study was to establish the inter­rater reliability of the Japanese version of the IDS­C. A total of 16 subjects with DSM­IV major depressive episode were evaluated. Two psychiatrists, who had completed a training session for evaluating the IDS­C before starting this reliability study, attended systematic interview sessions with each subject to evaluate the IDS­C independently, using the Japanese version of the structured interview guide for combined rating of the IDS­C and the Hamilton Depression Rating Scale. The severity of the 30 IDS­C items assessed by the two raters ranged from 0 to 4 for 27 items and from 0 to 3 for 3 items. The analysis of variance intra­class correlation inter­rater reliability values for the individual scale items ranged from 0.874 to 1.000. The present results suggest that the Japanese version of the IDS­C is a potentially useful rating instrument with high inter­rater reliability for measuring the severity of depressive symptoms in the hands of psychiatrists with sufficient evaluation training.

Catalase and alternative oxidase cooperatively regulate programmed cell death induced by beta-glucan elicitor in potato suspension cultures.

In potato (Solanum tuberosum L.) suspension cells, the expression of the gene encoding alternative oxidase (AOX) and H2O2 accumulation were induced by treatment with beta-glucan elicitor. The inhibition of catalase activity enhanced both AOX mRNA expression and the production of H2O2, whereas the ascorbate peroxidase inhibitor did not have any effect on these responses. Simultaneous inhibition of catalase and AOX activities in elicited cells dramatically increased H2O2 accumulation, leading to the disruption of mitochondrial membrane potential (deltapsi(m)) and programmed cell death (PCD). The results demonstrate, for the first time, that not only AOX but also catalase plays a central role in the suppression of mitochondrial deltapsi(m) breakdown and PCD induced by beta-glucan elicitor.

Suppressive effect of polysaccharides from the edible and medicinal mushrooms, Lentinus edodes and Agaricus blazei, on the expression of cytochrome P450s in mice.

To investigate the effects of lentinan from Lentinas edodes and polysaccharides from Agaricus blazei (ABPS) on the expression of cytochrome P450s (CYPs), lentinan (10 mg/kg/day) or ABPS (200 mg/kg/day) was administered to female BALB/c mice four times every other day by intraperitoneal injection. Lentinan and ABPS suppressed both the constitutive and 3-methylcholanthrene-induced CYP1A expression and ethoxyresorufin-O-deethylation activity in the liver.