TEIKYO SDGs reportSustainable community development starts with cancer.
――Accumulation of local information forms the basis for global problem solving―――
Kiyotaka Watanabe, professor at the Teikyo University School of Medicine, Internal Medicine Medical Oncology Program?
Graduated from the University of Tokyo School of Medicine in 1996. After training in internal medicine and emergency medicine, he joined the Department of Gastroenterology at the University of Tokyo Hospital. While working on basic, clinical, and policy research, he is energetically engaged in disseminating information on cancer care and cancer control as well as building partnerships.
To summarize this report ...
The word "cancer" is often used to refer to a single disease, but since each patient lives in a different region and in a different environment, it is important to create a community in which they can face their disease with peace of mind.
The quality of life for the individual and his/her family will be improved if accurate information is shared by all involved in treatment, care, and daily life.
Create a place to connect the information that the parties concerned want to know and the information that those in the medical field want to convey to others.
At Teikyo University Itabashi Campus, we are working to disseminate a model for creating collaboration with the support of various teachers from the Faculty of School of Medicine Hospital and the Faculty of Medicine.
The attempt to transform tacit knowledge accumulated in local communities into shared knowledge is an opportunity to propose solutions to the very social issues picked up by the SDGs.
Connecting cancer-related information needs to support
Today, about 1 million people in Japan are diagnosed with cancer each year. Thanks to advances in diagnosis and treatment, the survival rate has been improving year by year. Many patients continue treatment or face the fear of recurrence. Cancer is a word that means different things depending on the location, the degree of progression, and the presence or absence of other diseases. Some have just been diagnosed, some are about to begin treatment, some have reached the end of their treatment and are considering living at home, and some are finding their own way to spend time in their familiar environment while the disease progresses or recurs repeatedly. There is a need for a system in which various specialists can be close to patients and support them in dealing with the anxieties and worries of those affected by cancer. In 2025, when the baby boomers will be 75 years old or older, medical professionals such as doctors, nurses, and pharmacists, nursing care and welfare professionals, and government officials are expected to play their roles under a comprehensive support and service delivery system (community-based comprehensive care system) to enable people to continue living their own lives in their familiar communities as long as possible until the end of their lives. The importance of creating a community where everyone can live with peace of mind is emphasized, with doctors, nurses, pharmacists, and other medical professionals, caregivers, welfare workers, and government officials all playing their respective roles.
The key is information. Medical professionals support patients in medical matters according to their job position, such as doctors for diagnosis and treatment, nurses for treatment and care, and pharmacists for medicines and prescriptions. What about daily life? When patients return home, we may not have a full understanding of their daily living conditions, whether they live alone, whether they are being supported by elderly caregivers, or whether they live in an apartment without an elevator. They may be suffering from emotional or financial hardship. In addition to suggesting treatments and medications, we need to share the image of the patients' lives with them and those around them. From a caregiver's point of view, we share the patients' current capabilities, physical condition, prospects, and wishes, while coping with their daily changes as a person who live with the disease. The individual, those around them, and the people involved in treatment, care, and daily life can give accurate and useful information about this disease and treatment when considering the current issues, and the support that they can properly provide as a team. This can lead to a dramatic improvement in the quality of life during medical treatment. It is important to have many choices, but having too many choices can lead to confusion and anxiety if you cannot choose the right one, or if you are overwhelmed by uncertain information or information that does not suit you. You need a "navigator" who can point you in the right direction and give you hints on how to spend your time in the future.
Necessity and possibility of information from the party and site perspective
I used to work for the Cancer Information Service (https://ganjoho.jp/), run by the National Cancer Center Japan, creating and disseminating reliable information. It is the largest cancer information site in Japan with 3 to 4 million hits per month. The information is presented in an easy-to-understand manner based on reliable sources that are backed by scientific evidence, such as medical treatment guidelines, and is highly reliable and filled with information on basic diagnosis and treatment. On the other hand, what about the situation of individual patients? For example, the same lung cancer patient in his/her 40s who has never smoked and is doing well at work will require different support, such as information on medical treatment and care needed and support needed to continue working, than a patient in his/her 70s who has comorbidities such as diabetes and dementia. The anxiety that patients and their families face when they find out they have cancer is unimaginable. By being exposed to a large amount of information at random, they may lose sight of the information that they need to know, and this can lead to greater anxiety. The same can happen to family members and loved ones.
Based on this, we have continued our efforts to create a place that connects the information that the people involved want to know and the information that those in the medical field want to convey. Focusing on the two areas of information necessary for home care and information on care in a familiar area, we have begun building an information portal that will aggregate and provide useful and helpful information.. Since 2012, we have held the Cancer Medical Forum, and in 2015, we have been working on the Cancer Home Care (Information Dissemination and Utilization Project for Palliative Care and Recuperation Support for Cancer Patients in the Community), a guide with information necessary for home care and a portal site with useful information for home care. We aim to expand the circle of support for patients and their families in the community close to them by sharing information and promoting cooperation.
Cancer Home Care
Palliative Care and Treatment Support Information for Cancer Patients in the Community Dissemination and Utilization: ?https://plaza.umin.ac.jp/homecare/
"A guide to home care that connects cancer patients and their families for support and peace of mind," an information booklet for when cancer patients spend time at home, as well as workshops and forums held throughout Japan on the theme of home care.
Information on local medical treatment leads to the creation of face-to-face relationships
The Cancer Home Care website provides information for people with cancer and their families that is helpful when they want to spend time at home, as well as information and advice on how to deal with concerns and worries when spending time at home. In addition to compiling knowledge about medical care and nursing care, the site is characterized by the fact that it introduces the experiences of families and bereaved family members who have shared a life of recuperation, with the cooperation of many of the people involved. As a portal site dealing with medical care and convalescent life, many people take the time to read it. The book includes information about concerns about living at home, preparation, building relationships with staff like home doctors and nurses, and tips for talking with family members. The book is compiled based on interviews with many people including doctors, nurses, pharmacists, care managers, medical social workers, rehabilitation staff, and others involved in actual support at home.
What supports medical care at home is the information available in the area where you live and work. The medical system differs depending on the size of the population, and even within Tokyo, the aging population in some areas and the accessibility to medical care and nursing care, as well as the systems that are easy to use, vary from region to region. The project has proposed that cancer medical forums be held in local areas to provide a forum for sharing issues and innovations in those areas and sites. We have continued to work with people in the field to share community issues and unique innovations to deepen cooperation regarding home medical treatment in Sendai, Okinawa, Izumo in Shimane, Kesen in Iwate, Tsuruoka and Mikawa in Yamagata, Takamatsu in Kagawa, and northern Tokatsu in Chiba, as well as in other locations throughout Japan. At the Itabashi Campus of our university, a model for creating collaboration with the support of Dr. Tetsuya Sakamoto, the director of the Faculty of Medicine, Dr. Keiji Sano of the School of Medicine Cooperation and Counseling Department, and many teachers including the Faculty of School of Medicine, Faculty of Faculty of Pharma-Science, and Faculty of Faculty of Medical Technology. With the support of Dr. Tetsuya Sakamoto, Director of the School of Medicine Hospital, Dr. Keiji Sano of the Medical Cooperation and Consultation Department, and many other professors including those from the School of Medicine, the Faculty of Pharma-Science, and the Faculty of Medical Technology, the Teikyo University, Itabashi Campus, is working to disseminate a model for coalition building. With the support of the University's Advanced Research Promotion Grant, together with doctors from the Itabashi Ward Medical Association and doctors from the core hospitals, we are holding the "Teikyo Cancer Seminar / Community Comprehensive Care Roundtable 2019: Building a Team to Support Cancer Patients in the Community They Live In" where professionals supporting treatment in the community discuss the issue beyond the boundaries of their professional affiliations and facilities. 2019" was held in November 2019.
The three points of focus are: "How can the community support the physical, psychological, and social challenges that the patients are facing in their medical treatment life? We emphasize the process of building face-to-face relationships among participants. You can see the discussion meeting on the website "From Itabashi, a Model for Enhancing Survivorship". As we face the new challenge of the spread of the novel coronavirus infection, the nature of communication surrounding medical care is also changing. We would like to propose a model that can be applied in various settings, such as urban areas, regional areas, and professional areas, to find optimal solutions not only between patients and medical professionals, but also how patients, families, and medical professionals can share information and discuss issues.
Teikyo Cancer Seminar / Community Comprehensive Care Roundtable 2019: "Building a Team to Support Cancer Patients in Their Familiar Community" (at Teikyo University Itabashi Campus)
A wide range of professionals, including local medical and long-term care welfare professionals, university hospital staff, and faculty members, discussed the practice of comprehensive community care.
Tacit knowledge of "cancer model" and "regional model" into social knowledge - dissemination from academia
Now, when we consider our efforts from the perspective of the SDGs, it can be said that there is intrinsic value in converting and visualizing into social knowledge what has originally been shared as tacit knowledge in each region. Epidemic and disease control in local communities is one of the goals of the SDGs, and there are also goals in terms of safety and security of life in the community and urban development. However, beyond that, information sharing and collaboration efforts that enable the collection, organization, visualization, and utilization of information according to the characteristics of each community have the potential to commit to more SDG goals. As long as there are communities in any society, there will be many different people living in them and working professionals with various specialties. In our past projects in the region, we have realized that many students are aware of these issues and are enthusiastic about learning and contributing to society.
In today's world of ever-expanding IT and social networks, "community" isn't the only term that acts with proximity; virtual common spaces, where people share interests and concerns, also have the potential to become places where issues can be resolved. In the field of oncology, a system to share and collaborate on unique issues and hints for solutions is beginning to emerge in areas where there are high needs but insufficient support and collaboration, such as intractable and rare cancers, pediatric cancers, and AYA (adolescent and young adult) cancers. In these areas, there is information as tacit knowledge that has different characteristics. Challenges in a region or area are similar to diseases in medicine and treatment. Making visible the countless knowledge and clues to solutions buried in the community and the field, making them available to be shared with as many people as possible, and finding ways to solve problems autonomously as one team will enrich and reassure the quality of life in the community. This will lead to a healthy and secure quality of life. One in two people will be diagnosed with cancer in their lifetime (cumulative lifetime risk of cancer), and we believe that this will be an opportunity for academia to propose sustainable solutions to the social issues that the SDGs have identified.
Cancer Care Forum 2018 "Toward a Society that Knows Cancer and Lives with Cancer" (Held in Chiyoda, Tokyo)
