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A B S T R A C T S
S19
S63
CANCER TREATMENT SYSTEM IN JAPAN AND THE
BEGINNING OF PRACTICE IN GERIATRIC ONCOLOGY
Kazuo Tamura
General Medical Research Center, General Medical Research Center,
Fukuoka City, Japan
Japan is one of the countries where people aged over 65 is
rapidly increasing and they accounted for 26.7% of 126 million
populations in 2015 and the rate will be over 30% in 2025. We
are already in the aged society which leads to a large number
of elderly cancer patients. It has put a heavy burden on the
medical as well as Japanese society. To conquer such burden,
the Cancer Control Act was implemented in 2007, and one
regional cancer treatment hospital (RCTH) was established
in 400,000 populations (a total of 399 hospitals). RCTHs are
affiliated with a pivotal center for cancer in each prefecture
(49 centers) qualified by the Ministry of Health, Labour and
Welfare.The main purpose to establish such cancer treatment
system is to provide an equal access to the standard cancer
care by a multidisciplinary professional team throughout
Japan. In each RCTH, Cancer Board is held regularly by
physicians and other medical staff to discuss the complicated
patients especially for the elderly who often have multiple
comorbidities and functional derangement. The Cancer
Control Act has also reinforced education and training of
oncology in under- and post-graduate education curriculum.
Because of an overwhelming large number of the elderly
patients, RCTH alone cannot manage all patients from
diagnosis of cancer to the end of life. Therefore, RCTH needs
to collaborate with local hospitals and/or primary care
physicians who treat patients at home with nurses, care
workers and attendants. For example, in Shimane prefecture
located in the west-northern district of Japan, senior citizens
comprised 32.6% in 0.71 million populations in 2015. Shimane
University Hospital has made a ‘team oncology’ which has
established a management system for elderly lung cancer
patients. Geriatric assessments are undertaken by nurses or
pharmacists on a common assessment sheet in the electric
medical record (EMR). Patients’ information can be reviewed
among the University hospital and 31 local hospitals by
using the EMR through an internet and it is also accessible
to primary medical offices, pharmacies and nursing homes.
They have a trial of treating the cancer patients more closely
in collaboration with each other, and also will expand the
system to other malignancies.
The Japan Agency for Medical Research and Development
(AMED) was established in 2015 to promote and maintain an
environment for integrated research and development in the
field of medicine. To provide a one-stop service for research
expenses, AMED consolidated budgets from 3 Ministries
involving education, health and industry. Among many
research themes, management of the elderly with cancer is
one of the important subjects supported by AMED.
Thus, Japanese society is moving forward to cope with an
increasing number of elderly cancer patients by a team in
broad sense consisting of cancer professionals, other health
care providers and government, and by establishing a regional
medical network system further.
Disclosure of interest:
None declared
S68
GYNAECOLOGICAL CANCERS
WilliamTew
Memorial Sloan Kettering Cancer Center, Department of Medicine,
Gynecologic Medical Oncology Service, New York, USA
Ovarian cancer (OC) is the leading cause of mortality
among patients with gynecologic malignancies. More than
half of all OC occurs in women older than 65. Management of
newly diagnosed advanced ovarian cancer (OC) typically starts
with the combination of extensive debulking surgery and
postoperative platinum and paclitaxel chemotherapy. Careful
consideration of the chemotherapy dosing, scheduling, route,
and timing (neoadjuvant or postoperative) is essential. To
determine the safest andmost effective treatment, one should
consider a pretreatment geriatric assessment (GA) and close
cooperation with the gynecologic surgeon. In this session, we
will review the current guidelines and evidence of surgery and
chemotherapy in the older woman with ovarian cancer and
how to coordinate care within a multidisciplinary team.
Disclosure of interest:
None declared
S69
Janice Tsang
The speaker abstract has not been received at the time of
publication.
S70
MINIMIZING PERIOPERATIVE ADVERSE EVENTS IN THE
ELDERLY
Giampaolo Ugolini
University of Bologna, Department of Surgical and Medical
Sciences, Bologna, Italy
Elderly patients do not have a worse cancer survival than
younger patients; however, it is well known that they are at
higher risk of developing postoperative complications because
they are often affected by multiple comorbidities. It has been
reported that up to 80% of elderly patients might experience a
surgical complication that will more often lead to permanent
disability and postoperative mortality. The presentation will
focus on evidence-based perioperative strategies to improve
outcomes of onco-geriatric patients with a particular focus on
quality of life and functional recovery after surgery.
Disclosure of interest:
None declared