Providing prostate cancer survivorship care in Japan: Implications from the USA care model

Abstract

Despite an increasing number of prostate cancer survivors in Japan, the current delivery of prostate cancer survivorship care is insufficient and lacks a multidisciplinary approach. We carried out a study to characterize prostate cancer survivorship care in Japan, examine the Japanese workforce available to deliver survivorship care, introduce a conceptual framework for survivorship and identify opportunities to improve Japanese survivorship care. We systematically searched PubMed for prostate cancer survivorship care studies, including those from Japan. We also searched the internet for prostate cancer guidelines relevant to survivorship care. We found 392 articles, of which 71 were relevant, read in detail and reported here. In Japan, survivorship care is mostly provided by urologists. Primary care as a specialty does not exist in Japan, and there are no independent nurse practitioners or physician assistants to assist with survivorship care. Japanese quality of life studies characterize the long-term effects of prostate cancer treatment, but routine use of patient-reported outcomes is not common in Japan. In the USA, in light of a growing comprehensive awareness of challenges facing survivors and their providers, the American Cancer Society prostate cancer survivorship care guidelines serve as a tool for optimizing the management of long-term treatment effects and coordination of care. In order to deliver high-quality survivorship care in Japan, urologists need to establish collaborations with other disciplines within the delivery system. A multidisciplinary guideline for prostate cancer survivorship care in Japan appears warranted.

Background factors and short-term health-related quality of life in patients who initially underwent radical prostatectomy or androgen deprivation therapy for localized prostate cancer in a Japanese prospective observational study (J-CaP Innovative Study-1)

“…A recent review of several studies regarding prostate cancer survivorship found that prostate cancer survivors of different races might have different outcomes and needs concerning cancer control, expectations, general, urinary, bowel, and sexual QoL. 24 Because the overall satisfaction of patients in this study treated with PADT was superior to those treated with RP, it is possible that decreased physical and sexual functions were not important issues for the patients during the 1-year treatment period. The treatment decision, which patients made themselves, and the expectations of treatment may be more important for Japanese men treated for prostate cancer.…”

Current work environments: What problems are being faced by Japanese urologists?

“…Osawa et al . reported differences in the types of prostate cancer healthcare providers between Japan and the USA . There are huge costs required to educate and train physicians.…”

“…Osawa et al reported differences in the types of prostate cancer healthcare providers between Japan and the USA. 40 There are huge costs required to educate and train physicians. Therefore, a supportive work environment for other cancer healthcare providers, such as certified nurse specialists, will be important to improve cancer healthcare.…”