THE FRONT LINE OF CANCER REHABILITATION IN JAPAN: CURRENT STATUS AND FUTURE ISSUES

In Japan, we are transitioning from an era of cancer as an incurable disease to an era of living with cancer. Therefore, supportive care of all types is becoming increasingly important to provide solid support for quality of life (QoL) during cancer patients’ period of survival, and cancer rehabilitation plays an important role as one part of that support. However, up until the early 2000s, no aggressive actions were taken to address physical impairments due to either cancer itself or the treatment process. Then, the Cancer Control Act was enacted in 2006. Not only cancer prevention and treatment, but also support to alleviate symptoms and provide mental and physical care and social support, including home care and help in returning to work or school (= supportive care), are stipulated by law. Support for cancer rehabilitation continues to be received, including public research funds and commissioned projects. Various efforts are also being undertaken to promote cancer rehabilitation, including CAREER (Cancer Rehabilitation Educational program for Rehabilitation teams) cancer rehabilitation training workshops for the training of cancer rehabilitation personnel, establishment of a new cancer patient rehabilitation payment by the National Health System (NHS), and the formulation of Clinical Practice Guidelines for Cancer Rehabilitation. In the 10 years after the Cancer Control Act was established in 2006, significant strides were made in cancer rehabilitation in Japan. However, in a 2017 national survey, 49.5% of regional base hospitals were found to have appointed a rehabilitation physician (physiatrist), which is still insufficient. Rehabilitation services for cancer patients mainly target inpatients, and services for outpatients cannot be considered adequate. The roles that can be fulfilled by cancer rehabilitation will continue to expand, and accelerated efforts by both the public and private sectors will be needed over the next 10 years.