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Med in Japan Newsletter No.3 December 2012

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Gastrointestinal Cancer in Japan : Lifelong Lessons

Japanese hospitals are recognized world-wide for their expertise in the treatment of gastroenterological cancer. A report from the Japan National Cancer Center shows that the survival rate among Japanese gastroenterological cancer patients is high compared to those in other medically advanced nations such as the USA and the nations of Europe.

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Pediatric Live-donor Transplantation in Japan

Live-donor liver transplant was developed in Japan to compensate for the fact that Japan has been slow to adopt the practice of harvesting organs from brain-dead donors, and Japanese physicians are the acknowledged leaders in this field.

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Experiences with the Written Second Opinion Service

Med in Japan arranges to receive a written second opinion that highlights the Japanese approach to treatment of patient with his condition and that recommends medications not yet being used in his current treatment.

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Health Tips: The Power of Japanese Green Tee

Several medical studies show Japanese green tea to aid in the prevention of numer- ous diseases, including Sjogren’s syndrome, renal damage, hypertension, inflammation, oxidative stress, gastric carci- noma, prostate cancer, and others.

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What's new

●“Heavy Ion Radiotherapy Guide” Website is now open! The website “Heavy Ion Radiotherapy Guide” developed by a team, including Med in Japan, was launched online on November 1st, 2012. Initialized by Prof. Dr. Hirohito Tsujii, fellow radiologists from National Institute of Radiological Science and world-renowned expert on heavy ion radiotherapy, together with medical supervisors from all heavy ion radiotherapy facilities in Japan, the website is world first innovative site for advanced radiotherapy.

●Med in Japan joined the Abu Dhabi Medical Congress 2012

●Med in Japan participated in the “Japan-Kazakhstan Medical Exchange Seminar”

●Med in Japan held seminars on medical services in Okinawa

Experiences with the Written Second Opinion Service

 
Mr. SS, Male with Metastatic Prostrate Cancer, Republic of Georgia
Travel from the Republic of Georgia to Japan can be burdensome for a patient in poor health, especially as there are no direct flights. While the condition of this particular patient was not favorable to travel, the patient nevertheless wanted a Japanese physician to review the treatment plan he was undergoing in Georgia and to advise him with regard to its adequacy. Med in Japan arranged for him to receive a written second opinion that highlighted the Japanese approach to treatment of patients with his condition and that recommended medications not yet being used in his current treatment. The patient was able to pass these recommendations to his treating physician and, as a result, has continued to receive treatment in Georgia.
Ms. ZK, Female with Suspected Malignant Bone Tumor, Mongolia
The patient underwent surgery but was then told that the growth might not be cancerous after all. Her treating physician recommended that she obtain a second opinion from a Japanese physician. A friend residing in Japan delivered a pathology sample to a Japanese hospital, where an oncologist and an orthopedic surgeon examined it and delivered a second opinion.
Based on their test results and the patient’s medical records, the doctors concluded that the probability of malignancy was low. They could not, however, conclusively identify the cause of the pain that the patient was feeling, and consequently the patient decided to visit Japan four months later in order to undergo an extensive medical evaluation.

Health Tips: The Power of Japanese Green Tea

 
While Japan may be best known for its exports of automobiles and electronic goods, it is also known for its exports of Japanese green tea. Green tea is widely consumed both inside and outside of Japan by people of all ages. In this issue, we introduce some of the medical reasons for why Japanese green tea has developed such a great reputation.
Green tea leaves, which have a slightly astringent taste, contain various antioxidants and anti-cancerous substances. Among these is the polyphenol called “Catechin” or Epigallocatechin-3-gallate (EGCG). Several medical studies show Japanese green tea to aid in the prevention of numerous diseases, including Sjogren's syndrome, renal damage, hypertension, inflammation, oxidative stress, gastric carcinoma, prostate cancer, and others.

The effects of Catechin include the inhibition of cancer development, induction of cancer cell apoptosis (self-destruction), and synergy with COX-II inhibitor. A Japanese research group from Saitama Cancer Center has concluded that the combination of Japanese green tea EGCG with anticancer drugs can cause a decrease in tumor size and induce cancer cell self-destruction.

Regarding Japanese green tea's anti-oxidative qualities, experiments with Japanese green tea performed on rats by Dr. Itoh and group of urologists from Nagoya City University Graduate School of Medical Sciences show preventive effects on oxidative stress that can otherwise cause the development of kidney stones. The researchers were also able to induce cancer cell apoptosis in rats with hepatocellular carcinoma using only Japanese green tea.

Japanese green tea has gained in reputation around the world and is available in various forms. As well as its traditional use as a beverage infused in hot water, it is also used in baked goods, canned and bottled beverages, ice-cream, cologne, medical compounds (such as plasters, gauze, and foot pads), and even sanitary napkins!

We highly recommend that you acquire a taste for Japanese green tea during your next visit to Japan.

References:

[1] Suganuma M, Saha A, Fujiki H. New cancer treatment strategy using combination of green tea cathechins and anticancer drugs. Cancer Sci. 2011; 102(2):317-23.

[2]Ohno S, Yu H, Dickinson D, Chu TC, Ogbureke K, Derossi S, et al. Epigallocatechin-3-gallate modulates antioxidant and DNA repair-related proteins in exocrine glands of a primary Sjogren’s syndrome mouse model prior to disease onset. Autoimmunity. 2012;22849293.

[3] Yokozawa T, Noh JS, Park CH. Green tea polyphenols for the protection against renal damage caused by oxidative stress. Evid Based Complement Alternat Med. 2012;2012:845917.

[4] Itoh Y, Yasui T, Okada A, Tozawa K, Hayashi Y, Kohri K. Preventive effects of green tea on renal stone formation and the role of oxidative stress in nephrolithiasis. J Urol. 2005 Jan;173(1):271-5.

Pediatric Live-donor transplantation in Japan

A live-donor liver transplant involves surgical removal of part of the liver from a living donor and transplant grafting of the liver tissue in the recipient. This procedure was developed in Japan to compensate for the fact that Japan has been slow to adopt the practice of harvesting organs from brain-dead donors, and Japanese physicians are the acknowledged leaders in this field.
At the request of one of the physicians who has pioneered this field, Med in Japan is acting as the medical coordinator in a case involving a child from Indonesia. The doctor himself selected the hospital where the operation was to be performed and Med in Japan made all of the arrangements from before the patient came to Japan up until the operation.

The living donor in this instance was the child’s mother. Before the hospital could accept the patient and donor, however, the matter needed to first be approved by the hospital ethics committee. In conducting their review, the committee requested to see documentation issued by the appropriate authorities in Indonesia and translated into English and Japanese, certifying the family relationship between donor and recipient. Med in Japan coordinated the retrieval of this documentation and arranged for its translation.

Med in Japan also assisted the mother and child in obtaining the appropriate travel visas necessary in order to enter Japan, as well as acting as the patient-hospital payment intermediary, coordinating scheduling and communications between the hospital and patients, arranging lodging for accompanying family members, providing attendants to accompany the patients to and from the hospital for outpatient checkups and treatment following discharge, and assisting in the procurement of prescribed medications.

The operation was successfully completed and the donor released from the hospital, while the recipient was moved from intensive care to a room in the hospital ward. The recipient was kept in the hospital for slightly longer than was originally planned but was eventually released, and is currently returning once every two weeks to undergo observation.

Requirements regarding the proximity of familial relationship between donors and recipients are decided by each hospital independently, and all living-donor transplant cases are subject to review and prior approval by the hospital ethics committee.

For more information concerning living-donor liver transplants, please contact Med in Japan by clicking here and using the form provided.

Gastrointestinal Cancer in Japan: Lifelong Lessons

 
Japan ranks among the leading countries in terms of the longevity of its citizens. A recent report by the Organization for Economic Cooperation (OECD) shows life expectancy in Japan to exceed that in the USA and in the Scandinavian nations, and to have increased constantly from 2004 to 2010. At the same time however, Japan ranks among the highest among OECD nations in incidence of gastrointestinal cancer. The Japanese Society of Endoscopic Surgery reported a more than 20-fold increase in gastric cancer cases between 1991 and 2003 (Figure 2).
Prevention is better than cure
Dr. Tomohisa Uchida from Oita University is a leading pathologist in the field of H. pylori-related gastric cancer. He suggests that the subtypes of H. pylori hosted by Japanese differ from those hosted by other Asian populations.
For example, the subtypes hosted by populations in Tibet, Laos, Thailand and some other southeast Asian countries are not necessarily conducive to the development of gastric cancer. Dr. Uchida recommends undergoing a gastric examination at least once every three years. Using technology developed in Japan, the examination can be performed painlessly and without the use of anesthesia.
World-leading gastrointestinal oncologists and surgeons
Japanese hospitals are recognized world-wide for their expertise in the treatment of gastroenterological cancer. A report from the Japan National Cancer Center shows that the survival rate among Japanese gastroenterological cancer patients is high compared to those in other medically advanced nations such as the USA and the nations of Europe (Table 1).

Table 1: Site-specific cancer survival rate

Japan has conducted extensive research into the causes and treatment of gastrointestinal cancer. Dr. Shinei Kudo, one of the world’s most famous gastro- enterologists, developed a method to successfully distinguish between normal cells in the intestine and cancer cells. Dr. Kudo is also known as a leader in the field of gastroenterological endoscopy. A study conducted by the Federated Social Insurance Com- mission of Japan that compares healthcare in Japan to that in the UK and the Netherlands shows the surgical mortality rate in Japan to be significantly lower than in those two nations. Moreover, the same study shows the five-year survival rate for gastric cancer patients in Japan to be as high as 70%, to be compared to less than 50% in the other two nations (Figure3).

Figure 3 : Gastric cancer surgery Statistics

Variety of hospitals for treatment of gastrointestinal cancer
Due to the huge amount of patients with gastrointestinal cancer, there are various medical institutions in Japan with long history and most outstanding record in treating gastroenterological cancer. Med in Japan gathers the major medical institutions with excellent specialties in gastroenterological cancer diagnosis and treatment available for you in major cities in Japan. For more information regarding these institutions and the services they offer to patients from abroad, please contact Med in Japan.

Med in Japan Newsletter No.3 December 2012