Cancer in Japan

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Cancer is a non-commutable disease (NCD) which is a developed rather than infectious disease. Like many other high-income countries, there is seemingly an epidemic of NCDs. To highlight this fact, in the 1900’s one of the leading causes of death in Japan was TB- a highly infectious disease and according to the latest data (well 2015 is recent…) only 1 of the top 20 causes of death in Japan is due to infectious diseases, 1 due to external factors and the other 18 are due to NCDs.

Side note, the number 12 spot is classed as “self harm” which should be read as suicide.

Cancer takes up 8 of the top 20 spots from the 5th leading cause of death (lung cancer) down to the 18th leading cause of death (oesophageal cancer) and while other cancers have appeared and disappeared from the table at times, cancer is always present. Additionally it is always present of DALYs reports- Disability adjusted life years.

Japan has active cancer screening programs and cancer awareness events (the most recent that I was aware about was in Nabari at the ADS hall which I remembered 2 days after the fact) and this occurs all across Japan- especially in Fukushima Prefecture where the WHO has rules that there is little chance of cancer development throughout the region with the exception of children and infants who may have been exposed to higher doses of radiation after the 2011 earthquake.

CAM treatment options

While researching cancer in Japan I came across complementary and alternative medicine (Kanpo in Japanese- 漢方) cancer treatments. The research suggests that of respondents in 16 cancer treatment centers and 40 palliative care treatment centers and 44.6% of cancer patients used CAM and 25.6% of patients with benign tumors use a form of CAM.

While there is sparse research of CAM treatment options in a Japanese context, current research does suggest that CAM treatment options have been used without consultation with a doctor.

Cancer screening

Cancer screening in Japan is purely voluntary, like any other country. However, the screening rate in Japan is lower than other HDC (highly developed countries) which but organisations like the Japan cancer society (the name could use some work) screening more than 10 million people annually working to ideally reduce the prevalence of cancer to 0.

To put some numbers behind this, in 2017 the JCS screened over 11.2 million people and 13,712 people were diagnosed with cancer so their actions are saving lives.

There is also a free cancer consultation hotline 03-3541-7830 which is a Japanese only hotline which provides expert advice on treatment options, advise on being employed with cancer.

If you would like to help the JCS out, there are many fundraising events throughout the year and donations can be made directly to the society.

More information can be found on: https://www.jcancer.jp/ and there is information in English and Japanese.

The main cancers prevalent in Japan are:

  • lung cancer
  • stomach cancer
  • intestinal cancers
  • breast cancer
  • cervical cancer

More interestingly, according to the JCS (who grouped all cancers together), cancer was the leading cause of death in Japan in 2017 with a total 373,334 people dying of cancer out of a total of 1,340,397 in 2017. Obviously the JSC have a bias ; but should that distract from it’s importance?

There is plenty of research on cancer in Japan, but it is either never translated into English or it exists as research papers which most people avoid.

Japanese note

Cancer in Japanese is simply がん and it mostly appears in this form. While there is kanji for cancer 癌 it is rarely used- even though it is interesting. The kanji is made up of 3 parts: 疒 Cancer in Japanese is simply がん and it mostly appears in this form. While there is kanji for cancer 癌 it is rarely used. The kanji is made up of 3 parts: 疒 meaning sickness, 品 meaning goods (in this context) and 山 meaning mountain. Collectively it means sick goods as high as a mountain.

I will leave this article here but there is so much more available and there is so much more I can talk about including types of cancer, death rates, treatment options including palliative care options etc.

If you have the resources, please do consider either spreading the word of cancer in Japan or donating.

Thank you for reading and happy exploring.


If you would like a list of the resources used in my articles please do message me. I do not include my resources on blog posts but I usually, and if applicable, include links to major organisations and communities that may help.

Advanced directives in Japan

Not an easy topic but a necessary one.

Please look at this beautiful picture, its nice and pretty and if you are squeamish please try to read this article- its important.

Anything that is in relation to end of life care or dying is NOT popular at all. To be perfectly honest, I do not expect this article to be read but this is (I hope) the start of a conversation, the start of an understanding that will be covered.

Please note, I have not studied Japanese law extensively and as this concerns Japanese law please do consult a lawyer or solicitor to ensure that the information you need is legal and correct. Additionally, at the end of this article and on the further information page of this blog is a like to Advanced directives and the actual form in English and Japanese from the university of Michigan. Let us begin.

What is an advanced directive?

Firstly you will die, one day. That is at the core of an advanced directive- one’s mortality but more importantly one’s choice. You have a choice to make to either have an input into your last days and your funeral or to see what life throws your way.

An advanced directive or living will is a written document that states your wishes regarding end-of-life care (from live extension to removal of support), pain management, organ donation, and postmortem options. The link to the document I have provided includes mental health options, life ending decisions, end of life plans and giving someone the durable power of Attorney of health care.

Why choose an advanced directive?

An example for this is extension of life or allowing one to die in cases of incurable diseases such as cancer, ALS, dementia etc. At this stage, do you want your life to continue regardless of the chance (or lack therefore of) of recovery or allow yourself to die.

What are your personal beliefs? Under what circumstances (or none perhaps) do you believe life is not worth living. What about your religious beliefs? What are your options regarding end of life care or postmortem options?

What about a DNR or DNACPR?

You may be wish to have a DNACPR or commonly called a DNR- do not resuscitate. To add a personal note to this, my mother had a DNR- it was a decision I did not agree with but I accepted her decision. When her time came, the wishes were respected. Additionally, my mother had planned her entire funeral and it progressed exactly as she wanted. Even if no-one were to be at her funeral, it would have progressed exactly the same.

What this comes down to is personal choice. In Japan 58% of Japanese nursing homes have advanced directives (but that is not to say they are filled out) and this allows a person a choice.

The choice is simple: do you want a say in what happens to you if you cannot?

The final note on this article will be a piece of advice from my company. If you die in Japan, all expenses will be your (or your families) problem not the companies. The words used were more of the idea that you don’t have a choice nor a say- live with it. But what happens if you want a say in it? Or want/need a choice.

This is a needed topic to cover in the month of awareness and while leading a health life is one of my core principles, dealing with difficult topics will help either mentally, spiritually, or emotionally. This topic cannot be ignored death is the end of the journey of life.

Thank you for reading and enjoy exploring.

Advanced directive resource https://medicine.umich.edu/sites/default/files/content/downloads/99-10048_AdvanceDirectives_Booklet%28Japanese%29.pdf – advanced directive document in English and Japanese

Final note.

If you are part of the LGBTQ* community an advanced directive allows you to, for example, keep your gender identity after death. There have been cases where trans women have been changed to show them as males rather than females.

Additionally, some countries do not recognize same-sex partnerships and thus, legally, have to follow the directive of the next of kin rather than their partner. An advanced directive and giving someone the durable power of attorney for health care allows their partners to be involved in the entire process and even if your partner does recover, it is a safety net that is necessary even in LGBTQ countries (the US, the UK etc). Please consider an advanced directive no matter where you live!

COPD in Japan

Idamichi

COPD is finally getting the awareness that it needs in Japan. It a problem that the rest of the world is aware of but Japan liked to bury its head. Quick note, why the pretty picture? You’ll need something nice to look at.

The lack of foresight about COPD within Japan was made apparent by the “COPD awareness campaign” advertisements that have appeared in my newspaper recently. What is strange about this is the Victorian impression Japan gives to “curing” diseases but nothing (much) on treatment or prevention.

When I say a Victorian impression- I do mean this literally. In all Japanese newspapers, there is at least 5 companies offering a special product that will help cure X, or help alleviate Y or further improve the quality of life regarding Z. A lot of this comes from the mix of eastern (or Chinese) medicine and western medicine.

I am aware that communities and tribes in Africa, in Asia and south America use traditional medicine. However, Japanese law requires companies to list the ingredients used in the ‘miracle cure’ and most ingredients are either common plant extracts or vitamins and minerals so are mostly useless.

COPD, however, seems to be an unknown concept as the newspaper gives not only the kanji (with the entire reading), not only the international name (COPD), not only some causes behind the disease but the effects it has and where to find additional information- highly unusual for Japan. Kanji reading, for example, are expected to be known by the reader as you are an educated, respected person of culture (again Victorian in attitude). Moving on.

COPD is 慢性閉塞性肺疾患 「mann/sei/hei/soku/sei/hai/shik/kann」. The kanji used (as a quick side note) is fantastic. The Kanji is literally:chronic (first 2 kanji), closed, obstruct, lungs, rapid, disease. But is this a good translation?

COPD 101

COPD is Chronic obstructive pulmonary disease- so the kanji use is quite good. I imagine it comes from either a translation of a western term either recently or just after the collapse of the Tokugawa shogunate. The term is used to describe multiple similar conditions that cause limitation in lung airflow- which is an extremely basic definition of COPD (but this is a blog about cultures not medicine) and even though I am studying medical science I’ll keep it there (which is extremely painful).

COPD is caused (primarily) by smoking, indoor pollutants (the main cause in low-economically developed countries around the world, and cleaning products. Japan has seemingly discovered that smoking is harmful and with the ease of getting cigarettes, there are waking up to a wider problem.

The current campaign is focused on awareness. The advertisements I have seen are the COPD awareness strategies which are ideas like: increasing the warning label on cigarettes, letting people know smoking causes COPD.

But why has Japan been forced to acknowledge this? According to a national survey on the http://www.copd-jp.com, there are over 5.3 million people aged 40 and over that have a COPD and 2.1 million of those are over 70.

People with COPD need to be aware of every activity they would like to do that day (especially in later stages) and elderly people that have advanced COPD may require more help and in a country that has a rapidly aging population, there is immense strain (already) on the health care system.

What can you do about it? Firstly be aware of what COPD is and how to reduce your change of contracting it. COPD is a progressive disease Daily management of the disease is ensuring that you lead a healthy lifestyle.

What does Japan need to do? Simply put, change its’ attitude. Japan is changing and some old culturally accepted practices (smoking for example) are no longer as acceptable as they once where. I just hope that Japan is able to change sooner and avoid a major future problem rather than face additional millions of suffers and try to find a care solution.

On the first day of December I talk about COPD morbidity. Merry Christmas?

Thank you for reading and happy exploring.


Final note, there are still adverts for cigarettes in Newspapers as well as the COPD awareness campaign. This is case and point why awareness in English as well as Japanese is needed and warranted.