Let’s Support Cancer Survivors
January 31, 2018
Ph.D. Tadao Kakizoe
President, Japan Cancer Society
Cancer has become the top cause of death in Japan since 1981. As cancer is much more common in older people and Japan is a super-aging society, we are confronted with an increasing number of cancer patients and victims. Two-thirds of males and half of females in this country become cancer patients in their lifetime, while over 380,000 people die of cancer each year. I must say cancer is a global health issue. Some 14 million people develop cancer and 8.8 million people die of cancer every year around the world. Cancer was once believed to be more common in developed countries but an increasing number of Asian and African countries are challenged by the burden of cancer as their average life-expectancy increases.
Looking at the trend of cancer in Japan over the past 40-50 years, we notice a dramatic change. Mortality and incidence of gastric cancer used to be the highest for both males and females, while cervical cancers affected many women in the past. More recently, lung cancer has become the major cause of cancer deaths, followed by colorectal, breast and prostatic cancers. I must say changes in our lifestyle and living environment as well as aging of population have triggered such change.
The human body is made up of tens of trillions of cells. Each cell has a nucleus that contains 1.8-meter-long DNA made of over 20,000 genes. Cancer is a genetic disease, caused by certain changes to genes that control the way our cells function, especially how they grow and divide. Cancer development is a complex process that occurs over a long period of time. 75% of cancers are caused by lifestyle factors of tobacco smoking (30%), dietary habits (35%) and infectious agents of viruses and bacteria (10%). Cancer is a chronic disease, different from cardiac infarctions or cerebral strokes that require emergency treatment. This means even when cancer is suspected, we still have enough time to collect information and think what to do together with our loved ones.
70-80% of cancers gradually get worse over time. Medical intervention starts from preventive check-ups before one has any symptoms to diagnosis, treatment and finally palliative care provided to uphold terminally ill patients’ sense of dignity. As we know, prevention and early detection play an important role in reducing cancer mortality. Since tobacco smoking constitutes one of the major factors leading to cancer, we must take continuous measures to decrease smoking prevalence in Japan. Currently about 30% of Japanese men smoke, compared with over 80% in 1965, while smoking rate among women has remained at about 8%. Various safety regulations restrict food, additives, drinking water, air and medical products in Japan, yet tobacco is regarded as “a socially accepted item of personal preference” and therefore is not subject to any regulations. Tobacco business in this country has long been protected by the 1904 Tobacco Monopoly Law and 1984 Tobacco Enterprise Law to secure tax revenue and stimulate the industry. I believe the best way to reduce smoking is to raise the price of cigarettes, currently priced much lower than in other high-income economies.
Cancer screening tests allow early detection. In Japan, we can receive subsidized tests for cervical, breast, colorectal, gastric and lung cancers. Unfortunately, our screening rates average at around 20%, which falls far short of the targeted 50% by the government. As for the cervical cancer screening rate, Japan ranks the lowest among OECD member states, whereas the U.S. marks the highest at 83%, followed by Canada (73%), South Korea (41%) and Mexico (37%). It is really disappointing that over 3,000 women die of cervical cancer every year, while vaccination for its prevention and early detection methods are in place.
Let me highlight that the Japan Cancer Society sponsors the screenings of about 11 million people every year, which leads to the detection of over 14,000 cases. It was founded as a “nationwide campaign to control cancer” in 1958. Together with its prefectural affiliates, the Society promotes a wide range of activities, such as raising public awareness, training experts, promoting research of cancer prevention and treatment, providing hotline consultation and educating children on cancer. All the activities rely on donations made by individuals and corporations, which totaled 380 million yen in 2016.
Let me also highlight that the Cancer Survivor Club was established in June 2017 to support cancer patients and family members. The number of cancer patients in Japan kept growing from 1975 to 2008, of which 30% are of working age (20-64 years old). Not a few patients suffer from a sense of alienation and isolation.
Patients who receive treatment must also cope with fear and anxiety of the possibility of recurrence. Currently there are about 7 million cancer survivors in Japan. I must say nobody is exempt from getting cancer and we must promote an inclusive society of mutual assistance. The Club will render support by providing the most reliable information to patients so that they are not isolated. I will organize the “Cancer Survivors Support Walk” across Japan, starting from Kyushu on 05 February and finishing on 23 July at Hokkaido. Through this 3,500-kilometer-walk that will connect the 32 facilities affiliated to the Japan Association of Clinical Cancer Centers, I will dedicate myself as an advocate for the importance of supporting cancer survivors.