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Predecessor
Volume 67, Issue 10
Displaying 1-14 of 14 articles from this issue
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Theme I
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Kazuaki Sasaki, Keisuke Oono, Ai Konno, Daisuke Kyuno, Takeshi Murakam ...2014 Volume 67 Issue 10 Pages 869-876
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSPostoperative adjuvant chemotherapy aims to reduce recurrence and improve overall survival in patients with stage III and high-risk stage II colorectal cancer. Western guidelines recommend oxaliplatin-based adjuvant chemotherapy. However, recent Japanese results reported better overall survival and disease-free survival than in European countries. Among patients receiving oxaliplatin, peripheral sensory neuropathy during and after treatment showed a high frequency. Oxaliplatin-based adjuvant chemotherapy may not be available in Japan. Based on recent Japanese evidence in adjuvant chemotherapy for stage II/III colorectal cancer, we need to determine a suitable regimen for individual cases.View full abstractDownload PDF (680K) -
Takeshi Kato2014 Volume 67 Issue 10 Pages 877-887
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSThe treatment of patients with liver metastases from colorectal cancer continues to evolve. However, while surgical resection alone is regarded as the standard of care for patients with liver metastases of colorectal cancer relapse is common. Recently, the use of novel agents as a first-line treatment in metastatic colorectal cancer has generated cautious optimism in the field of oncology. This review describes perioperative chemotherapy for patients with liver metastases of colorectal cancer.View full abstractDownload PDF (742K) -
Masatoshi Oya, Shinichi Sameshima, Takashi Okuyama, Shinichiro Koketsu ...2014 Volume 67 Issue 10 Pages 888-896
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSLocal control is the most important goal of the surgical resection of rectal cancer. A number of randomized trials in Western countries disclosed the superiority of preoperative chemoradiotherapy (CRT) over surgery alone, preoperative radiotherapy (RT) alone, and postoperative CRT. Preoperative CRT is therefore the standard care for rectal cancer in Western countries, and is getting to be more commonly performed in Japan. However, it has not been clarified which is superior: short course RT or long course CRT. In addition, the best regimen of concurrent chemotherapy and the methods for predicting the response to preoperative CRT have not been clarified. Moreover, the feasibility of preoperative chemotherapy prior to CRT and preoperative chemotherapy without RT are currently being explored.View full abstractDownload PDF (682K) -
Hideyuki Mishima, Kengo Kimura, Masakazu Ikenaga, Masayoshi Yasui, Tai ...2014 Volume 67 Issue 10 Pages 897-905
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSNew types of targeted molecular therapies are becoming available in metastatic colorectal cancer (mCRC). Bevacizumab, a humanized anti-VEGF antibody, used with chemotherapy prolongs survival and delays tumor progression in patients with mCRC. Monoclonal antibodies (mAbs) targeting the epidermal growth factor receptor (EGFR) prolong survival in mCRC KRAS exon 2 wild-type tumors. Bevacizumab or Cetuximab with FOLFOX or FOLFIRI offer similar, extended survival in mCRC. The results from this trial suggest that drug selection should be based on anticipated adverse effects rather than efficacy. Regorafenib is an oral multikinase inhibitor used for the treatment of patients with mCRC. The most common side effects of regorafenib are fatigue, decreased appetite, hand-foot skin reaction, diarrhea, and hypertension. An intra-individual titration study is needed in the management of regorafenib for patients who would not like to have serious side effects during chemotherapy.View full abstractDownload PDF (1072K) -
Ayako Doi, Kohei Shitara, Toshihiko Doi2014 Volume 67 Issue 10 Pages 906-918
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSRecently, prognosis of advanced colorectal cancer has remarkably improved through the introduction of several new agents. Moreover, treatment for colorectal cancer becomes more individualized based on new information regarding correlation between RAS mutation and response to chemotherapy or targeting therapy for BRAF mutated colorectal cancer. In this review, we discuss recent topics about oncogenic mutation as the predictive factor for chemotherapy and promising new agents for colorectal cancer as well as future perspectives.View full abstractDownload PDF (1165K) -
Toshiaki Nakayama2014 Volume 67 Issue 10 Pages 919-927
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSRecently, a number of new drugs for advanced colorectal cancer have dramatically improved prognosis. Meanwhile, the resulting side effects as well as the treatment regimens have been diversified. If patients with side effects from anticancer drugs are untreated without recognition, the side effects become severe and may have an adverse effect on the continuity of the treatment. Therefore, in order to provide patients with the full benefit of chemotherapy, the prevention and early treatment of side effects are important. However, since the majority of patients receive chemotherapy as outpatients, education of self-care and practice by patients themselves as well as appropriate treatment by medical staff are necessary. In this paper, the preventive measures against side effects in colorectal cancer chemotherapy are reviewed from the viewpoint of the pharmacist.View full abstractDownload PDF (772K)
Theme II
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Tatsuo Okasora2014 Volume 67 Issue 10 Pages 928-929
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSThe Japan Society of Coloproctology is the only medical society which consists of proctologists and is in charge of the speciality system of coloproctology. However, the negative aspects of the speciality system cause a sense of insecurity among the members of this society. I discuss this problem, because we members of this society must argue by ourselves.View full abstractDownload PDF (567K) -
Morito Maruta2014 Volume 67 Issue 10 Pages 930-933
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSThe Japanese Board of Medical Specialties started in May 2014. 'Medical specialist' defined by the Japanese Board of Medical Specialties is very different from that defined by academic societies. New medical specialists will start from 2020. The 29 categories of subspecialties in this system do not include coloproctologists as medical specialists. We must discuss and decide the optimum solution in the new Japanese Board of Medical Specialties. One suggestion is that a new education system with clinical practices for professional experts in authorized hospitals for proctologists should be established independently, without no relation to the Japanese Board of Medical Specialties.View full abstractDownload PDF (632K) -
Akira Sugita2014 Volume 67 Issue 10 Pages 934-938
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSThe Japan Society of Coloproctology has approved 'board certified coloproctologists' that include medical doctors such as gastroenterologists, radiologists, pathologist, colorectal surgeons and proctologists under its strict criteria. The Japanese Ministry of Health, Labour and Welfare is now reforming the medical board system in Japan. 'Board certified coloproctologists' have not been approved as board certified doctors in the new board system. Our society will continue to request the approval of 'board certified coloproctologists' who can examine patients from the specialized standpoint of doctors, surgeons and proctologists, and the overall standpoint of the three kinds of fields.View full abstractDownload PDF (783K) -
Junichi Iwadare2014 Volume 67 Issue 10 Pages 939-947
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSCurrently, proctology clinics are not allowed to advertise as specialized clinics dedicated to treating patients with proctology disorders, and so certification of proctology specialists under the new Japanese board certification system is extremely difficult.
Based on my experiences of undergoing training and working as a staff member in a center specializing in proctology diseases at a semi-public general hospital (Colo-proctology Center, Social Insurance Central Hospital), I firmly believe that proctology is not merely a branch of surgery, but a surgical specialty that requires special skills and expertise.
When examining patients, physicians need to have utmost sensitivity and compassion because their patients often have psychological problems, including fear and a sense of shame. In the operating room, surgical treatment should be provided skillfully and in a painless manner, rather than performing a simple repair. In addition, a short healing period is vital to avoid functional problems that can result in sequelae. Thus, proctologists need extensive experience in treating anal diseases. They also require experience in treating colonic disorders because both areas are part of the digestive system.
Loss of specialized proctology clinics should not lower levels of medical treatment, and should not lead to patients suffering from complications and sequelae.View full abstractDownload PDF (1275K) -
Tadao Kanai2014 Volume 67 Issue 10 Pages 948-956
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSSystems of medical specialists have been established and carried out by many medical societies in Japan. However, the systems are not easily understood by the nation at present, because many medical societies have individual systems and their standards of authorization differ among the societies. As a result, some patients do not know which department of medicine they should visit. Therefore, a third party independent of medical societies, the Japanese Board of Medical Specialists, was established. The Board is going to unify the system and raise the quality of specialists. Proctologists are very important for the medical specialties system, and need to advertise and declare themselves as specialists. Proctologists require advanced skills, so the Board must improve training programs.View full abstractDownload PDF (805K) -
Naoki Inatsugi2014 Volume 67 Issue 10 Pages 957-961
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSProctologists have become alarmed by the possible extinction of traditional Japanese proctology as arguments about a new medical specialist development program have progressed. All patients with anal disease are concerned about where they should visit, because the anus is an intimate part. All patients need a program which trains proctologists having a high degree of professionalism, which means that proctologists should learn about a variety of anal disease diagnoses and treatments, understand patients' concerns, be trusted, and acquire excellent skills. Responding to patients' expectations, proctologists should be certified as doctors fulfilling the Japan Society of Coloproctology's (JSCP) IIb criteria. When doctors who fulfill the JSCP's IIa criteria want to become proctologists, who are certified doctors fulfilling the JSCP's IIb criteria, they should experience a certain number of anal operations.View full abstractDownload PDF (663K) -
Akio Kurokawa2014 Volume 67 Issue 10 Pages 962-966
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSBefore discussing the significance of proctology specialists, their importance must be considered because proctologists are disappearing already in Japan. The reason is that proctologists never had a sense of crisis and pride as specialists.
The Japan Society of Proctology was first established by proctologists in March 1940. I believe that we need to recapture the passion held by proctologists of the old era. The Ministry of Health, Labour and Welfare notified the "Revision of a possible advertising department name" in 2008, which might have been an opportunity. But, it's not too late. It is a matter of great urgency to promote the importance of proctologists to the Japanese Medical Specialty Board and the Ministry of Health, Labour and Welfare.View full abstractDownload PDF (769K) -
Takashi Sameshima, Kiyoshi Niwa, Tadaaki Eto, Yoshirou Imamura, Kanako ...2014 Volume 67 Issue 10 Pages 967-973
Published: 2014
Released on J-STAGE: November 01, 2014
JOURNAL FREE ACCESSProctology is an important specialty for medical specialists. The prevalence of anal disease in Japan is estimated to be hemorrhoids 51-60%, anal fistula 5-18%, and anal fissure 9-25%, requiring a high degree of specialty in this area. Medical care has a range of know-how which has been inherited from classical treatment. In addition, the increase in inflammatory bowel disease as a treatment associated with anal lesions and pelvic viscera have led to eliminating organs, and neurological pathologic elucidation and treatment for proctodynia subdivided into particular specialties. Anal medical specialists have a responsibility to inform patients about doctors who have standard and advanced technologies for anal treatment. Patients will suffer without them.View full abstractDownload PDF (1085K)
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