Psycho-oncology has been developed as a field of practice and research based on a holistic medical care model for cancer patients, that is Bio-Psycho-Social Model. One practical example of Bio-Psycho-Social Model in psycho-oncology is a comprehensive assessment for psychiatric and psychological consultation for cancer patients. Comprehensive assessment is a framework to assess patients’ problems in the order of (1) physical symptoms, (2) psychiatric symptoms, (3) social and economic problems, (4) psychological problems, and (5) existential problems. In this paper, the concept and practical methods of comprehensive assessment are explained. In addition, the detailed methods in assessment of psychiatric symptoms and psychological problems including problem-solving approach are discribed, in which experts dealing with mental problems will play an important role in the team-approach of cancer care. Finally, direction and agenda of the future development of Bio-Psycho-Social Model are discussed.

A gastric cancer elimination project that combines H. pylori eradication therapy and endoscopic examination is both appropriate and feasible for Japan, where excellent methods of diagnosis and endoscopic treatment for early gastric cancer are already available. In this country, the baby-boom generation is now passing 60 years old and reaching the cancer-prone age, so an increase of medical costs related to gastric cancer is impending. Application for medical insurance in patients with H. pylori related chronic gastritis due to the Basic Plan to Promote Cancer Control Programs should be an important issue to eliminate gastric cancer deaths in Japan.

Behavioral medicine is the interdisciplinary field concerned with the development and integration of behavioral, psychosocial, and biomedical science knowledge and techniques relevant to the understanding of health and illness, and the application of this knowledge and these techniques to prevention, diagnosis, treatment, and rehabilitation. Changes in behavior and lifestyle can improve health, prevent illness and reduce symptoms of illness. However, lack of the standardized classification system of behavior change technique (BCT) has prevented the researchers and the clinicians from identifying effective BCTs and reproducing behavior change interventions which were shown to be effective. This paper is aimed to summarize such recent trends in standardized reporting of BCT and discussing what kind of effort is needed for behavioral medicine to improve the health and welfare of individuals, communities, and populations.

To manage recuperation behavior for an extended period by medical examination and treatment of lifestyle-related disease such as diabetes, it is important to bring out one’s own voluntary will. But the negative stimulations (risk and fearfulness of a complication) cause behavioral modifications for a short span of time. At a clinical site, we tend to think of a patient as a person unmotivated, and we also try to motivate him by scolding and persuasion. As a result, the patient is offended and will not visit hospital again with his scraped motivation. Behavioral therapy is expected to be useful in the treatment of lifestyle-related disease. In behavioral therapy, behavior is being observed specifically as a chain of stimulation and reaction, while the environment is arranged so that voluntary action is easy to start.

I’d like to report my practical approach at my clinic ; an interview style that is based on clinical coating and motivational interview. My original way is easy to do in a short time practice.

Recently, a company and an organization make corporate efforts at health and productivity management to promote employees’ mental and physical health and to improve their productivity. Many efforts were made by each company, such as (1) offering education to broaden employees’ consciousness, (2) organizing the work environment under which employees are encouraged to start and continue their health behavior, and (3) offering a psychological approach to heighten employees’ awareness of health behavior. Based on the previous research on corporate efforts, the effectiveness of these efforts was verified. Nevertheless, we have a problem with employees’ participation rates and continuation of health behaviors.

We assume that cooperation with the behavioral science is one of the important factors to continue health behavior and to motivate employees to participate in their company’s efforts. We expect that penetration of health and productivity management among the companies would increase by cooperating with behavioral science.

In recent years, socioeconomic conditions around workers and organizations have rapidly been changing, such as changes in industry structure and working style, and advancement of information technology. These changes of working condition call for being more healthy and productive from workers. This article focuses on work engagement, as a key concept to achieve both health promotion and productivity improvement. I first define work engagement which consists of vigor, dedication, and absorption, and introduced the theoretical model of Job Demands-Resources model which integrates antecedents and outcomes of work engagement. Then, I referred to strategies to achieve a healthy work place and employees in terms of behavioral medicine.

Background : At our hospital, psychological consultation is routinely provided for living kidney transplantation recipients and donors prior to surgery, then immediately and again 1 year after surgery. The procedure of living kidney transplantation has not only physical risk, but also psychological stress including mental conflict and anxiety for both recipients and donors. Furthermore, Haruki (2006) reported that underlying family problems tend to be heightened when the recipient and the donor are family members. Though the relationship improved in most of the cases at 1 year after the procedure, the author reported and discussed a case in which changes took place in family dynamics following living kidney transplantation.

Subjects : The recipient A, in his 40s, was a married man with a wife in her 30s and a child. Renal function in the recipient A had shown a drastic decrease 3 years prior, for which hemodialysis therapy was introduced. With further aggravation, living kidney transplantation from his wife, the donor B, was performed. The recipient A was an outstanding employee at his company, and the donor B was as a housewife.

Methods : The contents of psychological assessments and consultations performed preoperatively, postoperatively and 1 year after surgery were examined. As for the donor B, the contents of the psychological consultation performed occasionally was also examined.

Course : The recipient A, the work-oriented man, became depressive prior to the surgery, as hemodialysis therapy introduced obstacles to his ability to perform at work. However, his mental state recovered after the procedure, as his physical condition was improved. The donor B had been under stress from a family problem, which led to her mental instability after surgery. She continuously felt ill with a variety of physical complaints even at 1 month after discharge from the hospital, thus an additional psychological consultation was performed. A psychogenic disorder was suspected, and a psychiatric visit was suggested and accepted by the donor B. After approximately 6 months of psychiatric treatments, her symptoms remitted. A psychological consultation performed 1 year after surgery found that the relationship between the husband and wife had become closer, to the extent that they went out together every weekend.

Discussion : In this case, the work-oriented recipient changed his view of life based on the experience of kidney transplantation and began to play a role as a father in his family, which changed the family dynamics to the point that his wife, the donor B, could rely on the recipient A. Accordingly, we considered that psychological consultation contributed to improve the family relationship, which had reached a critical situation. Continuous mental support from the perspective of family dynamics is considered important for living kidney transplantation recipients and donors.

Introduction : In routine clinical practice, we encounter patients who remain peaceful and calm regardless of their disease status. We report two patients in whom harsh and rapid changes occurred in their disease condition, and we discuss these cases from the viewpoint of resilience.

Case 1 : The patient was a male in his 60s with small-cell lung cancer. Paresis of the bilateral lower limbs and left upper limb appeared due to cervical spinal metastasis. The patient always interacted with people with a smile. He decided on discontinuation of treatment during partial remission after tertiary chemotherapy and died after transition to home care.

Case 2 : The patient was a male in his 40s with concomitant gastric cancer that developed after surgery for pulmonary adenocarcinoma. Paralysis of the bilateral lower limbs appeared due to brain metastasis and thoracic spinal cord compression by the tumor. He was always bright and positive. Home care was being coordinated with consideration for the care burden on his mother.

Discussion : These two patients showed psychological adjustment while facing progression of disease and the reality of reduced independence. This suggests the presence of resilience in the process of self-determination with appreciation of the need to adjust to the situation. The psychological process of maintaining a significant connection with others while being aware of one’s own psychological character and experience, in addition to the management of the disease condition, may influence activation of intrinsic resilience.