Unique Challenges in Cancer Care of United States Military Personnel and Their Families in Japan
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Toshiaki Takahashi1, Tomoki Nagano2, Kikue Higashida3
1Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI 96813, United States.
Abstract:
U.S. military personnel and their families stationed overseas face unique challenges when navigating cancer care in host nations. This article presents the case of a woman in her 40s stationed at a U.S. military base in Japan who was diagnosed with stage III triple-negative breast cancer and received treatment coordinated between a local Japanese hospital and a U.S. military facility. Her experience reflects multiple barriers, including stigma, language and cultural differences, limited access to specialized care, and disruptions in continuity. Reluctance to seek care may result from stigma within a culture that values resilience and self-reliance. Language barriers and Japan's high-context communication style can impede understanding of diagnoses and treatment plans, leading to psychological isolation. Geographic distance from tertiary care centers may delay urgent treatment and reduce access to evidence-based resources. Transitions in care, such as returning to the United States for further treatment, involve complex logistical and clinical considerations, including coordination between healthcare systems and compliance with international regulations. A cancer diagnosis may also affect a service member's career, deployment eligibility, and unit dynamics, with implications for both personal and operational outcomes. Support services and collaborative care strategies play a key role in helping patients navigate these multifaceted challenges. Advances in cancer treatment and supportive care have led to increasingly diverse therapeutic options, requiring more individualized approaches to care. Broader awareness of these issues may support the development of more effective cancer care systems for military personnel and their families abroad.
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