Recent progress in cancer pain management and palliative care in Japan

One out of every four deaths in Japan is due to cancer, so that health-care workers and the lay public have gradually become aware of the importance of cancer pain relief and palliative care in recent years. In 1984, the feasibility and effectiveness of the WHO method for relief of cancer pain was demonstrated in Japanese cancer patients. Thereafter, information on the latest knowledge and skills in cancer pain relief and palliative care has been disseminated through medical meetings, publications and mass communication networks. The national government published manuals of care for terminally ill cancer patients and amended narcotics regulation in order to improve the accessibility of opioid analgesics, especially morphine, to cancer patients with pain. These activities resulted in a 35-fold increase in the annual consumption of morphine preparations for medical purposes between 1979 and 1992. However, the annual consumption per capita is still much smaller than that in other developed countries, indicating the need for further information dissemination and professional education in the implementation of palliative care programmes.