[The present situation and problems of home care for advanced cancer patients]

An attempt to introduce home care for advanced cancer patients has started throughout Japan. However, there are many problems which prevent its development into an established medical care system. We conducted a nationwide survey on the current situation surrounding home care for advanced cancer patients. We selected 20 hospitals around the country and examined 268 cases. The categories surveyed were: type of cancer; medical care system; medical treatment; informed consent; and the patient's death at home. The result shows that cancer of the colon, stomach, breast and lungs are the most prevalent forms of cancer. In some cases the team approach organized mainly by doctors and nurses was introduced, though to limited extent. The most common forms of treatment were chemotherapy, pain management and nutrition control. At the same time, many hospitals tried to establish a system which focuses on QOL. Informed consent was obtained in 60% of the cases and 10% of the patients died at home. According to our survey, a medical care system incorporating traditional home care (hospice home care) and high-technology home care is being pursued in Japan. The insufficiency of the home care system and the lack of education leading to qualification for clinical oncologists and oncology nurses are the most significant problems.