[Cancer palliative medicine turning point in palliative oncology]

Hospice palliative care programs are rapidly growing in Japan. Although human science has attached importance comparing with natural science in this field, the latter approaches are recently developed to manage symptoms in terminal patients with advanced cancer. These scientific approaches include basic and clinical studies such as physiology, pharmacology, immunology, biochemistry, molecular biology, medical oncology, psycho-oncology and clinical ethics. These multidisciplinary approaches can clarify not only the mechanisms and relationship between cancer pain, cancer anorexia-cachexia syndrome and neuro-endocrine-immune systems with or without the abnormalities of body fluid, electrocyte balance, glucose-protein-lipid metabolisms but also clinical ethics and decision-making in terminal patients with advanced cancers. Based on these analyses, the strategies to modulate "homeostasis" for improving quality of life and even prolongation of life span could be developed in the near future. Our goal is to establish science-based medical practice for management of symptoms and improving the quality of life through ethical and scientific clinical trials. Hospice-palliative care in cancer would be expected to confirm what the academic area has termed "cancer palliative medicine" or "palliative oncology".