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Aichi Cancer Center Hospital

Department of Gastroenterology

The primary concern of our department is to become a professional cancer center. We effort to early detection and precise diagnosis of gastrointestinal and pancreatobiliary malignancies. Also, we implement effective endoscopic treatment for these malignancies with prominent skill. In addition, not only clinical chemotherapeutic treatment for unresectable cancers in digestive organs, but also we are conducting clinical and molecular trial studies for gastrointestinal cancer, especially pancreatobiliary cancer. In the meanwhile, we are distributing the information about knowledge of new treatments and diagnostic techniques of gastrointestinal and pancreatobiliary cancer to our communities and we are also constantly improving the scope and quality of care offered to patients. In 2017, we performed more than 420 ERCPs and 44 duodenal stentings. And we performed more than 1200 EUS including 441 EUS-FNA procedures and 73 EUS-guided therapy. In addition to skillful endoscopic procedures, we also performed chemotherapy and chemoradiation therapy for 200 patients with pancreatobiliary malignancies. We thus play an important role in the process of GI tract and pancreatobiliary cancer diagnosis and treatment strategy. Currently, we have training program for Japanese physicians and international physicians in advanced endoscopy included ERCP and EUS. So, the trainees who accomplished the training program can become competent in advance endoscopic skill, and enhancing their institute' s capability in EUS and ERCP field for both service and research areas. In the future, we expect to expand our capability of care the cancer patient, thus we need to continue make more efforts to improve our practice and research outcome and contribute to our society not only in Japan but also all over the world.

Department of Endoscopy

Gastrointestinal endoscopy is an essential part of modern clinical gastroenterology, and our department plays an important role in the diagnosis and treatment of patients with diverse gastrointestinal (GI) diseases. Diagnostic endoscopy includes gastro-duodenoscopy, colonoscopy, and endoscopic ultrasonography (EUS). Therapeutic endoscopy includes balloon dilation for the stenosis, polypectomy, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD). For the precise diagnosis of tumor borders and depth of invasion of superficial GI tract malignancies, we use narrow band imaging (NBI), Blue LASER Imaging (BLI), and magnification endoscopy. In 2017, we performed more than 6,300 EGD, 2,700 colonoscopies, 190 balloon dilations of operated esophagus, 360 polypectomies and EMRs, and 200 ESD procedures, for tumors in the esophagus, stomach, and colo-rectum. Recently, we started the double-balloon enteroscopy for the fine examination of small intestinal disease. Furthermore, double-balloon endoscopy is useful for ERCP in patients with Roux-en-Y anastomosis and Billroth II gastrectomy and for patients after incomplete conventional colonoscopy. In collaboration with the Department of Head and Neck Surgery, we treated 2 patients with the superficial hypo laryngeal cancer using endoscopic laryngo-pharyngeal surgery (ELPS). In addition to endoscopic procedures, we also perform chemotherapy and chemoradiation therapy for the patients with GI tract malignancies such as esophageal cancer, gastric cancer, and colo-rectal cancer. We thus play an important role in the process of disease diagnosis and the patient's treatment strategy.

Department of Thoracic Oncology

The particular goals of our department are to provide the highest quality of care to our patients and to advance the treatment of lung cancer, mediastinal tumor and mesothelioma through innovative clinical and laboratory research. The most important clinically relevant advances were the discovery of driver oncogenes that are constitutively activated by mutation, translocation or fusion, and the discovery that oral small molecule tyrosine kinase inhibitors (TKIs) of these oncogenes produce high response rates and relatively long duration of these responses. Patients with EGFR activating mutations, ALK fusions or ROSI fusions receive a TKI due to superior progression-free survival whereas chemotherapy is superior if no mutation is present. Additional potential drivers in patients with lung cancer have been found in adenocarcinomas including mutations in KRAS, BRAF, HER2, MET, and fusions involving the RET and NTRK1 rearrangements. Recent studies indicated that monoclonal antibodies to antigens involved in immune checkpoints were useful for lung cancer. Antibodies to the programmed cell death protein 1 (PD-1) or programmed cell death protein ligand 1 (PD-L1) called nivolumab, pembrolizumab, and atezolizumab have been shown to produce responses in lung cancer. We discuss diagnosis and treatment options for patients with thoracic malignancies at chest conferences every Monday evening with thoracic surgeons, pathologists, and radiation oncologists. Clinical trials are based on work with the Japanese Clinical Oncology Group (JCOG) and the West Japan Oncology Group (WJOG), some being carried out under contract with pharmaceutical companies.

Department of Hematology and Cell Therapy

The Department of Hematology and Cell Therapy provides the diagnosis and the treatment of hematological malignancies (leukemia, lymphoma, and myeloma). About 100 new patients per year are treated. For high risk or relapsed patients, high dose chemo (radio) therapy with stem cell transplantation (allogeneic stem cell transplantation from unrelated or related donors and autologous peripheral blood stem cell transplantation) are extensively applied. We focus on clinical trials for the development of more effective treatment and new anti-cancer drugs. Research on diagnosis, clinicopathological feature and treatment of hematological malignancies is also carried out in collaboration with experts in the Department of Pathology and Molecular Diagnostics in the Hospital and the Aichi Cancer Center Research Institute.

Department of Clinical Oncology

The clinical subjects treated in the Department of Clinical Oncology are mainly cases of gastrointestinal cancer such as esophageal, gastric, and colorectal cancer, but we also treat patients with other carcinoma of unknown primary (CUP), germ cell tumor (GCT), head & neck cancer, breast cancer, sarcoma and so on. Although it has been thought efficacy of chemotherapy against gastrointestinal cancers is insufficient, we are trying to investigate and establish new strategies of chemotherapy or chemoradiotherapy. We treat many patients practically (110 patients at out-patient clinic in a day, about 60-70 hospitalized patients, and the average hospital stay is 11 days) and participate in various clinical studies to develop a new or standard treatment prospectively. The most appropriate treatment for all patients is determined in case conferences consisting of medical, surgical, radiation oncologists, and diagnostic radiologists.

Department of Clinical Laboratories

The Department of Clinical Laboratories is committed to provide a wide range of diagnostic laboratory services for hospital inpatients and also to a large number of outpatients. The clinical laboratories are divided into several major sections: biochemistry, hematology, microbiology, molecular diagnostics and cytopathology, as well as functional tests, such as electrocardiography, diagnostic ultrasonography, and respiratory examination. The mission of our department is to provide reliable, timely, and informative services through physicians for the benefit of the patient. To achieve this mission, we also try to develop and improve laboratory technology and services through applied research.

Department of Clinical Laboratories [Major equipment for testing]
  Flow cytometer:
   FACScanto U,Becton Dickinson Hematology analyzer:
   XN-3000 + D 160 , Sysmex Automatic enzyme immunoassay system:
   ARCHITECT i2000SR, Abbott Laboratories,and LUMIPULESE PrestoU,
   Fujirebio Automatic chemical analysis system:
   LABOSPEC T008,Hitachi DNA sequencer:
   Genetic analyzer3500,Applied Biosystems Liquid-based cytology system:
   PrepsStain Slide Processor for Sure Path, Becton Dickonson
   Next generation sequencer:
   Ion S5 sequencing system, Thermofisher

Department of Pathology and Molecular Diagnostics

Department of Pathology and Molecular Diagnostics The Department of Pathology and Molecular Diagnostics aims to achieve the highest standards in clinical practice and research. The department provides three major services, including pathologic, cytologic and molecular diagnosis, in a wide variety of areas, with the most modern available technologies and highly trained faculties who are recognized nationally and internationally for their expertise. The department recognizes the critical role of pathology as a discipline that touches all of medicine and research, and our goal is to foster collaborative study to develop novel therapeutic strategies in cooperation with members of Aichi Cancer Research Institute and throughout the world. In 2017, personalized medicine using next generation sequencing technique, , was introduced into clinical practice, and the Precision Medicine Initiative program was started. We provide practical information for patients' treatment of choice, such as EGFR, KRAS, ROS1 and ALK alterations in lung cancer, HER2 amplification in breast and gastric cancer, KRAS mutation in pancreatic cancer, and many gene alternations of soft tissue sarcoma. We also collaboratively work with domestic clinical study groups, such as JCOG (Japan Clinical Oncology Group) and WJOG (West Japan Oncology Group)., as well as international collaborators.

Department of Transfusion

The mission of our department is quality control and education regarding transfusion of blood cell components and the testing of blood compatibility for transfusion and transplantation. Peripheral blood stem cells for allogeneic or autologous transplantation and cell therapy are extensively harvested and preserved in our Department.

Department of Head and Neck Surgery

Head and neck cancers include epithelial malignancies of the upper aerodogestive tract and glandular neoplasms of salivary and thyroid origin. Treatment of head and neck cancer involves not only issues of survival, but also concerns about preserving forms and functions such as speaking and swallowing. To meet these diverse needs, our department cooperates with various medical professionals, including specialists in plastic surgical reconstruction, radiation oncology, medical oncology, neurosurgery, maxillofacial surgery, and swallowing and voice therapy. Our research focuses on chemosensitivity and molecular targeting, voice restoration and preservation, and sentinel node navigation surgery, all of which have significant potential to improve control of disease, while maintaining patient quality of life.

Department of Plastic and Reconstructive Surgery

Plastic surgery concerns the correction or restoration of form and function. Our department specializes in the treatment of reconstructive surgery after cancer ablation. We aim to recover or maintain patient's quality of life. We think the purpose of head and neck reconstruction is optimization of function and low morbidity. In order to accomplish this, we select proper free flap and perform secure microsurgical technique. Breast reconstruction involves the use of implants or autogenous tissue. We actively perform muscle sparing transverse rectus abdominismyocutaneous flap or deep inferior epigastric perforator flap to reduce donor site morbidity.

Department of Thoracic Surgery

We serve patients with thoracic malignancies including primary lung cancers, metastatic lung tumors, and mediastinal tumors. About 300 patients with primary lung cancer are operated on annually. Recently, Video-Assisted Thoracoscopic Surgery (VATS) is routinely applied for early stage lung cancer as a standard radical surgery. However, patients with lung cancer sometimes recur even after complete resection. To improve treatment outcomes, multi-disciplinary strategies combining surgery with chemo- and/or radiotherapy are sought in collaboration with the Departments of Thoracic Oncology, Radiation Oncology, and Pathology and Molecular Diagnostics. We are also active in clinical trials as a member of collaborative oncology groups such as JCOG (Japan Clinical Oncology Group) and WJOG (West Japan Oncology Group). The research programs in our Department include development of individualized therapy of lung cancer through molecular analysis of the resected tumor specimens to maximize treatment effect while minimizing adverse reaction to the therapy. We have been interested in clinical application of mutational analysis of the driver oncogenes such as epidermal growth factor receptor (EGFR) gene or ALK gene to individualize treatment in order to obtain maximal benefit with minimal toxicities.

Department of Breast Oncology

Our department is in charge of total breast care from diagnosis to treatment including surgery, systemic therapy, and palliative care in our hospital. Many primary and metastatic breast cancer patients were treated in the outpatient office and inpatients' ward. About 450 patients had a primary operation performed last year.
We make efforts to diagnose early using special technologies such as vacuum-assisted core needle biopsy (Mammotome) and MRI for breast cancer without mass. Sentinel node navigation surgery using combination methods with radioisotope and dye has been the standard treatment for early breast cancer without lymph node metastasis for 15 years. We already experienced more than 4,000 patients treated with sentinel node biopsy (SLNB). Currently, we are challenging the re-SLNB for breast cancer patients with local recurrence at conservative breast and SLNB after neoadjuvant chemotherapy for primary breast cancer patients. Furthermore, immediate reconstruction (Expander or TRAM flap or other methods) has been an option in standard treatment for early breast cancer with wide ductal spread. More than 40% patients who underwent a mastectomy chose immediate reconstruction last year. Patients can choose the surgical procedure according to cancer condition and patient's preference.
We perform systemic therapies such as neoadjuvant and adjuvant treatment for early breast cancer patients based on global guidelines and the consensus of specialists obtained by multidisciplinary conference in our hospital. Current data showns excellent results in our hospital. Disease-free survival rate is 98.6% for early breast cancer patients without lymph node metastasis (median follow -up : 5.6 years).
However, unfortunately some patients experience distant metastases to the liver, lung, bone, or other organs. The aim of treatment for metastatic breast cancer is long survival with good quality of life. We make an effort to choose the best selection among many drugs according to cancer condition, molecular subtype and patient's preference. For that reason, we attend many clinical trials including global registration studies. We can use new drugs without approval by health insurance for some eligible patients. We strive to improve the outcome of primary and metastatic breast cancer patients with seven staff, several residents and all co-medical specialists in our hospital.

Department of Gastroenterological Surgery

Our department consists of four groups, and each group has experts of surgical oncology. The Esophageal Surgery Group performs approximately 75 operations per year. For the complete cure of locally advanced esophageal cancer, we combine esophagectomy with pre-operative chemotherapy in a safe manner. The Gastric Surgery Group deals with 220 new patients every year and actively participates in national clinical studies to establish and revise standard treatments for gastric malignancies. Also we strive to offer minimally invasive surgery. Likewise, the Colorectal Surgery Group annually operates on about 350 cases. We perform not only laparoscopic resection for early stage cancer, but also extend resection for advanced or locally recurrent colorectal cancer. More than 180 operations are performed by the Hepatobiliary and Pancreatic Surgery Group every year. We make every effort to improve the outcome of liver, bile duct, and pancreas cancer. Especially, the treatment results of pancreatic cancer and liver metastasis from colorectal cancer are outstanding.

Department of Orthopaedic Surgery

We specialize in the diagnosis and treatment of bone and soft tissue sarcomas as well as metastatic bone tumors. Malignant bone and soft tissue tumors are aggressive tumors, and it is important to remove them widely in order to prevent further local recurrences. The recurrence rate is less than 9% in our department. 5-year overall survival rates of soft tissue sarcoma are 100% in stage I, 100% in stage II, 73.3% in stage III, and 0% in stage IV. Those of bone sarcoma are 100% in stage I, 88.2% in stage II, 66.7% in stage III, and 12.5% in stage IV. Moreover, we provide dose intensive treatment for patients with osteosarcomas, Ewing's sarcomas or rhabdomyosarcomas with a good survival rate.

Department of Rehabilitation

The Department of Rehabilitation currently operates with three full-time physical therapists, one occupational therapist and one full-time speech-language-hearing therapist. We tailor therapy to each patient's condition and aim for recovery of ADL function and the function of postoperative patients. To this end, we proactively perform cancer rehabilitation aimed at post-discharge recuperation, as well as maintenance and improvement of patient quality of life (QOL). With respect to points of concern for patients in each clinical department, a joint rehabilitation conference is held with rehabilitation staff, ward nurses, post-discharge coordination staff, and the palliative care team, during which issues concerning each patient's rehabilitation are discussed and rehabilitation goals are unified.

Department of Urology

We are specialized for diagnosis and treatment of cancers of the genitourinary and male reproductive system, encompassing the kidney, adrenal glands, bladder, prostate and testes. With the definite increase of aged population in Japan, we are especially interested in early diagnosis and QOL-oriented treatment of prostate and bladder cancers. Basic research is focused on the regulatory mechanisms of abnormal prostatic growth and molecular diagnosis of bladder cancer.

Department of Gynecologic Oncology

Our Department is the most comprehensive gynecologic oncology center in the Tokai area. We perform approximately 140 major operations on new patients with gynecologic malignancies every year. We are committed to offering high standard options in technology and treatments for patients with gynecologic malignancies of the uterine cervix and endometrium, ovary and vulva. In addition to the decision to undergo surgery, patients can choose traditional or minimally invasive surgical treatments: for example, laparoscopic surgery for early endometrial carcinoma, trachelercomy for early cervical cancer, and robotic assisted surgery for early cervical cancer. Comprehensive surgery is followed by adjuvant therapy such as chemotherapy or radiation to improve the prognosis for patients with recurrence risk factors. For advanced cervical cancer, chemo-radiation therapy is ongoing in partnership with the Department of Radiation Oncology. In the treatment of the recurrent cancer, we perform chemotherapy, radiotherapy, or drug clinical trials for disease control and palliation. We also perform the total pelvic extirpation for recurrent cancer if appropriate. To improve the treatment for gynecologic cancer, the research program in our department emphasizes three major areas: (1) molecular analysis of mechanisms of progression of CIN lesions; (2) presentation of optimal combination chemotherapy and salvage chemotherapy for chemoresistant ovarian cancer; (3) treatment of hereditary cancer such as HBOC or lynch syndrome. Women with BRCA1 and BRCA2 mutations can undergo risk reducing salpingo-oophorectomy (RRSO) as a clinical trial.

Department of Neurosurgery

The Department of Neurosurgery, established in 2016, has a very short history. Although many patients with cancer suffered from involvement of the central nervous system such as brain metastasis, our Center was not able to provide sufficient neurosurgical service. However, now we are developing neurosurgical apparatus, staff and an environment in the Center to provide adequate service for those patients who have brain metastasis for good quality of life. We will also treat primary brain tumors including benign ones in the near future.

Department of Anesthesiology

More than 3,000 operations for various kinds of malignant disease are performed annually. We are responsible for perioperative management of these patients in the OR as well as in the ICU. Another important task is to treat cancer patients with acute and chronic pain, alleviation of which is essential for maintaining quality of life.

Department of Intensive Care

The Department of Intensive Care at our center was established in April 2009. The Unit is now a 21 bed, state-of-the-art facility in the 4th East Ward of the hospital, including 4 beds in the intensive care unit (ICU) and 17 beds in the high care unit (HCU). Our medical system manages 24-hour acute dysfunction in patients with respiratory, circulatory, or metabolic disease. Especially, a respiratory support team (RST) composed of physician and special co-medical staff has been organized to achieve the optimal results for patients with respirators in April 2011. RST assists in making decisions regarding long-term respiratory management. Our medical staff is aiming to achieve zero mortality rate in the ICU and HCU.

Department of Diagnostic and Interventional Radiology

Our department has major responsibilities in imaging diagnoses and image guided percutaneous treatments. Current diagnostic systems such as CT, MRI, US, mammography and unified CT/angiography (Interventional CT system) provide high diagnostic quality. Concerning image guided percutaneous treatments, we perform all kinds of interventions involving biopsy, drainage, embolization, ablation, and regional chemotherapy for better management of cancer patients. Especially, we have introduced many techniques and regimens in the treatment of hepatic cancer.

Department of Radiation Oncology

We have three linear accelerators (linac), 192Iridium high dose rate remote-after-loading system (RALS), and low dose rate radiation sources (125I) for a brachytherapy treatment. Features of our Department are conformal radiotherapy as an external beam therapy, chemoradiotherapy. The conformal radiotherapy developed by ex-President Dr. Takahashi was a first in the world and has been used in many cases for radical treatment. Chemoradiotherapy is being applied for most cases of locally advanced head and neck cancer, cervical cancer and esophageal cancer. Alternating chemotherapy (5FU and Nedaplatin or Cisplatin) and radiation therapy is standard therapy for locally advanced cervical cancer. The definitive radiotherapy for head and neck cancer or prostate cancer is a modern type of IMRT by helical tomotherapy or volumetric modulated arc therapy (VMAT), supported with image-guided radiotherapy (IGRT).

Department of Outpatient Services

Our Department is responsible for maintaining high quality and efficient outpatient services and provides comprehensive and specified medical care services, including radiation treatment, diagnostic imaging, infusion therapy, cancer specific clinics and support services. In addition, there are a number of designated services including diabetic clinic and genetic counseling. Sections of Ophthalmology and Dermatology have been assigned to the Department of Outpatient services.
The Section of Ophthalmology is committed to treatment of ocular, orbital and ocular adnexal malignancies, as well as providing comprehensive ophthalmic care for cancer patients in cooperation with Nagoya University Hospital and Nagoya Medical Center. The Ophthalmology clinic is open every Friday.
The Section of Dermatology provides clinical services for the diagnostic evaluation of skin cancer and interdisciplinary management of various diseases affecting skin and connective tissues. The Dermatology clinic is open every weekday except Friday. Patients with skin cancer are treated in close collaboration with tertiary care hospitals, such as Nagoya University Hospital.

Department of Surgical Center

The mission of our department is linkage and coordination among various surgical departments. Actual operations are conducted through cooperation among the staff of the Department of Anesthesiology and of various sections of surgery, and nurses working in the operating rooms. Our department has multiple operating rooms where various endoscopic surgeries, intraoperative radiation therapy, and sentinel navigation surgeries can be performed. The number of surgeries has been increasing yearly and we perform about 3,000 surgeries per year.

Department of Cardiology

There are many cancer patients with heart troubles. Many heart diseases are life-threatening, and heart diseases associated with cancer are special and complicated. Therefore, in patients with cancer, medical treatment of heart disease is very important but very difficult. Our department is responsible for solutions to heart problems related to cancer by superior cardiological skills. Furthermore, this department performs cancer therapy via Kampo medicine (Japanese oriental herbal medicine). It has become clear, recently, that treatment with Kampo medicine is very useful for cancer therapy. There are many Kampo drugs with anti-cancer activity such as Juzen-taiho-to, Ninjin-youei-to, Hochu-ekki-to, Kaiji, and Hange-shashin-to. These drugs are very effective to cancer therapy. However, Kampo medicine can be very dangerous in cancer therapy, because the misuse of Kampo drugs exacerbates the cancer. Therefore, Kampo medicine for cancer therapy must be made by expert medical doctor with the correct knowledge of Kampo medicine. Our department has 25 years therapeutic experience and a wealth of knowledge concerning Kampo medicine as anti-cancer therapy.

Department of Palliative Care

Our Department assists cancer patients and their family suffering from various types of physical, psychological, social and spiritual pain so as to enable them to cope successfully with their illness. Our most important mission is to help maintain the quality of life and daily functions of patients and their family as much as possible. Though we do not have a palliative care ward (so-called hospice ward) at Aichi Cancer Center Hospital, all the staff are united in carrying out the palliative care program led by the Palliative Care Team to support patients and their family who live their lives as true to themselves as possible. A psycho-oncologist joined our department in April 2006 to provide in-depth counseling and support aimed at relieving patients' anxiety, depression, delirium, and so on. In July 2012, a palliative care doctor joined in full time to deal with patients total pain (physical, psychological, social and spiritual pain) more systemically. We believe that the hopes of patients and their families take priority over all other things. In April 2014, the Palliative Care Center was established in our hospital. This Center integrates the Palliative Care Team, palliative care outpatients and functions for regional palliative care collaboration. We not only advise patients about options such as home care and admission to a hospice, but also offer counseling related to financial problems and interpersonal relationship issues.

Department of Psycho-Oncology

Although Psycho-Oncology division had been included in the Department of Palliative Care since 2006, it became independent of it in 2017. The psychiatrist as a member of Palliative Care Team/Palliative Care Center provides the care/treatment for Total Pain. The illness of the patients is varied from the organic/functional disease (delirium, dementia, and depression) to the psycho-social problem (adjustment disorder, alcoholic problem, etc.) The works features the Narrative Therapy, Dignity Therapy, and Cancer/Family Education (Graphic Medicine) in addition to the general Bio-Psycho-Social Approach.

Department of Nursing

Our Department is dedicated to providing a cancer-nursing service with the highest possible level of quality based on the mission of the Aichi Cancer Center. Through the collaboration of physicians and other medical staff, we help patients to cope with cancer and increase their quality of life. Although the duration of time of living with cancer can vary depending on the cancer type, we continue to make every effort to support patients and their families at any stage of the disease.

Department of Pharmacy

Our Department is dedicated to providing high quality pharmacy services that result in optimal medication. We also provide admixture of anti-cancer drugs for patients undergoing chemotherapy. Our pharmacists provide to take medicine guidance to inpatients in wards, where we work closely with physicians and nurses to prevent, identify and resolve medication-related problems. Our Department is also responsible for providing drug information that facilitates optimal and safe drug use.

Department of Nutritional Management

There are many patients who think meals are the most pleasant events in their hospital life. We serve meals and play a role in nutritional management for patients. Clinical dietitians, together with licensed cooks, work hard to prepare appropriate meals for their condition. Furthermore, we give nutritional advice and instruction for both inpatients and outpatients.

Department of Medical Safety Management

The Department of Medical Safety Management is composed of three sections involved in patient safety.
Section of Medical Safety Management: Our mission is reducing medical errors in our hospital. All of the section members strive to attain and maintain the safe and comfortable environment of our hospital. To improve our medical care, we offer educational programs to reduce medical errors. Infection Control Management Section: We are working to control various infectious diseases and to maintain the quality of medical treatment. Our main objective is the prevention of nosocomial infection and the control of multidrug-resistant bacteria such as MRSA. We consistently monitor the frequency of detection of multidrug-resistant bacteria so as to take proper measures against outbreaks.
Medical Electronics Maintenance Section: Medical electronics (ME) equipment is a part of modern medical advancement, and has applications in every area of medical specialization. We aim to ensure the security of our ME equipment inside the hospital and to keep it in reasonable operating condition.

Department of Clinical Research

The Department of Clinical Research at Aichi Cancer Center Hospital supports industry-sponsored, cooperative group, and investigator-initiated clinical trials in accordance with the Good Clinical Practice (GCP) and clinical research guidelines in Japan This department consists of three branches (Center of Support for Clinical Trial under the Japanese GCP to support industry- or investigator-initiated trials for investigational new drug (IND) or medical device), Center of Support for Clinical Trial under the Japanese Guideline for Clinical Research, and Center of Clinical Trials Management). The Department conducts operational activities including registration of application forms, management of essential documents, preparation for source data verification by monitors, preparation for audits, management of hospital charges for study participants, accounting, preparation for the Institutional Review Board (IRB), etc. Clinical Research Coordinator (CRC) assists investigators to facilitate clinical trials and provides consultative support to study participants. In 2017, 165 industry-or investigator- initiated trials for IND and 120 cooperative group and investigator-initiated clinical trials have been supported.

Outpatient Treatment Center

Outpatient Treatment Center The Outpatient Treatment Center is committed to provide infusional chemotherapy or oral anticancer agents against all kinds of cancers for a large number of outpatients. On July 1st 2013, we established a new "Outpatient Treatment Center" for increasing patients year by year who are undergoing chemotherapy as outpatient care with confidence in the comfortable environment utilizing the natural light and warmth of wood. Our Outpatient Treatment Center have 60 beds and reclining chairs which are largest in Japan, and also have full-time professional medical stuffs such as doctors, nurses, and pharmacists to be able to offer highly safe treatment with high quality. In 2017, we have treated 25,598 patients, and 104 patients as the average of a day.

Precision Medicine Center

It is now possible to obtain whole genome sequences of cancer, and the genetic status of individual cancers becomes an important information to determine the therapeutic strategy in clinical practice. Accordingly, Aichi Cancer Center has started a new program for precision medicine in 2017 to utilize the cancer genomics for clinical practice. The program is being conducted in close collaboration with the Department of Pathology and Molecular Diagnostics. Currently, lung and colorectal cancer patients are analyzed with cancer panels using Ion Torrent S5, and the number of analyses had surpassed more than 1,000 as of December 2017.

Regional Medical Liaison and Patient Support Center

The Center is located on the 2nd floor of the Outpatient Building and is open Monday - Friday 9:00 am - 4:00 pm. This center provides regional medical liaison services and patient support services. Newly diagnosed patients have lots of questions and concerns: Should I tell my family about my cancer? How do I choose treatment for my cancer? How much does treatment cost? To provide patients with the fullesut support, knowledgeable staff including social workers in the Patient Support Services Department provide an opportunity in a confidential setting to respond to questions, concerns and complaints from patients and families or to seek resolution. They also provide information about resources and services, including financial support programs, community support programs and hospice care, available to patients and families, as well as education about patient rights and responsibilities. In addition, they collaborate with clinical staff to provide cancer patients, caregivers and the general public with accurate, reliable information to help them make intelligent decisions about cancer care. Regional Medical Liaison Department provides pre- and post- hospitalization support. As a pre-hospitalization support, we provide medical referral assistance services.Through this medical acceptance process, referring physicians can smoothly obtain appointments for patients. As post-hospitalization support, we provide medical referral services as well as coordinate with the local attending doctor to arrange a return to home or to another community care setting when inpatients are discharged.

Palliative Care Center

Our Center, newly opened in April 2014, is located in just the center of the outpatient clinic. All the staff of this center (nurse, pharmacist, social worker, registered dietitian, doctor, etc.) specializes in palliative care. We assist cancer patients suffering from total pain (physical, psychological, social and spiritual pain) so as to enable them to cope successfully with their illness. Though we do not have a hospice ward at Aichi Cancer Center Hospital, all the staff are united in carrying out the palliative care program. We not only advise patients about options such as supportive care during anticancer treatment, home care and admission to a palliative care unit, but also offer counseling related to financial problems and interpersonal relationship issues.

 Palliative Care Center

Sarcoma Center

Sarcoma is one type of cancer that arises in the connective tissue of the body including bone, muscle, nerve, blood vessel, and fat. Compared to the major cancers (gastric cancer, lung cancer, colon cancer, breast cancer, liver cancer) it is a rare cancer with an extremely low incidence. Because of its rarity, experts of sarcoma are extremely few, interfering with its diagnosis at most institutions to such an extent that sarcoma has come to be referred to as 'THE FORGOTTEN CANCER'. For the optimal treatment of sarcomas a multidisciplinary approach at specialized institutions is essential, and it is considered desirable that patients be concentrated and treated at such specialized institutions. Against this background in October 2016 we established the first Sarcoma Center in the Chubu region of Japan.
At our hospital centered on the Department of Orthopedic Surgery, we are engaged in the care of numerous sarcoma patients from throughout the central Japan region, and offer a team of professionals with extensive experience in sarcoma management, consisting of orthopedic surgeons, medical oncologists, pathologists, radiologists and reconstructive surgeons, being one of the very few such institutions in Japan. Since sarcomas are not limited to the extremities but can also arise at any other site in the body including the head and neck region, trunk and retroperitoneum, we often hear of patients being baffled as to the hospital department they should report to, namely orthopedic surgery, dermatology, general surgery, plastic surgery, urology, gynecology and so on. As a result of this confusion, not a few patients finally end up at our hospital without a proper diagnosis having been made, despite having consulted multiple medical institutions and multiple hospital departments. Our mission therefore is to make it possible for this kind of patient to be seen immediately and benefit from multidisciplinary therapy in our center without hesitation or anxiety. To this end we closely collaborate with multiple hospital departments to be able to provide the most up-to-date team medicine for all sarcoma patients wherever they may be from diagnosis to treatment. Furthermore, we participate in clinical research with other institutions specializing in sarcoma throughout Japan, and are active in the establishment of standard therapies and the devising of novel ones.

sarcoma center

Statistics

Organization

Number of staff
Type of profession\Organization Total Administration
Office
Hospital Research
Institute
Total staff
755 29 668 58
Administrative staff 34 28 6  
Medical social workers 1   1  
Physicians 142 1 110 31
Dentists 2   1 1
Senior researchers 13   1 12
Radiological technicians 28   28  
Physical therapists 5   5  
Speech-language-hearing therapists 1   1  
Occupational therapists 1   1  
Pharmacists 34   34  
Clinical laboratory technicians 32   31  
Clinical engineers 4   4  
Nurses 409   409  
Assistant nurses 2   2  
Dieticians 3   3  
Dental hygienists 1   1  
Other meal service workers 15   15  
Clinical trial coordinators 14   14  
Certified genetic counselors 1   1  
Research assistants 13     13

as of January 1, 2019

hospital

patients
Item 2015
fiscal year
2016
fiscal year
2017
fiscal year
1) Outpatients
  Number of new patients 5,240 5,404 5,705
  Number of total patient visits 138,798 139,270 144,006
  Average number of patient visits per day 571.2 573.1 590.2
  Average visiting frequency of patient 26.5 25.8 25.2
2) Inpatients
  Number of new inpatients 9,775 10,289 10,581
  Number of total discharged patients 9,789 10,301 10,616
  Number of deceased patients 370 346 392
  Average number of inpatients per day 386.8 384.7 386.3
  Average patient stay in hospital 13.5 12.6 12.3

Resident training

The resident system was started in April 1986 to train physicians in the diagnosis and treatment of cancer patients.

2015
fiscal year
2016
fiscal year
2017
fiscal year
Number of residents
48 55 55

Research Resident training

The research residency system was started in April 2001 to train young researchers in the field of basic and applied cancer researches at our research institute.

2015
fiscal year
2016
fiscal year
2017
fiscal year
Number of research residents
12 10 8

Training of technical personnel for medical treatments

The shortage of specialized technical personnel for the treatment of cancer is an obstacle in the promotion of cancer control programs. To solve this problem, since 1966, full scale training has been provided. The accomplishment of this Center in this area has gained an international reputation and applicants for this training course now come from various countries as well as from all over Japan.

1966-2017
fiscal year
2015
fiscal year
2016
fiscal year
2017
fiscal year
Total
5,643 72 66 62
Physicians 3,556 26 36 44
Radiology technicians 228 0 1 1
Clinical laboratory technicians 600 7 5 6
Nurses 317 15 0 0
Others 942 24 24 11

Budget for the Cancer Center

(Unit:thousand yen)

Revenue

Item 2016
fiscal year
2017
fiscal year
2018
fiscal year
Total
23,574,351 21,959,474 23,085,119
  Revenues from medical practices 20,769,240 18,951,189 20,006,032
  Revenues from non-medical sources 2,805,111 3,008,285 3,079,087

Expenditure

Item 2016
fiscal year
2017
fiscal year
2018
fiscal year
Total
22,391,814 21,320,108 22,319,890
  Expenditure for medical practices 22,211,626 21,140,880 22,121,839
  Expenditure for non-medical sources 175,188 174,228 193,051
  Reserve fund 5,000 5,000 5,000

Facilities

facilities


facilities

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