Takuji Gotoda is an ESD (endoscopic submucosal dissection) expert, and operated more than 500 ESD procedures on stomach or gastric cancer each year.
The number of ESD procedures by Dr. Gotoda exceeds most of his peers, which makes him one of the best doctors for gastric cancer despite his young ages.
Masaki Kitajima first introduced the surgical robot for the remote control endoscopy procedure in 2001. Naturally, his reputation is worldwide for his minimum invasive surgeries in Gastric Cancer.
Toru Mitsushima is the specilaist in colonoscopy, or gastrointestinal endoscopy. He operated more than 100,000 endoscopic procedures.
Masahiro Igarashi is a director of endoscopy division at the Japanese Foundation For Cancer Research. Dr. Igarashi is the leading surgeon and surgical trainer in the gastrointestinal endoscopy procedure in Japan.
Tomoyuki Kato is the endoscopy specialist in gastric/stomach cancer treatment. He is instrumental in promoting Aichi Cancer Center to be one of the best medical institutions in Japan. Nihon Keizai Shinbun, Japanese version of FT or IHT, announced his division to achieve the "best clinical outcome". He became a head of Aichi Cancer Center hospital as of 2004.
Prof. Mitsudo is a top surgeon in cardiac catheterization, and coronary angiography. He is considered one of the best surgeon of catheter in the world. Initial success rate for Percutaneous Coronary Intervention (PCI) at chronic total occulsion is said to be greater than 90%, as can be cross-validated by the success rates at Okayama Central Hospital (Table I).
Dr. Nabuchi is a top surgeon in Aortic dissection of cardiovascular disease. He operates about 200 surgeries per year. The surgical skills he posses are known to be exceptional, and he keeps successful surgical track records.
Legendary surgeon operated the first gastroepiploic artery bypass surgeries in the world, and was the first surgeon to do the Batista procedure in Japan in 1998. He became a medical icon for his excellent track records of bypass surgeries.
His current responsibility is a supervisor at the Cardiovascular Institute Hospital.
Highly recommended doc.
Dr. Yoneda is a top cardiovascular surgeon. He had been doing more than 3000 surgeries, in particular, aortic valve plasty and coronary artery bypass.
Dr. Yoneda is known with his active attitude to accept patients with advanced symptoms. Only a few surgeons could match his experiences in Japan.
His current responsibility is vice head of Nagoya Heart Center.
Highly recommended doc.
Dr. Yamamura is a top surgeon for treatments of later gastric cancer with peritoneal metastasis.
In 1991-1995, he did 985 surgeries.
5 years survival rate for gastric cancer patients is:
Dr. Yamamura is appointed to the director of Aichi Cancer Central Hospital.
Professor Iwasaka is a specialist in cervical cancer treatment. He is a pioneer in concurrent chemoradiation therapy, and MEP therapy.
Yearly number of surgeries on cervical cancer patients is about 35. Up till Ia1, laser conization would usually be applied.
From 1982-91, 5 years survival rate is:
From 1995 onward, 5 years survival rate is:
Professor Yoshikawa has acute reading skills on MRI and CT. His screening has a strong credentials among Japanese medics. His yearly surgeries on Cervical cancer are about 60, Endometrial cancer 50 (CRT, Hormone therapy), and Uterine cancer 50 respectively.
Five year survival rate for respective cancers:
Cervical Cancer: (I 90%, II 75%, III 50%, IV 15%)
Endometrial Cancer: (I 95%, II 85%, III 75%, IV 30%)
Uterine Cancer: (I 92%, II 90%, III 46%, IV 25%)
Professor Yaegaki is a specialist in sentinel lymph node biopsy, and the top surgeon for Cervical cancer screening in Japan.
Professor Yaegaki is appointed to the Professor at Tohoku University.
Dr. Nishimura is a top surgeon specializing in Photodynamic Therapy (PDT). In 2005, he did 130 cervical cancer surgeries, 95 Endometrial cancer surgeries, and 37 ovarian cancer surgeries.
Five year survival rates for patients for respective cancers.
Dr. Ueda is a specialist in laser conization of Cervical Cancer. For last 5 years, he did 109 surgeries of which 43 were laser conizations.
He is appointed to the director at Osaka Cancer Prevention and Detection Center which had 3000 surgeries of Cervical cancer over 20 years, and yielded 98-99% successful surgeries.
Professor Aiko has done pioneering research on sentinel lymph node theory, and applied to more than 200 patients with early stage cancer. Clinical results of his sentinel node theory yielded many good results.
Prof. Yamaguchi is the specialist in Laparoscopy. In 2005, he operated 405 surgeries, of which 93 are laparoscopic surgeries of Colon Cancer. Median stay time in hospital for patients who underwent laparoscopic surgeries is 7 days after surgeries. With cross-departmental coordination, Endoscopic mucosal resection (EMR) has been applied to the cancer patients at early stage. If EMR is deemed inappropriate, laparoscopic surgeries are used and done by his team.
Dr. Uesaka is a specialist in hilar bile duct carcinoma, and had more than 30 surgeries since he joined the Shizuoka Cancer Center.
Dr. Uesaka is appointed to the departmental head at Shizuoka Cancer Center.
Cell based Immunotherapy (Autologous immune enhancement therapy) has been more frequently practised in Japan.Techniques to harvest the cells are extremely intricate and delicate processes. For the treatments to be rountinely available to the cancer patients apart from the clinical trials, advanced engineering cell reprocessing center must be available with good corroboration with the hospitals.
Since Japan made the Immuno-Cell Therapy to be a part of health care systems, the cell processing centers (CPCs) rapidly increased in the past decades. For the therapy of high complexity such as dendritic cell / autologous enhancement immunotherapy to be regularly practiced in the hospital, those CPCs were essential, and this explains why much of innovations in cell based cancer immunotherapy took place in Japan.
Both EMR and ESD was originally developed in Japan. EMR / ESD (endoscopic biopsy or polyp resection procedure on gastrointestinal tract) is the area that Japanese surgeons are leading the research at forefront. It is the minimally invasive endoscopic procedure that conserves organs / tissues, and patients can be discharged from the hospital in the same day or a week after the operations. It is usually applicable to early stage cancer / tumor, and improves the post-surgical health conditions such as loss of appetite, fever, chills, pains and life-long medication.
Currently there are about 31 proton (or carbon ion) therapy facilities in the world, 8 of which is built in Japan. Proton Beam Therapy is much less invasive than other radiotherapy treatments, and can treat the cancer without incision of the body, and with much less side effects than X-ray treatments. Japan has invested in Proton beam therapy (PBT) / Carbon Ion Therapy infrastructure for a long time, and clinical level studies are numerous and thus well experienced with all kinds of localized tumors.
Japan has been leading the RFA intervention technology for a long time, and the yearly number of RFA interventions in Japan currently exceeds that of United States and China. (See the Table below.) Survival rates for the patients undergoing the RFA are not different from those of surgery. But the surgery is harder to be operated multiple times, whereas the RFA is not restricted by the number of interventions or by the presence of Hepatitis. For this reason, RFA becomes a standard treatment in Japan.
| Yearly volume of RFA on Liver Cancer | |
|---|---|
| Japan | 34,000 |
| US | 14,000 |
| China | 9,500 |
Table: Yearly number of Radiofrequency ablation of Liver or hepatic tumors by country.
Recent technological advances in cell sheets engineering extended to the pre-clinical trial of the treatment of heart disease patients often in need for the heart transplant.
In japan, complex operations towards varicose veins below the knee are established with safey and high response rates. Various catheter and micro-catheter devices are extensively used, and some of them are only available in Japan.
Medical technology in Japan for cancer screening and gastrointestinal diseases are known to be very strong, supported by good clinical statistics, i.e., high five year survival rate after the surgery (or radiology / chemotherapy) among the colon, rectal, stomach, and esophageal cancer patients as well as liver, lung, and larynx cancer (See Table below).
Since Japanese health agency is notoriously slow and counter-productive when it comes to the approval of new drugs, Japan's hospitals and patients suffered for so long by the technology lag from the rest of the world. Ironically, these regulatory problems lead physicians to the innovations in the fields other than drug discoveries, i.e., in the surgical / laparoscopic, endoscopic, micro-catheter procedures, cell based immunotherapy / vaccinations, radiation (carbon ion and proton beam), and regenerative medicine (iPS cells, cell sheets).
Since the Japanese physicians had less options in chemotherapy, they had more opportunities in experiencing difficult surgeries, and tried the new treatments due to the low availability of new drugs. Thus, many exotic and unique medical technologies emerged out of the isolations casued by the incompetence of Japanese health agency.
| Site (Survival Rate: %) |
7 Cancer Registrates in Japan |
US SEER Program | Eurocare-3 |
|---|---|---|---|
| Esophagus | 25 | 14 | 10 |
| Stomach | 58 | 22 | 23 |
| Colon | 66 | 62 | 51 |
| Rectum | 63 | 63 | 48 |
| Liver | 17 | 7 | 7 |
| Gallbladder | 18 | 16 | 12 |
| Pancreas | 6 | 4 | 4 |
| Larynx | 77 | 65 | 62 |
| Lung, bronchus | 20 | 15 | 11 |
