Medical Fields suitable for Medical Travel 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 drugs. Thus, many exotic and unique medical technologies emerged out of the isolations casued by the incompetence of Japanese health agency. 7 Cancer Registrates in Japan
Site (Survival Rate: %)
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
For initial considerations, we believe that there are seven options for overseas patients (healthy, or already diagnosed with cancer, heart disease, or other diseases).
- CT-PET / Medical Check-up on cancer or heart disease
- EMR / ESD examination / procedure on gastrointestinal cancer
- Micro-Catheter treatments on varicose veins (including the veins below the knee)
- Radiofrequency Ablation on lung, kidney or liver cancer combined with chemotherapy using optimal pathway for drug delivery
- Proton Beam Therapy / Carbon Ion Therapy
- Regenerative treatment on cardiomyopathy (myocardial infarction), blind (vision loss), esophagus cancer patients.
- Cell based Immunotherapy (Autologous immune enhancement therapy) on advanced stage gastrointestinal cancer combined with chemotherapy
CT-PET is both low cost, and widely available in Japan. Essentially targeting other asians who may not have ready access to the facility, CT-PET check-up for cancer, heart disease, etc., may facilitate the early detection of cancer / polyps. For patients from US, Europe, or Middle East, the check-up may be the good initial trial for health to give the physician the careful analysis of their health conditions.
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.
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.
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.
Cell based Immunotherapy (Autologous immune enhancement therapy) has been more frequently practised in Japan. Cancer Adoptive Cell Immunotherapy had obvious advantages in research and development since all the therapy materials are extracted from the patients, and considered natural as opposed to the chemical compounds of chemotherapy, thus escapes the significantly long years of drug approval processes. For that reason, japanese hospitals and cell processing research firms developed many exotic immunotherapy treatments tailored towards individual patient's genetic markers and immune class. Every year, citizens from USA and Europe comes to Japan to get cancer vaccinations only available in some japanese hospitals.
Gastrointestinal Procedures
Japan is traditionally known for the leading medical technology in gastrointestinal tract. Esophageal, gastric, colon, rectal, and liver cancers are particularly the focuses of elite surgeons in Japan. It is the rare field that Japanese surgeons outperform the US and European counterparts. Each year, a few informed patients from USA and Europe seek medications in the field of gastrointestinal tracts in Japan.
As illustrated in the table below, Japan has a better tracking record in the treatment of gastrointestinal cancer. It is however to be pointed out that the early detection of cancer and minimally invasive endoscopic procedures (EMR / ESD) allowing the conservation of organs / tissues were key drivers to decrease the mortality in Japan.
| Procedures | Description |
|---|---|
|
Endoscopic Ultrasound |
Endoscopic ulatrasound is the screening method for pancreatic cancer, esophageal cancer, and gastric cancer. Pathogenic legions in the tract can be biopsied by a fine needle aspiration. This tecnology particularly promotes QoL of patients. |
|
Sentinel Lymph Node Biopsy |
The sentinel lymph node is the first lymph node to which cancer is likely to spread from primary tumor. Node is extracted and examined to determine the presence of cancer. By using this technique, lymph node can possibly be preserved, while the tumor is removed. Generally less side effects than removing all lymph nodes. |
|
Endoscopic Submucosal Dissection (ESD) |
Japan has been leading the gastroendoscope technology since 1950s with the domestic medical device company like Olympus. Japanese surgeons are considered the best in the world for diagnosis and treatment of gastrointestinal related diseases. ESD is not usually avaialable outside Japan. |
|
Natural orifice transluminal endoscopy (NOTES) |
NOTES are still experimental, but possibly revolutionize the minimum invasive surgery techniques by eliminating abdominal incisions. |
Table 2: List of Gastrointestinal / Endoscopic Procedure
EMR / ESD, Ultrasonograpy, NOTES are extensively operated in Japanese hospitals, and some patients, especially those with early stage cancer, may benefit from the procedures. Since those procedures are in rare clinical applications outside Japan, many Japanese surgeons are recognized world-class pioneers.
Patients or potential patients of gastrointestinal tract may consider a travel or a tour of a few days, a week, or longer to Japan to have medical examination of stomach, esophagus (Barrett's esophagus), colorectal (colon or rectal), and small bowel cancer, and remove the polyps / tumors at the same procedure. Outside Japan, surgeons usually have no choice other than removing the whole stomach, or digestive tract thereby causing loss of appetite, and swallowing pains, but in Japan, many surgeons can apply the special technique called EMR / ESD to preserve the stomach or digestive tract to allow the patient to live the normal life after the operation.