A leading palliative care doctor, who himself is battling stage-4 cancer, continues to pursue his life's work of providing in-home support to terminally ill patients to allow them to live their final days with dignity.
Fumio Yamazaki, 75, started his career as a doctor at a hospital in the 1970s and witnessed first-hand the suffering and despair of people dying of cancer in hospital wards.
As it was considered taboo in Japan at the time to inform cancer patients of their true diagnosis, they were left in the dark and without knowing the nature of their condition.
Although doctors knew there was no hope of recovery, they often performed excessive resuscitation techniques on their patients, such as artificial respiration and cardiac massage.
In his bestseller, "Byoin de Shinu to Iukoto" ("Dying in a Hospital"), published in 1990, Yamazaki questioned the medical practice in which patients at Japanese hospitals, who deserve the utmost respect as death approached, are instead alienated and given neither treatment options nor decision-making power.
In pursuing ideal end-of-life medical care, Yamazaki became involved in palliative care and has been at the bedsides of more than 2,500 people in their homes or elsewhere at the time of their death.
Yamazaki was diagnosed with colorectal cancer in the summer of 2018. Metastasizing to both lungs the following year in May, it became stage-4. Since surgery and radiotherapy were not viable options, he was advised to receive anticancer drugs.
But he feared that he would have to discontinue his palliative care work due to the strong side effects of the drugs. He said he was unwilling to end his work and give up what he cared about most.
"Up until recently, I had treated many patients and listened to their traumatic experiences. I could empathize with them but I couldn't share in their experience," he said, explaining that now that he is also sick, he has a new perspective.
People with stage-4 cancer can continue their normal lives for a period. Although palliative care may become necessary to alleviate pain in the future, Yamazaki wondered if it was possible to maintain his current condition as long as possible.
He read related books and tried alternative treatment methods based on certain theories, such as diet and drug combinations, to suppress the growth of the cancer.
Although a causal relationship has not been proven, the metastasis has shrunk, now four years since his stage-4 diagnosis. On weekdays, he works at a hospital in Tokyo and a clinic he used to operate for home-visiting medical care.
Being a cancer sufferer himself, he now has a more serious outlook on death. He says the essence of palliative care is "helping terminal patients live the rest of their days in a way that affirms who they are and what they are going through."
The style he is accustomed to as a physician remains unchanged.
He goes to patients' homes alone, dressed in casual clothes, behind the wheel of his car and unaccompanied by a nurse. He tells his patients about his own battle with cancer, leading to sincere and honest conversations.
With the reality of his own death looming, Yamazaki said, "I want my patients to live with dignity until the end."
On this day, the patient asked, "Doc, didn't you promise to be at my bedside when I die?" "That is my plan...I probably can do it," Yamazaki replied.
© KYODO
27 Comments
Login to comment
TaiwanIsNotChina
If medical science is going to fail so spectacularly, it should know when to get out of the way and let people exit with a minimum of suffering.
kintsugi
A real hero.
Spitfire
A true Japanese hero.
Paul
In September last year I was diagnosed with stage 4 B-cell lymphoma. The chemotherapy treatment has so far succeeded, Yesterday I had my third PET-CT scan and will find out the results on Monday. But future is uncertain, every 6 months I have a PET-CT scan and monthly marker blood test, therefore live one month at a time... It is good to know that there are doctors like him that prioritize patients dignity!
piskian
@Paul.
My mum had a similar experience.
I hope that all goes as well as it can,and that in that time,you enjoy your time as much as you can.
Concerned Citizen
God bless you Dr. Yamazaki. What a wonderful example you are.
mountainpear
@Paul So sorry to hear about your illness. Hope you get good news on Monday!
garypen
I remember when my wife first told me about this, I was shocked. They were still doing this crap in the 90's, too. At least they would tell the family the truth, but not the patient. (Her father died of stomach cancer.)
I realize it's a different culture. But, how did relatively modern medical practitioners justify such madness? Insane.
virusrex
One very important change that have been taking importance in medicine is to include the concept of Orthotanasia as an option instead of euthanasia, giving patients proper care without artificially extending suffering and pain. This is a perfectly valid option that not so many patients have in Japan and that has to change.
gcFd1
Looking forward to the day when there is finally a cure for cancer.
theFu
Cancer isn't a single disease. There will be no single "cure". There are many different types, each will likely need a different treatment.
THOMAS R MOUNTCASTLE
I wish I could understand the negative votes. There are some totally uninformed and insensitive readers of this article. Perhaps a terminal illness will bring them around?
THOMAS R MOUNTCASTLE
I wish I could understand the negative votes. There are some totally uninformed and insensitive readers of this article. Perhaps a terminal illness will bring them around?
virusrex
Exactly, modern medical treatments means that some varieties of cancer can be cured, this includes varieties that a re described even as "frequently cured". Patients no longer have to think they will die of the disease even with treatment, many will be cured by it and live long and prosper lives dying of something completely unrelated.
virusrex
Why is that, cures are being continuously being found by companies, and not only that but being improved, produced more efficiently and getting them cheaper and cheaper.
The problem is that you have repeatedly supported drugs used in a way that provide no benefit and only increase the risk for patients, that is the opposite of what you are trying to say here.
Obviously the irrational argument that not curing cancer is more profitable makes absolutely no sense, cured people do not become immune to disease, so curing anybody so they can get decades more of life is much more profitable, specially because with age disease becomes more common and difficult to treat, thus much more profits.
iraira
Paul....went through the same large B lymphoma about 6 years ago. 6 rounds of RCHOP. Side effects were really not that bad at all....got lucky that shape of my head is reasonable. Complete remission. Getting blood work check-ups every 4-6 months and an imaging fluid infusion CT-scan once a year (kinda like those actually). Best of luck to you.
cuddly
Although doctors knew there was no hope of recovery, they often performed excessive resuscitation techniques on their patients, such as artificial respiration and cardiac massage.
Very sad. Until a cure is found, best of luck to this dr.
Lola
@Paul Wishing you the best results on Monday! Best of luck to you, stay strong!
Coulda been
The world can ill-afford to lose such humanitarians.
opheliajadefeldt
What a wonderful caring doctor, he has cancer himself and is 75 yrs old. His dedication to his patients is beyond mere words alone.
kintsugi
Who will take care of him in his last days and hours?
Speed
I vote to divert the 7,000,000,000,000 yen they're spending on defense next year to cancer research to find cures or effective treatments.
This doctor has a heart of gold. Put him on TV and get rid of all those yelling "talentos".
theFu
While I wouldn't wish an early death on almost anyone (perhaps certain dictators and multiple murderers, I know what it is like to see a loved on dying. Doctors do all they can and are always hopeful. They have someone to try the stuff known to work, then the stuff that is experimental on. So often, some doctors loose track of "quality of life" in their consideration.
My father had terminal cancer. For the last 3 months of his life, there was no doubt he was going to die and we knew about 3 weeks before the 3 days when he'd actually be gone. There was no reason he needed to be alive that last 3 weeks. He'd said all his goodbyes and was just waiting to die. Helping him end his life would have been a great kindness.
virusrex
It is very likely he already made arrangements for his own care when he can no longer work, also science progress very quickly in the field of oncology. Many treatments and even cures are being developed continuously, it would not be impossible that a patient he took care of was able to survive the disease and pay back the attention, I would think even families would do that without thinking it twice.
cuddly
Cancer is a disease of the body's cells.
Regardless, with no cure at the moment, someday there will be a cure for cancer.
Also, "treatment" is different from a "cure".
There already are treatments for cancer.
virusrex
But fortunately for cancer there are both. Doctors and other specialists cure cancer patients every day. It is no longer a death sentence and some varieties are even cured more often than not.
Paul
UPDATE
I had the results from my Thursday PET-CT scan, it is negative except for some inflammation of one lymph node. No change from six months ago.
@ iraira
Side effects from chemotherapy were not that bad except that I have no sensation in both of my feet. My right leg lost 30% of mussel mass due to the fact that the tumor moved on to my right hip and damaged the main nerve for the right leg, therefore I walk with a limp. But I can drive OK, which is lucky as I live in the countryside.
Thank you all for your support!!!