The
Cancer Control Act of Japan came into effect in 2007. Most physicians, however, have not yet had sufficient opportunity to learn about
pain management and other clinical
palliative care practices. In an attempt to rectify this situation, the Japanese Society for Palliative Medicine has initiated the
Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education project. The two major roles of this project are to establish a faculty development program in
palliative care, and to provide support for conducting workshops about basic
palliative care throughout Japan. Another important movement is the development of a clinical guideline for the management of
cancer pain. The Japanese Society for Palliative Medicine developed a clinical guideline for the pharmacological management of
cancer pain in 2010. On the other hand, although clinical experience has demonstrated that psychological dependence is not a major concern when
morphine is used to control
pain in
cancer patients, undue anxiety about psychological dependence on
morphine in
cancer patients has led physicians and patients to use inadequate doses of
opioids. In an attempt to remedy this situation, therefore, Japanese basic researchers are cooperatively involved in conducting high-quality basic research to answer clinical questions in
palliative care. They have demonstrated to the world, for the first time, that (i)
chronic pain dramatically attenuates the reward effects of
opioids and that (ii) atypical
antipsychotics, such as
olanzapine, can suppress
morphine-induced
emesis and alleviate the sleep dysregulation associated with
neuropathic pain in animals. Thus, we are working in close collaboration to establish new strategies for
palliative care in Japan.