Purpose: To evaluate
palliative care for patients with gynecologic
cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate
palliative care, current status of
end-of-life care, provision of symptom relief, palliative
radiation therapy and
chemotherapy, and cases of death from gynecological
cancer, was mailed to facilities treating gynecologic
cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a
palliative care ward.
End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where
end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment,
pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative
radiation therapy or
chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological
cancer. There were 1,134 cases of death. The median time between the last cycle of
chemotherapy and death was 85 days for all gynecological
cancers. The proportion of patients receiving
chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of
palliative care given to patients with gynecologic
cancer in Japan. Assessment of death cases showed that the median time between the last cycle of
chemotherapy and death was relatively short.