Breast cancer is a common female cancer occurring globally, and it is the most common cancer among Japanese women. Interestingly, it’s more likely to affect middle-aged women in Japan than older women, which is different from most other cancers①. There’s been a worldwide rise in breast cancer cases, especially noticeable in Japan too. This increase in Japanese breast cancer rates might be linked to adopting western dietary habits, particularly high-fat consumption, which has contributed to obesity among females②. Another factor which is accounted to this rise in breast cancer cases is alcohol consumption③.

In Japan, breast cancer is the fifth most fatal cancer, claiming thousands of lives of the Japanese population. The outcome for breast cancer patients depend on factors like the cancer’s stage and other medical conditions present at diagnosis. Thus, understanding the complexities of breast cancer is crucial for the development of effective prevention and treatment strategies. Clinical trials by 3H help to better understand cancer and enhance future treatment strategies.

The number of total cancer incidents have been on the rise with 1005157 cases added annually in Japan. Out of this, breast cancer accounts for 91916 new cases in females each year. This is the most prevalent cancer in females recording 21.6%. Breast cancer is the predominant cancer in females followed by colorectum and stomach cancer. Annually, there are 17638 breast cancer deaths which is 4.1%. Breast cancer has a 5 year prevalence of 389 650 with 606.1 cases reported per 100000 people④.

Japan has three main breast cancer registries to gather information about breast cancer patients. The first is a national registry collecting data from hospitals and clinics nationwide. The second is a registry focused on data collected from specific cancer hospitals, while the third is run by breast cancer experts of the Japanese Breast Cancer Society (JBCS). This is part of the National Clinical Database (NCD). This database, with data from 1423 hospitals, primarily includes surgical patients. Since incorporating this expert registry, the NCD has seen a substantial increase in breast cancer cases being reported across Japan⑤. This data is valuable for healthcare planning, surgeon evaluation, and breast cancer research and trials.

Japan joins the international fight against breast cancer research with a multitude of ongoing clinical trials. These trials focus on discovering new methods of prevention and treatment.

3H is at the forefront in cancer research recruitment and follow-up, helping in patient recruitment and retention in clinical trials in Japan and Asia. Launched in May 2015, the ONCOLO website by 3H has become a leading cancer information resource in Japan and Asia. This website is aimed at patients, families and caregivers of patients, and healthcare professionals to provide a comprehensive information on various cancers, survivor stories, the latest oncology news, and insights from top oncologists.

3H’s presence in Breast Cancer Research in Japan and its active interaction with prospective cancer patients: Breast Cancer Study on the assessment with Olaparib

3H has played a pivotal role in conducting cancer clinical trials in Japan with Oncolo website being a great resource. Many cancer patients show a lot of interest in participating in ongoing clinical trials in Japan with emails been sent to the Oncolo website requesting for guidance in participating in trials.

Below is an  email received by 3H Oncolo team from a women with BRCA+ Triple Negative breast cancer.

This email was an inquiry for  the clinical trial on the assessment of the efficacy and safety of Olaparib monotherapy versus physician choice chemotherapy in metastatic breast cancer patients

This breast cancer patient’s  physician seemed to have checked the Japanese clinical trial site (JAPIC), where he found that the patient has been  treated with more than two types of medication. In such a case, this excludes this cancer patient, from the study.

Although, 3H was not the  patient recruiter for this study, when this cancer patient reached our cancer experts, they analysed the clinical trial information with her current medication status and then they found that medication before the surgery was exempt in counting  the number of medications and there was a higher possibiliy for her to get enrolled in this study. We explained the situation and asked her to contact the sponsor directly as 3H was not supporting the study.

However, it took 4 months of her effort to get enrolled for the study and in the meanwhile her symptoms worsened.  When 3H oncology team sent the thank you letter for her participation.

we found out through her husband’s email reply that she is no more. We were deeply saddened by this news. However, we followed up with the information of approval of the medicine and we received a  very emotional reply from her husband.  In this, he mentions that  in future participation in such clinical trials can save the life of another breast cancer patient.

The above story is a painful reminder of the immense suffering endured by cancer patients and their loved ones during their battle with cancer. This incident is not one off, but applicable to many cancer patients, and displays the need for quick accessibility for potentially life-changing treatment to improve the quality of life of cancer patients and give them hope of survival. We believe cancer patients should not go through such an arduous process to gain enrolment in clinical trials. 3H is committed towards helping out with streamlined processes to increase support for such cancer patients and navigate through the complexities of clinical trials.

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References

1.     Nakamura, K., Okada, E., Ukawa, S., Hirata, M., Nagai, A., Yamagata, Z., … & BioBank Japan Cooperative Hospital Group. (2017). Characteristics and prognosis of Japanese female breast cancer patients: the BioBank Japan project. Journal of epidemiology, 27(Supplement_III), S58-S64.

2.     Sasaki, S. (2011). The value of the National Health and nutrition survey in Japan. The Lancet, 378(9798), 1205-1206.

3.     Suzuki, R., Iwasaki, M., Inoue, M., Sasazuki, S., Sawada, N., Yamaji, T., … & Tsugane, S. (2010). Alcohol consumption‐associated breast cancer incidence and potential effect modifiers: the Japan Public Health Center‐based Prospective Study. International journal of cancer, 127(3), 685-695.

4. https://gco.iarc.who.int/media/globocan/factsheets/populations/392-japan-fact-sheet.pdf

5.     Tada, K., Kumamaru, H., Miyata, H., Asaga, S., Iijima, K., Ogo, E., … & Jinno, H. (2023). Characteristics of female breast cancer in japan: annual report of the National Clinical Database in 2018. Breast Cancer, 30(2), 157-166.

6.     Hori, M., Matsuda, T., Shibata, A., Katanoda, K., Sobue, T., & Nishimoto, H. (2015). Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project. Japanese journal of clinical oncology, 45(9), 884-891.