Second opinion of cancer treatment, dramatically and conveniently online (February 28, 2022) ｜ BIGLOBE News

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　Cancer treatment usually starts suddenly.After being diagnosed with cancer, the patient must make decisions, such as surgical surgery and anticancer drug treatment that takes part of the body at a tremendous speed, and select treatment and policies in long -term battles.Sometimes.Even if it is the most effective at the moment, and the safety is established, it is familiar, such as patients and families who are uneasy whether they are suitable for themselves or the pain they feel.There are many people.Even if you trust your doctor, the second opinion can be used when you want to ask other doctors if diagnosis or treatment is Fiveod.

　The second opinion is to ask a doctor of a different medical institution for "second opinion", assuming that it will continue to be treated under the current attending physician.You can receive it at your own expense that is not covered by insurance, and a specialist will give you an opinion on the current treatment and selection based on the progress of past tests, diagnosis, and treatment.

　The National Cancer Center Central Hospital began on February 15, 2021, with the provision of second opinion online, and limited to rare cancer, etc.We asked Dr. Tei Goto, the director of the respiratory internal medicine, how it was actually doing and the benefits.

—— It's been about a year since the online second opinion was introduced, and who is using online?

Dr. Tei Goto (hereinafter referred to as Goto) There were 166 online second opinions in about half a year until the end of November 2021 (2740 in the whole second opinion).In the questionnaire for those who have received it, there are many reasons that it is difficult for those who are purely far away to visit the hospital rather than want to come to Tokyo because of concerns about the new colon virus infection, so it is difficult to come to the hospital.Most people can still receive a second opinion.At present, online is not a pure comparison with the number of our hospital as a rule, as a general rule, but there are more face -to -face face -to -face.

——What kind of patients can you receive a second opinion at the National Cancer Research Center Central Hospital?

Goto: In general, when searching for something other than the treatment that the patient is currently receiving, some people want to confirm when the treatment policy is changed, consider options, and confirm the treatment so far.Some people want experts to teach their future outlook from a different perspective than their doctor.Our second opinion is prepared for one hour, and what is cancer treatment in the first place, what your cancer is, what is expected in the future, and what kind of treatment is there.I often talk about general theory.In addition, a family of patients who are treated in rural areas often ask for a second opinion, "Is there another treatment in a large hospital in Tokyo?"

　Since it is difficult to talk about the time in a normal consultation, there is a need to listen carefully about illness and treatment, and if the patient and family are satisfied and satisfied, there are many opportunities.I want you to actively use the second opinion because it would be Fiveod.In fact, every time the treatment changes, some patients come to receive second opinions many times.

—— Is it common to change the treatment with a second opinion?

Goto does not intervene in specific treatment.However, a rare cancer patient may ask the attending physician to "receive a second opinion on treatment" while receiving treatment, so he may give advice.Rare cancer is rarely less than six per 100,000 population, and its type is nearly 200 and treatment is often difficult.We have accumulated a lot of knowledge at our rare cancer center, so we thought that it was necessary to provide online so that the second opinion was not stopped in the corona.

—— How can the online second opinion proceed?

Goto uses an online consultation system service called "Findme", and patients can receive a computer, smartphone, or tablet.The general online consultation, which has increased due to corona, seems to have a lot of one -to -one exchanges using TV phone functions, but in "Findme", three channels are prepared so that families who live away can participate.I have.

　You can also see images and data that are indispensable for cancer second opinions.It feels like a meeting and screen sharing with ZOOM.This is a unique consultation system that has been jointly developed so that doctors can put handwritten notes, and to be as close to the second opinion as possible.

　If you are online, patients living in the distance will not pay for transportation and physical strength, and you will be able to listen to the second opinion together without a family living in a remote land.。It can be used by hospitalized patients, and the attending physician can be present and explain the condition, and we can answer specialized questions.

　However, it seems difficult to secure a place if you try to receive an online second opinion in the hospital.One patient who was received with the attending physician seemed to have a conference room convenient, but it seems difficult to prepare a place in the hospital where privacy can be secured.

　I would like to have the opportunity to exchange information between medical professionals if there is little information about treatment such as rare cancer, but it is difficult to operate the patient's consent and who will pay for it.is not it.However, as a system, it can be done at any time.

——If the patient's family and stakeholders live away from the corona, many people will be uneasy if they are infected by moving, so it would be nice to be able to be online online.

Goto: We thought so, but it was surprising that most of the people who gathered at the patient and listen to them on the spot were few and use many channels.After all, it is safer to be with each other, and after the fact, you will be discussing the future.

——It may be very beneficial for patients living far from the National Cancer Research Center.Will it continue even if the corona evil ends?

Goto will continue.Many diseases, including cancer, have difficulty in online medical treatment, but in second opinions, patients are already diagnosed and under treatment, so the hurdles of online difficulties are low.For those who have a heavy burden from a distance, it will be easier to receive a second opinion.In the questionnaire for those who used it, some responded that they had consulted because the online was opened.

——Do you have any disadvantages as a doctor?

Goto: Isn't the subtleties of each other?Usually, even in second opinions, doctors are observing how well the patient is looking at the speed and attitude of walking since entering the consultation room.If it's over the screen, you can only see sitting, and it's hard to understand the details of sitting for one hour or everyday.

　In addition, I often talk about bad stories, and there are some fears of whether communication can be successful at that time, and there is a reason that it is limited to rare cancer.If the disease progresses not only online but also very fast, waiting for a second opinion may delay treatment, which can be a major disadvantage.

——Do you have a questionnaire that the patient was better at face -to -face?

4 % of Goto said that it was better to meet, but that was because the system could not be used well.System companies, such as the communication environment, also checked well, but for some reason, I did not connect to the day and switched to the phone, and only sounded.

——There aren't many scenes that require second opinions other than cancer.

Goto: Certainly, the treatment of infectious diseases will not be a second opinion.There are few treatment options, and patients do not decide on it.In the United States, if athletes are injured, they will first receive a second opinion, so if you have time to choose a treatment, you need to think about the merits and disadvantages.There may be, but it comes out especially in cancer treatment.

——In, not only patients, but also families, such as families, often want to recommend or receive second opinions.

Goto patients and their families may want a second opinion that "a hospital specializing in cancer in Tokyo can make the right decision."Certainly, in a limited field such as rare cancer, such a thing, but the physician who has been examined for a long time, such as the patient's values, family structure, and social position, is the most grasped, and then treated.Most of them are judged.

　It is difficult to understand, understand, and answer such a background in an hour of the second opinion, so we do not always make Fiveod proposals in front of you.

　Even if you are not a patient, you can receive a second opinion, so you can increase your family's satisfaction and satisfaction.The second opinion is very important to eliminate the patient's anxiety, increase the satisfaction of treatment, help to understand the treatment of treatment.If you have to tell your doctor's teacher, be sure to reply in writing.

——There is to be unable to talk to your doctor carefully, and you often do not understand and understand the disease and treatment.

There are many Goto.In other words, it is a problem that you cannot take such time in daily medical treatment, and there are problems with medical fees as well as the busyness of doctors.In our hospital, we set 44,000 yen (49,940 yen including system usage fee in online) as a second opinion consultation fee.You will need to pay.

　If you have the same medical fees when you need sufficient explanation in normal outpatient care, it will be easier to take plenty of time and talk to patients and families.It seems that the Internal Medicine Social Insurance Union and the Central Social Insurance Medical Council want to add expenses to the patient's explanation, but it has not been fully realized.

　There are many patients who receive second opinions many times because they cannot listen to the explanation carefully, so there are some opinions that it is better to discount after the second time.

—— Even if there are no other treatments in the second opinion, patients and related people can be convinced of illness and treatment, and can create a relationship with the current physician to think about the future.

Goto second opinion also has such a role.It is an important task, sometimes you may be reminded that your doctor's policy is definitely a strict prospect.

　The local hospital you are seeing now will do your best, but when the treatment to cure is Fivene, this cancer is like this, and it will be sick and will die in the future.By telling that in a second opinion, of course, you will be depressed and return, but you may be perceived as a fact.The same result in the second opinion was the same, so you may be able to rebuild the relationship without resentment of your doctor.We believe that it is an important role in the second opinion to take on the dirty roles for the patient's future.

　However, as I mentioned earlier, I think it would be difficult to convey the delicate subtleties online.

[Related Site] National Cancer Research Center Central Hospital Online Second Opinion HTTPS: // www.NCC.Five.jp/jp/NCCh/d001/secondopinion/online_secondopinion/index.html

National Cancer Research Center Cancer Information Service "What is the second opinion?" Https: // Ganjoho.JP/Public/DIA_TRE/DIA_TRE_DIAGNOSIS/SECOND_OPINION.html

I: Nozomi Sakamoto