Introduction

In Corporate action for promoting cancer control, we have created e-learning "Cancer prevention and Work-Life Balance support" for improvement of cancer screening consultation rate and support for balancing cancer treatment and employment at partner companies.
The "trump card" for cancer control and cancer prevention is to know about cancer. Through this e-learning, we hope that you will acquire basic knowledge about cancer and protect your life and body from this disease.

This e-learning consists of four sessions. Sessions I to III are for all employees, and Session IV is for managers (which is optional for employees other than managers).

Message from Dr. Keiichi Nakagawa, University of Tokyo Hospital

Everyone may get cancer

• Two-thirds of men and half of women develop cancer.
• More young women especially are developing cancer.

Why do people get cancer?

• Cancer develops fromcopying errors in cells (genes mutate) during cell division.

Malignant tumor (cancer) and benign tumor

• A benign tumor, if removed, is not life-threatening.
• Cancer that remains localized is relatively easy to cure. (Early stage)
• However, if cancer metastasizes, it is difficult to cure completely. (Advanced stage)

Japan, the world's top country for longevity, has the highest cancer rate among all countries

• A lot of cancer cells (5,000) develop in us every day.
• As we age, the number of copying errors during cell division increases, and the function of the immune system to destroy cancer cells diminishes.
• For this reason, if you live longer, you are more likely to get cancer.

30% of cancer patients continue to work

• Along with an aging society, the number of older cancer patients is increasing.
• An increasing number of cancer patients are young women.
• With working years extended and more women working, more and more cancer patients are of working age.

Japan is an undeveloped country in fighting cancer

• The cancer mortality rate is increasing in Japan but decreasing in the United States.
• As of 2016, the cancer mortality rate in Japan has been1.6 times that in the United States.
• The leading factor of the increase in the cancer mortality rate is a rapidly aging society. Nonetheless, poor cancer prevention activities (high smoking rate, low screening rate, etc.) contribute to the high mortality rate.

Cancer can be prevented

• More than halfof the cancers in men and up to 30% of the cancers in women are attributed to preventable causes.

Lifestyle control for cancer prevention (1) smoking cessation

• Looking at causes of death by the organ system, lung cancer is No. 1.
• Cigarette smoking causes not only lung cancer but also cancer of the throat, pancreas, liver, and other organs throughout the entire body.
• Eliminating cigarettes would reduce male deaths from cancer by 40% in Japan.
• Cigarette smoke harms the health of people around smokers.
• Reports of health problems due to e-cigarettes/HTPs (heated tobacco products) are also increasing.

Lifestyle control for cancer prevention　(2) alcohol consumption and physical activity

• Drink alcohol in moderation - For example, if your face turns red when you drink alcohol, drink with care. –
• Even a little physical activity can have a positive impact.

Lifestyle control for cancer prevention (3) diet

• Eat meat in moderation. Be sure to eat vegetables and fruit every day.
• Be careful to limit your salt intake and avoid scalding hot drinks or food.
• A balanced diet is the best way to prevent cancer.

Cancer also caused by infection

• Around 20%of cancer incidence in Japan is due to infectionswith bacteria or viruses. (Around 5% in Europe and the United States)

What should men be careful about?

• Smoking cessation and control of alcohol consumption can reduce the risk of cancer development in men by around 40% .
• Infection accounts foraround 20% of cancer incidence in Japanese men too.
• Try to get examinations early to determine whether you are infected with the Helicobacter pylori bacteria or hepatitis virus.

What should women be careful about?

• Cancers specific to women are increasing rapidly in the younger generation (who are in their thirties or forties) in the prime of their lives.
• Their incidence rises significantly in the middle-aged and elderly, particularly those in their late forties .
• They are increasing in younger women in their twenties to forties.

Cancers specific to women (1) breast cancer

• Breast cancer is the most common cancer specific to women, causing more than twice as many deaths than from traffic accidents.
• The number of women who have developed cancer has increased by about sevenfold in the past 40 years.
• Self-checks (self-palpation) and cancer screening are thus important.

Self-check for breast cancer

• Regularly check your breasts once a month, four to seven days after your menstruation period ends.
• By examining your breasts by hand on a regular basis, you will be able to remember how each part feels to the touch. Even if you do not recognize any changes, make sure to get a mammography every two years.

Cancers specific to women (2) cervical cancer

• The cause is a persistent human papillomavirus (HPV) infection.
• In recent years, with sexual intercourse starting at an earlier age, cervical cancer israpidly increasing in younger women in their twenties and thirties
• The magic bullet for them is to start cancer screening in their twenties.

Even saints get cancer

• Not only should you practice a good lifestyle but also you need to try to get cancer detected early (cancer screening and self-check).

If you get cancer, will you ever get better?

• Taking all types of cancer into account,60% of cancers today are curable.
• Many types of cancer at an early stage arecompletely curable, at a rate of 90% or higher.

Era when people who have cancer are continuing to work

• Cancer treatment has shifted from hospitalization to outpatient treatment Most patients can get outpatient treatment at a hospital.
• According to 2019 statistics, 448,000 cancer patientsreceived treatment while they continued working.

Cancer treatment

• The treatment depends on the type of cancer and stage of progress. Patients may be provided a combination of treatments including an operation (surgery), chemotherapy (anticancer drugs), and radiation therapy.
• The treatment tends to take a long time.
• Patients may sometimes experience a decrease in physical strength and/or side effects from the treatment.

To continue working while being treated

• Check the cancer control employment support handbook and check the system to continue working reasonably.
• Talk to your superior, industrial physician, manager as a contact point for HR Management Department, HR Management Department, or anyone else who can help you.

Cancer Screening

• Cancer screening recommended by the Ministry of Health, Labor and Welfare "Manual for Cancer Screening in Occupations" to reduce cancer mortality

Importance of early detection

• Whether or not you get cancer screening makes a big difference in how far cancer has progressed by the time it is detected.
• Let’s get cancer screening for early detection.

Get cancer screening regularly

• Cancer cannot be diagnosed until it grows to a size of about 1 cm.
• In most cases, when cancer can be detected early (2 cm or smaller), it is completely curable.
• Early stages of cancer present few subjective symptoms.

Importance of work-ups

• Cancer screening is effective only when a detailed examination or treatment is received.

Cancer is like a traffic accident

• Though some accidents cannot be avoided, the risk would surely decrease if you paid attention!

Importance of a workplace where employees with cancer can work with peace of mind

• About one third of the people who get cancer are of working age .
• The aging workforce and the increase in the number of female employees will further increase the number of people who continue working as they get cancer treatments.

Basic knowledge of cancer treatments

• Cancer treatments do not end with the completion of surgery. Other therapies and follow-ups are required. Furthermore, patients may suddenly experience subsequent complications from surgery or the side effects of treatments.

Key points when listening to workers with cancer

• Most people who are diagnosed with cancer temporarily feel a considerable amount of stress.
• They need someone to listen to them and understand why they are depressed.
• Try listening to them carefully by using counseling techniques.