The Japanese version of EORTC QLQ-C15-PAL has sufficient validity, acceptable reliability, and feasibility for patients with advanced cancer.

Objective: In cancer patients, adjustment disorders, delirium and depression have been identified as common psychiatric disorders. Although a comparable result was reported in the National Cancer Center in Japan, the nature of patients in that hospital may differ from that in local hospitals. There is a possibility to expand the findings of psycho-oncology by evaluation of the data from a local university hospital and comparison with the National Cancer Center data. Methods: We retrospectively reviewed the medical records of cancer patients who were referred to the Department of Psycho-Oncology at Saitama Medical University International Medical Center. We identified their characteristics and psychiatric diagnoses and compared these with the National Cancer Center data. Results: During the study period, 765 cancer patients were referred. The numbers of inpatients and outpatients were almost the same. The most common psychiatric diagnosis was adjustment disorders (24%), followed by delirium (16%) and then major depressive disorder (12%). The rank of these three was the same as that at the National Cancer Center. Outpatients constituted more than 80% of the patients with major depressive disorder. The proportion of cancer patients with schizophrenia in this study (4.3%) was higher than that in the National Cancer Center (1.6%). Conclusions: This study revealed basic information about the consultation data of cancer patients at a local university hospital in Japan. The importance of communication with outpatients was suggested. It seems that cancer treatment for patients with schizophrenia in a local hospital is also important.

Psychological distresses of the bereaved who have lost a loved one and have asked for medical counseling are revealed. Their distresses are strongly related to the cancer trajectory of a family member. Some of these distresses are related to medical misunderstanding about the course of cancer. These findings might provide basic information for considering their appropriate treatment.

Objective: The aim of this study was to identify problems experienced by psychologists involved in cancer and palliative care and consider an education system for psychologists. Methods: We conducted a questionnaire survey of psychologists involved in cancer care and palliative care. At the 403 facilities, 419 psychologists who received the questionnaire were asked to fill it out anonymously. A total of 294 people (61 male, 233 female, average age + SD ¼ 36.3 + 9.4) responded about troubles and hardships actually faced by psychologists working in cancer care. We performed qualitative content analysis of free responses. Results: We obtained the following five categories: 'Hospital system', 'Psychologist role and specialization (ambiguity of the role expected of psychologists and problems arising because psychologists are not nationally licensed)', 'Collaboration with other medical professionals (problems with the method of requesting psychologist cooperation and problems of consultation and liaison work within the hospital)', 'Specialized support provided by psychologists (difficulty of interaction with patients and their families, inadequate provision of psychological support in cancer care, problems related to death care and lack of psychiatric knowledge)', 'Stress faced by psychologists (psychologist's isolation and anxiety, psychologist's internal conflicts, psychologist burnout and helplessness and psychologist self-improvement)'. Conclusions: Psychologists must acquire at least a minimal level of medical knowledge and understanding of cancer treatment. Furthermore, they require training through specific case studies in order to facilitate collaboration with other medical professionals and concrete training in aspects of psychological support that are specifically tailored to cancer treatment through case studies.