Introduction: Though the animal assisted therapy and the animal assisted activity with animal visiting are widely introduced to general hospitals in Japan, the report of those activities in palliative care units (PCU) of general hospitals are few. Methods: In June 2013 therapy dogs started to visit our PCU with the help of NHO Japan Animal Association. We discussed on the effects and the problems as a part of the palliative care about this activity. Results: Three therapists with 3 therapy dogs came to our hospital twice a month and the total number of 487 patients took part in 73 sessions until September 2016. Those activities made the patients and their families felt better and their communications with staffs were improved. No adverse effects concerning the safety and health were observed in those activities. Discussion: The reliable training and infection control of animals can make easy the introduction of animal therapy to the PCU of a general hospital. Visiting of therapy dogs can provide the healing to not only the patients and their families, but also the staffs in the PCU.

Those involved in end-of-life care need to understand the patient’s view of life and values, and support them so that they can approach the end of their lives in a way that suits them, and this requires sufficient communication. We report a deaf-mute patient who developed advanced lung cancer during treatment of chronic myeloid leukemia. The communication with him was difficult for those who did not use sigh language routinely, but through trial and error, we tried to build a good relationship through nonverbal communication as well as sign language and written communication. It was necessary to recognize and understand that deaf-mute people have different living environments and communities and have their own language and culture. These experiences can be utilized for the treatment of cancer patients in daily clinical practice, and it is considered that the attitude of the medical worker to approach the patient is necessary for mutual understanding.

POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is an extremely rare neurological disease exhibiting various symptoms. Few reports have investigated rehabilitation in this disease. The present study reported the details of rehabilitation in a 40-year-old man with POEMS syndrome. Abnormal sensation was initially observed in the distal legs, followed by deterioration of muscle strength. He was admitted to our hospital 2 months after onset and received high-dose chemotherapy with autologous peripheral blood stem cell transplantation for acute exacerbation of polyneuropathy. Electrophysiological examination revealed axonal neuropathy. Gradual improvement in muscle strength was observed after high-dose chemotherapy with autologous peripheral blood stem cell transplantation. He was able to walk with a knee-ankle-foot orthosis and crutches at the time of discharge, but he used a wheelchair for routine activities. He could ascend and descend stairs in his house with bottom shuffling. As it is difficult to predict the extent of ultimate improvement and timing of remission in this disease, it is important to devise a rehabilitation program from a long-term perspective and to aim at recovery of independence for daily living activities and social reintegration using supportive devices and compensatory methods.

POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is an extremely rare neurological disease exhibiting various symptoms. Few reports have investigated rehabilitation in this disease. The present study reported the details of rehabilitation in a 40-year-old man with POEMS syndrome. Abnormal sensation was initially observed in the distal legs, followed by deterioration of muscle strength. He was admitted to our hospital 2 months after onset and received high-dose chemotherapy with autologous peripheral blood stem cell transplantation for acute exacerbation of polyneuropathy. Electrophysiological examination revealed axonal neuropathy. Gradual improvement in muscle strength was observed after high-dose chemotherapy with autologous peripheral blood stem cell transplantation. He was able to walk with a knee-ankle-foot orthosis and crutches at the time of discharge, but he used a wheelchair for routine activities. He could ascend and descend stairs in his house with bottom shuffling. As it is difficult to predict the extent of ultimate improvement and timing of remission in this disease, it is important to devise a rehabilitation program from a long-term perspective and to aim at recovery of independence for daily living activities and social reintegration using supportive devices and compensatory methods.

Palmoplantar pustulosis is a chronic inflammatory skin disease involving the palms and soles where mild accumulation of helper T cells and neutrophils in the dermis histologically are observed. Leukoencephalopathy is a brain disease affecting white matter but is rarely accompanied by skin lesion. Here we report a unique case of leukoencephalopathy accompanied by palmoplantar pustulosis with identical pathological feature of helper T cell accumulation in both the brain and skin, suggesting a possible link in the pathogenesis.