Introduction: SEIQoL-DW is a method of measuring the subjective QOL of each patient by focusing on five areas considered important by the patient in a semi-structured counseling session. The objective of this study was to longitudinally evaluate the shift in areas considered important by advanced-cancer patients along with the shift in the subjective QOL. Methods: Patients who underwent SEIQoL-DW at the time of palliative care visit (first session) and after palliative care hospitalization (second session) within 1 year, in addition to also meeting the inclusion criteria such as a pain level of STAS 1 or lower, were included as the study subjects.Results: A total of 5 cases (mean age of 67.6 years among 1 male case and 4 female cases) were included. The P.S. was 1 for all cases at the first session, among which 3 cases were undergoing chemotherapy. At the second session, the P.S. was 3 or 4 for all cases. The mean time between the two sessions was 164 days. In all cases, 3 or more of the 5 important areas changed at the time of the second session. The SEIQoL-index, which is a comprehensive subjective QOL, improved in 3 cases but decreased in the other 2 cases. Conclusion: The areas considered important by terminal phase patients widely change. The shift in subjective QOL of each patient does not necessarily correspond to the decrease in the P.S. level.

Introduction: SEIQoL-DW is a method of measuring the subjective QOL by focusing on five areas considered important by the patient in a semi-structured counseling session. The objective of this study was to evaluate areas considered important by patients undergoing anti-cancer therapy and the subjective QOL. Methods: SEIQoL-DW was carried out consecutively on patients who met the inclusion criteria such as pain STAS-J 1 or lower at palliative care outpatient service. Results: The study was implemented on 68 subjects (35 anti-cancer therapy patients, and 33 palliative care patients). Commonly selected areas by anti-cancer therapy patients were “family” at 94%, “cancer treatment” at 69%, “health” at 43%, “friends” at 43%, “hobbies” at 40%. The mean subjective QOL of anti-cancer therapy patients was significantly lower than that of palliative care patients (61.5 vs 74.4). Conclusion: The area “family” makes great impact on the QOL. On the other hand, putting high importance on “cancer treatment” may have a negative impact on the QOL.

Introduction: Although spiritual care is one of the challenges of palliative care, structured interventions are limited. We report on the original development of the Dignity Individual Music Therapy Program (DMT) incorporating the elements of Dignity Therapy (DT) for spiritual care. Program: Developed by a research group including a music therapist based on the experience of DT. Procedure: First, the patient selects important songs based on questions such as "When did you live the most in your life? Are there any songs that remind you of those days?" Next, a music therapist plays the music on a piano in a hospital room (individual concert). Encourage the patient to talk freely about their thoughts and life episodes after the performance. Discussion: Patients who have performed DMT have been very well received. Because it is a structured program, it can be implemented in various places. The utility and feasibility of spiritual care will be investigated.

Introduction: Carotid sinus syndrome is rarely associated with head and neck malignant cancer. We usually have no effective treatment for carotid sinus syndrome in terminal stage of cancer. We experienced a case in which continuous explanation of his condition and lifestyle guidance resulted in alleviation of syncope attacks. Case: A 73-year-old male who was diagnosed with oropharyngeal cancer and with multiple lymph node metastases in the neck. Dizziness and syncope attacks occurred to him due to carotid sinus syndrome. He was referred to the outpatient department of palliative medicine, then he and his wife received explanation of his condition and lifestyle guidance of avoiding triggers and of how to avoid syncope attacks at the onset of prodomal symptoms. The frequency of attacks decreased and he resumed his daily walk. However, attacks without triggers began to occur to him seven months after the intervention started. Although he continued to stay at home, he was hospitalized due to difficulty in body movement and died the next day. Discussion: Explanation of his condition and lifestyle guidance were useful for management of syncope attacks because the syncope attacks had triggers and prodomal symptoms. The interventions including lifestyle guidance improved his quality of life and let him stay at home.