Objective: This study aimed to clarify the current practices of occupational therapy (OT) in addressing the employment aspirations of individuals with advanced or terminal cancer. Methods: A web-based questionnaire survey was administered to occupational therapists (OTs) working at designated cancer care hospitals across Japan. Data were analyzed using descriptive statistics and a qualitative descriptive approach. Results: A total of 278 OTs responded to the survey, of whom 119 (43%) had experience supporting employment in this patient population. The purposes of employment aspirations were categorized as financial reasons, social roles and responsibility to others, and self-realization or self-fulfillment. Agreed-upon goals included full-time return to work (32 cases, 27%) and part-time or reduced-hours return to work (38 cases, 32%). In addition, some goals did not lead to actual employment but reflected patients’ wishes, such as life review (7 cases, 6%) and simulated activities (7 cases, 6%). Conclusion: Employment aspirations in patients with advanced or terminal cancer are rooted in diverse psychosocial factors beyond economic motivations. OTs play a vital role in supporting these patients by respecting their wishes and helping set realistic goals that enhance quality of life.

We herein report on a case in which we conducted bypass surgery for occlusion of a left axillary artery aneurysm with ischemic symptoms 21 years after the contraction of Kawasaki disease and achieved symptomatic improvement. The case involved a 22-year-old man who had been suffering from Kawasaki disease since the age of one. He had been undergoing antiplatelet therapy for bilateral axillary artery aneurysms by orally taking aspirin for 20 years. He suffered from symptoms of upper limb ischemia 21 years after receiving a diagnosis of peripheral aneurysms and occlusion of a left axillary artery aneurysm upon 3DCTA. We conducted aneurysmotomy, plication, and bypass surgery between the axillary and brachial arteries via the autologous vein. Pathological examination revealed due to the formation of atheroma in the tunica intima and disarrangement of the layer structure in the tunica media : thickening of the tunica media was partially observed. His fatigue upon exertion of his left upper extremity remarkably improved following surgery. Although peripheral aneurysms associated with Kawasaki disease are rare, as seen in this case, peripheral arterial disease remains and progresses even after long periods of time. It is believed necessary to carry out long term follow-up and examine the approaches to therapy including surgery in accordance with the site and degree of the disease.