Terminal illness and cancer in Japan

This morning, I got some very bad news from my mother. One of my uncles has advanced pancreatic cancer (膵臓癌　すいぞうがん　suizou-gan), and the whole family was called to the hospital so that the doctors could brief them on his condition.

This may not seem so unusual to you, but it is a fairly new development in Japanese society. Until about 20 years or even 10 years ago, the norm was for doctors to not tell the patient, and sometimes not even the patient's family, about a terminal illness or an illness that has some kind of stigma attached to it, such as AIDS or other sexually transmitted disease. Cancer especially was considered to be an illness that should be hidden. The reasoning behind this was that telling a patient that he or she had such a grave illness would be detrimental to the patient's wellbeing. Ignorance is bliss, as they say. It also reflects the doctor-patient relationship as it used to be, where the doctor told the patient what to do, and was an authority figure. Even now, a doctor is addressed in the same way, [last name]-sensei, as a teacher or other figure to be held in esteem is, and a medical doctor is talked about as an お医者さん　(おいしゃさん　o-isha-san), with the honorific o.

This has, as I've already mentioned, been changing in recent times. Now patients have way more 'rights' in the Western cultural sense, and demand more information. A patient is told right away about any illness that was detected. And more people are likely to bring on malpractice suits if they are unhappy with the care they received. However in some areas of the country (especially away from the big cities) the custom of withholding information from the patient still persists. (See this study for example.) If you're a non-Japanese person living in Japan, you may run into some problems getting information out of your doctor. This isn't necessarily (or should I say, not just) because you're a gaijin or even a problem of language; it's just the way things have been for a long time.

Some medical vocabulary:

• Cancer - 癌　がん　gan
• Illness - 病気　びょうき　byouki
• Terminal or advanced/late stages of illness - 病気の末期症状　びょうきのまっきしょうじょう　byouki no makki shoujou. Terminal illness is 末期症状の病気　まっきしょうじょうのびょうき　makki shoujou no byouki.
• Medical doctor - 医師　いし　ishi or 医者　いしゃ　isha. In conversation, お医者さん おいしゃさん　o-isha-san
• Hospital - 病院　びょういん　byouin (sounds very like bi-you-in 美容院　びよういん　which is a hair salon, so be careful!)
• Ambulance - 救急車　きゅうきゅうしゃ　kyuukyuusha

Comments

[kim]

Hi Maki, I'm sorry to hear about your uncle. I'm wishing your family a lot of strength.
I didn't know that (until recently) doctors hid the condition from their patients. I saw the movie "Kirschbluten" the other day where the doctor and wife concealed the fact that the husband had cancer as well, I thought that was a bit strange too - and the doctor and couple are from Bavaria.

[Andrew J]

My father-in-law passed away from cancer 9 years ago yet was never told the exact nature of his illness. At the time, there was much discussion as to whether this was the right thing to do or not but ultimately he wasn't told - at that stage the cancer was quite advanced. Several years before that I remember watching the Itami Juzo movie 'Daibyounin' and thinking what a strange thing that you wouldn't tell the patient.

All the best for your uncle and family

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