Why We Need “Preventive Healthcare” and “Consulting Physicians” as Specific Measures for the Era of the 100-Year Life

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[Publisher] ORIX Group

Japan is a super-aged society. In this time of increased average life expectancy, also referred to as the “Era of the 100-year life,” staying healthy for a long time and being able to lead an independent life are becoming major issues for everyone. To eliminate the gap between the average life expectancy and healthy life expectancy, it will be essential to have healthcare structures with new approaches, such as early treatment when abnormalities are found and early detection, rather than the conventional medical treatment after illness becomes apparent.

Meanwhile, efforts are being made toward early detection and treatment of cancer, which causes around 30% of deaths in modern Japanese society. Dr. Toshihiko Sato is the founder of Utsunomiya Central Clinic, a specialist cancer treatment clinic which works to provide healthcare that responds to the changing times, including the introduction of the latest equipment. We asked Dr. Sato for his opinions on the future form of healthcare based on early treatment when abnormalities are found and preventive healthcare and new relationships between people and healthcare, and what matters we should be aware of. We also spoke with Takanori Sekine, General Manager of the Domestic Business Promotion Department at ORIX, who agrees with Dr. Sato’s ideas and is supporting the operation of Utsunomiya Central Clinic, creating systems that allow doctors to focus on healthcare.

Delivering early detection and early treatment to as many people as possible

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――In the super-aged society that Japan has reached where 1 in 4 people are aged 65 years or older, we have a lot of issues, including increasing social insurance costs and shortage of medical personnel. What are your views on this situation?

Dr. Sato: Healthcare reform will be needed for the next generation. I also think that how to extend healthy life expectancy will be at the center of the discussions about those changes. In future, healthcare from the perspective of early treatment when abnormalities are found and prevention will become even more important. As a healthcare provider, I feel that we have a duty to build a health management system that enables people to avoid going to hospital in the first place and to live their life without insecurity.

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Exterior view of Utsunomiya Central Clinic

――Utsunomiya Central Clinic is highly trusted as a specialist clinic for cancer testing and cancer treatment. What sorts of areas are you working on?

Dr. Sato: The formal name of the clinic is DIC Utsunomiya Central Clinic Medical Corporation. DIC is an abbreviation for Diagnostic Imaging Center. We commenced business in 1997 as a clinic aimed at early detection of cancer through diagnostic imaging.

Actually, I myself have experienced getting cancer in the past and overcoming it. At that time, I saw firsthand the importance of early detection and early treatment. The later the cancer is detected, the harder it is to treat it. Early detection is essential for effective treatment. We need to conduct tests to find cancer at the Stage I level when the patient has no symptoms. However, it is still not common for people to have checkups before they are aware of symptoms.

Therefore, while continuing with the goal of educating people about these matters, since the clinic was opened we have introduced state-of-the-art diagnostic imaging equipment to provide early detection and appropriate treatment through the latest technology. We have also repeatedly updated our cancer testing and cancer treatments.

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Importance of early detection of cancer
It is said that it takes around 10 to 20 years after occurrence for a cancer to grow to the size of 1 cm (there are individual differences) and, in general, when the tissue enlarges to more than 2 to 3 cm, a complete cure becomes difficult. It is possible to detect cancers of 1 cm using PET/CT screening, but when relying on conventional screening such as group health checkups, the detection rate is low. (Source: Central Medical Club website)

In 2003, PET* scans that can detect cancer in the whole of the body at once were introduced, and the first PET center in Tochigi prefecture was established. Also, the Breast Center, a specialist facility for testing for cancers specific to women such as breast and cervical cancer, was opened in 2013. Breast cancer is the most common cancer that women can get. It is contracted by 1 in 11 women but around 90% of cases are completely cured if detected early. I want more people to be aware of these facts so I established a health screening center and breast outpatient clinic exclusively for women as an environment for making it easy for women to visit a medical center.

* PET: Abbreviation for Positron Emission Tomography. It is a test in which a radioactive drug is administered into the body and analysis of the result is captured and imaged by a special camera.

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【Left】Breast Center 【Right】Radiotherapy Center

Innovations at the forefront of cancer treatment

――I understand that you have repeatedly updated your cancer testing and treatments. Whenever we think of cancer treatment, we have an image of surgery, but what are some of the latest treatments available today, such as focused radiotherapy?

Dr. Sato: Currently, CyberKnife and TomoTherapy are the two latest types of equipment introduced in the clinic. Radiotherapy is treatment that kills cancer cells through radiation from outside the body, but there has been the problem of the radiation damaging normal cells as well. That problem is solved by these two devices. CyberKnife is effective for early stage cancer that is limited mainly to the affected area, and TomoTherapy is effective for advanced cancer with metastasis. By using these two devices in different ways, we’re trying to deal with most cancers.

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【Left】CyberKnife 【Right】TomoTherapy

Also, an approach that is gaining a lot of attention recently is combining radiotherapy with the human body’s innate immune system. A leaflet of the Japanese Society for Radiation Oncology says that “Radiation cleaves the cancer genes. The immune cells will also be able to attack the cancer more easily.”

In other words, through DNA cleavage of the cancer cells by radiation exposure, it will become easier for the immune cells to attack the cancer and for the person’s innate immune system to exert its therapeutic effects. This is an eye opener. Based on this concept, my motivation to improve my expertise in radiotherapy so that I can provide effective treatment has increased.

As I said before, the latest radiotherapy can be expected to have a high therapeutic effect while reducing the burden on the body more than before. It also has the major advantage that we are able to treat patients regardless of their age. This is a very effective method in Japan, where the population is expected to age further in the future. I want patients to choose the best treatment method for their own condition.

How do you decide on the best treatment for yourself?

――In short, there are a variety of choices available for cancer treatment, aren’t there? People who receive treatment also need to have the latest correct knowledge.

Dr. Sato: As medical technology is evolving at an ever-increasing pace, I believe that cancer is no longer a disease to be feared. It is very important to know the correct medical knowledge which is updated daily.

However, through my own experience of being affected by cancer, there was one more thing I noticed in addition to the importance of early detection and early treatment. That was that I didn’t know which treatment method at which hospital would be best for me. Accurately understanding your own medical condition and choosing the best treatment requires considerable knowledge on the part of the person being treated. Doctors specialize in their respective fields of expertise, but there seems to be no-one who can make the total decision for the patient. That makes it very difficult for the patient to receive optimal healthcare.

This led me to understanding the need for a kind of “consulting physician” who will convey the correct information that only a doctor can understand while always accurately assessing the patient’s condition. From there, I began to consider whether it would be possible to create a structure that would allow such physicians to record and manage each patient’s health status and give advice based on a comprehensive assessment of the patient’s condition.

――I see. So it involves building a relationship with healthcare before the patient’s disease appears.

Dr. Sato: In those circumstances, I launched a membership system-based medical club called the “Central Medical Club.” Under the concept of “Live to be 100 years old in good health,” it is aimed at constantly delivering peace of mind to patients. Currently, we have around 800 members throughout Japan. In addition to receiving a thorough examination in our clinic, including for the three major lifestyle-related diseases, daily health consultations are also available online, with a specialist reviewing the patient’s medical records.

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Reception office of Central Medical Club, which has a bright and calm atmosphere.

――Having a consulting physician who always understands your health condition is reassuring in the era of the 100-year life. What are your future plans?

Dr. Sato: I think that initially we need to develop an online-based structure. The first step is to do online diagnostic imaging, and if tests are necessary, the patient will make an appointment via the Internet and then go to the medical center. Based on the results of the tests, their treatment plan will also be reviewed online with their doctor. Unless the patient really needs to go to medical center for tests, surgery or other reasons, everything will be handled online. In accordance with this structure, we are aiming to create a form of organization in which the Diagnostic Imaging Center and the Medical Club function as a network in each part of the process.

With the support of ORIX, we want to expand that network to other major cities, including Tokyo. Using the most advanced technology, we aim to be able to provide early detection and early treatment to patients throughout Japan.

Creating an environment where doctors can focus on healthcare

ORIX has developed a variety of businesses in the medical field to date, including leasing and financing for medical corporations and a CT/MRI-equipped vehicles rental service.

Meanwhile, ORIX shares the ideas of Dr. Sato, who works to provide early detection of cancer using state-of-the-art equipment, and it concluded a capital tie-up in 2017 with CMC Corporation, which provides business support services to Utsunomiya Central Clinic.

Takamori Sekine, who is the head of the ORIX Domestic Business Promotion Department, says, in relation to the involvement of ORIX in the medical field in the form of providing support: “We want to contribute to solving social issues through development of community healthcare.”

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――What sorts of support do ORIX and CMC Corporation provide to Utsunomiya Central Clinic?

Mr. Sekine: We create systems that allow Dr. Sato and others at Utsunomiya Central Clinic to concentrate on healthcare. Specifically, we provide support in areas including dispatching staff from ORIX to CMC Corporation, formulating business plans, preparing various types of information, establishing internal regulations for the clinic, creating a structure for coordinating medical examinations, and membership recruitment and operations management for the Medical Club.

――What are your future plans for development of community healthcare?

Mr. Sekine: As Dr. Sato mentioned, a major goal is to enhance the medical network. If doing so makes preventive medicine more accessible to people, it should naturally increase the rate of people receiving tests. This can lead to early diagnosis of illness and also contribute to extending healthy life expectancy. As a result, healthcare costs will be reduced. The project has only just begun but we will do our best to contribute to maintaining social security and development of community healthcare.

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―Dr. Sato and Mr Sekine, thank you very much for our discussion today.

[Interviewer]

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Yoshiaki Aizawa
Born in Akita Prefecture in 1983. After graduating from university and working part-time at a used bookstore and publishing company, joined DECO in 2009, an editing production company in Jimbocho, Tokyo. Edited and produced magazines, books, corporate pamphlets and website articles. Working as a freelance editor and writer since 2018.

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