Personal Views

Managing gastric cancer in Britain: a Japanese experience

BMJ 1997; 314 doi: (Published 01 February 1997) Cite this as: BMJ 1997;314:382
  1. Sano Takeshi
  1. Takeshi, Sano consultant surgeon, National Cancer Center Hospital in Tokyo

    When the endoscopist drew the scope out of her patient's stomach without taking a picture I was speechless. She was talking to the patient, “Well done, Mr Smith. Your stomach is normal.” OK, I thought to myself, but who can prove it without pictures? I whispered to the endoscopist, “If he is found to have an advanced gastric cancer 12 months from now how can you prove that his stomach looked normal today?” This question was not meant to sound malicious. I was genuinely concerned that an early gastric cancer could have been overlooked.

    Japanese surgeons have published countless papers on the early detection of gastric cancer, the high curability, the low morbidity and mortality, the high survival rates, and the benefits of radical lymphadenectomy. The data diverge so markedly from those of Western countries that many people (on both sides) can hardly believe that they are discussing the same disease.

    Several British surgeons have visited the National Cancer Center Hospital in Tokyo to convince themselves that the Japanese data are not fabricated. During one professor's three week stay he …

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