Interview with Tomoki Maeda, Who Supported Hiroko Yamashita’s Cancer Battle: The Key to Family and Team Support
What is LA Butterfly?
LA Butterfly is a platform originating from Los Angeles that shares stories of cancer survivors who found their “true selves” and gained strength through their journeys. Inspired by the imagery of a chrysalis transforming into a butterfly, it compiles their words and lessons to spread hope and courage.
Introduction
Hiroko Yamashita, known for appearing in an Aflac commercial, was diagnosed with liver cancer at 19 and given six months to live. Despite this, she carved out a vibrant life through marriage and new challenges. Her husband, Tomoki Maeda, leveraged his extensive experience as an investor, politician, strategist, and entrepreneur to provide strategic support. Collaborating with friends and family, he took a big-picture approach to guide her through her battle.
This page, based on an interview with Maeda, explores Hiroko’s life and the strategic support system that sustained her, emphasizing the importance of calm, forward-thinking decision-making. While emotional support came from her mother and friends, Maeda’s objective perspective contributed to long-term success in her fight.
About Hiroko Yamashita
- Fall 2012 (Age 19): Diagnosed with liver cancer as a college freshman, given six months to live.
- 2012: Surgery temporarily eliminated the cancer.
- 2013: Met Tomoki Maeda. Cancer recurred in her lungs and liver, requiring resection.
- 2014: Featured in media and tried paragliding.
- 2015: Appeared in the Nippon TV program Cancer Gift: Is Cancer a Misfortune?
- 2016: Starred in an Aflac commercial.
- 2017: Married Tomoki Maeda and held a wedding ceremony.
- March 25, 2018: Passed away at age 25.
About Tomoki Maeda
Tomoki Maeda, Hiroko’s husband, is an investor, politician, strategist, and entrepreneur. During her cancer battle, he maintained 99% of their daily life as “normal,” while strategically researching clinical trials and treatment options, acting as a “commander” with a broad perspective. Comparable to the calm leadership of Japan’s soccer captain Makoto Hasebe, Maeda focused on strategic planning and coordinated support efforts.
In 2014, while battling illness, Hiroko Yamashita tries paragliding in Turkey:
Role Division: Cancer as a Small Part of Life
How was the division of roles during the 5–6 years of Hiroko’s cancer battle?
“Well, we didn’t live together full-time. For about two years, including before and after our marriage, Hiroko split her time roughly 50-50 between my place and her parents’ home. Her mother handled most of the daily hospital visits. After we got married, when she needed to go to places like Kinki University Hospital, about an hour and a half away, I’d drive her there. When schedules aligned, I’d join for doctor consultations to discuss her condition.”
Keywords: Role division, mother’s support, prioritizing daily life.
So, her mother handled most hospital visits?
“Yes, probably about 70–80% of the time, it was her mother.”
Keywords: Mother’s role, hospital visit support.
What did you consciously focus on in this division of roles?
“It’s like soccer. Kids all chase the ball, but in a team, the goalkeeper, forwards, and coach each have specific roles. In patient support, many people can offer empathy and listening, but few can stay calm, control emotional fluctuations, and decide on next steps. That’s my strength, so I consciously took on that strategic role.”
Keywords: Soccer-like role division, big-picture perspective, calm decision-making, commander role.
Visible Actions: Minimizing Stress
What tangible support did you provide after marriage?
“Hiro was almost always full of energy. There were rare moments—maybe 2% of the time—when side effects led to hospitalization or we had to call an ambulance for severe coughing. But mostly, she was a vibrant woman, just like me. I don’t think our specific care would necessarily apply to others.”
Keywords: Living normally, stress minimization, energetic couple.
In an Asahi Shimbun interview, you mentioned “thinking about cancer only 0.1% of the time and living normally.” Was that the case?
“Yes, exactly. We focused on things like shopping and everyday activities.”
Keywords: Enjoying daily life, not focusing on cancer.
What specific support did you provide as her condition progressed?
“There were tough moments, like severe pain from coughing, but those lasted days or weeks. Medication often helped. Tumor markers sometimes spiked dramatically—normal is under 10, but hers hit 20,000, 50,000, or even 100,000—which was mentally tough. But physically, she was rarely limited. Side effects like skin itching or rashes from chemotherapy were temporary, lasting a week or two.”
Keywords: Temporary side effects, maintaining daily life, mental care.
Did you take any behind-the-scenes actions, like researching clinical trials?
“Clinical trials were the main focus. When standard treatments in Japan ran out and palliative care was suggested, I researched Phase 3 trials, which are nearly approved and have a 33–50% chance of success. Hiroko had doctors and medical students in her circle who shared information about new treatments. I’d analyze these options with her, using my experience with due diligence in biotech startups to assess trial processes and approval likelihoods. In her case, around 2014, she was treated with sorafenib. After the options for standard treatment ran out, she participated in clinical trials for lenvatinib and nivolumab.”
Keywords: Clinical trial research, treatment possibilities, strategic approach, Nivolumab, Keytruda.
Supplementary Notes for Readers
- Aflac Commercial: Aflac is a major insurance company in Japan, and its commercials often feature inspiring personal stories, like Hiroko’s, to promote their cancer insurance products.
- Kinki University Hospital: A leading medical facility in Osaka, Japan, known for advanced cancer treatment and research.
- Tumor Markers: Substances in the blood or bodily fluids that increase with cancer activity, used to monitor disease progression. Examples include AFP (linked to liver cancer) and CEA (linked to digestive cancers). Spikes don’t always confirm cancer progression, as inflammation or other conditions can also elevate levels.
- Sorafenib: A targeted therapy drug used primarily to treat advanced liver cancer (hepatocellular carcinoma) and kidney cancer. Approved in Japan in 2009, it works by inhibiting tumor growth and blood vessel formation, helping to slow disease progression in patients with limited treatment options.
- Lenvatinib: A multi-kinase inhibitor used for unresectable hepatocellular carcinoma (liver cancer) and other cancers like thyroid cancer. Approved in Japan in 2017 for liver cancer, it became a standard option after earlier treatments failed, often explored in clinical trials for advanced cases.
- Nivolumab: An immune checkpoint inhibitor that boosts the body’s immune response against cancer cells. Approved in Japan in 2014 for melanoma and expanded to liver cancer in 2017, it was commonly tested in clinical trials, especially when standard therapies were no longer effective.
- Phase 3 Clinical Trials: The final stage of drug development, involving large-scale testing to confirm safety and efficacy, often compared to standard treatments or placebos. Approval rates are estimated at 33–50%.
- Japanese Healthcare Context: Japan’s universal healthcare system covers most standard treatments, but access to experimental treatments like clinical trials can be limited, requiring proactive research by patients or families.
- Makoto Hasebe: A well-known Japanese soccer player, admired for his calm and strategic leadership as captain of the national team.
Other Links
- [Tomoki Maeda Interview (Japanese)]
- [Tomoki Maeda Interview (French)]
- [Surviving Stage 4: Interview with Manga Artist Tamifuru/Mifuru Shirato]
Maeda’s Mindset: Controlling Emotional Swings
How did you feel during test results or symptom flare-ups?
“I was always prepared. We called ambulances several times for symptoms, and I’d get nervous a couple of days before test results. I had to think about how to react—my expressions, my response—especially if the news was bad. The worst was when great results led to celebration, only to be crushed by bad news later. That emotional rollercoaster damages the patient most, so I tried to stay calm, avoiding extremes in good or bad times to minimize those swings.”
Keywords: Emotional swing control, mental management.
How did you handle bad results?
“For bad times, listening and empathizing—saying ‘that’s tough’—was done by her parents or friends. Many people can offer that comfort, but few can stay calm and decide on next steps. I consciously filled that gap, focusing on strategic decisions.”
Keywords: Calm decision-making, next steps, role division.
How did you manage your own stress? “We sought ‘non-ordinary’ experiences, like travel. Meeting new people, exploring different perspectives, or encouraging Hiro to give talks or appear in media helped her stay positive. Instead of dwelling on cancer in a fixed routine, new experiences sparked hope and excitement, countering negative thoughts about her condition.”
Keywords: Non-ordinary experiences, positive thinking, new experiences.
Advice: Calm Judgment and Maintaining Hope
What advice would you give to families supporting a cancer patient?
“If you’re the closest supporter, act like a coach. Many people can provide emotional support, but few can strategize next steps. I filled that gap by researching treatments and encouraging a positive life. Doctors may not know about advanced treatments, like particle beam therapy at places like the Hyogo Ion Beam Medical Center. Patients may hesitate to seek second opinions or new treatments due to emotional or psychological barriers, so supporters should proactively research options. Cancer patient support centers and counselors are also valuable resources. Building a team with complementary roles is key.”
Keywords: Coach-like role, new treatments, second opinions, cancer patient support centers.
Supplementary Notes for Readers
- Hyogo Ion Beam Medical Center: A specialized facility in Hyogo, Japan, offering particle beam therapy, an advanced form of radiation targeting tumors with precision. Such treatments are often not widely known, even among doctors.
- Cancer Patient Support Centers: Common in large Japanese hospitals, these centers provide counseling, treatment information, and emotional support for patients and families.
What was most important as a supporter?
“Mental management is critical. The placebo effect—where believing in a treatment can positively impact the body—is real. Instead of focusing solely on cancer, we prioritized a fun, fulfilling life. This not only improved her quality of life (QOL) but also helped her respond to the disease more positively.”
Comment: Maeda’s reference to the placebo effect highlights how Hiroko’s positive outlook may have bolstered her resilience. Mental management and QOL were central to her battle.
Keywords: Enjoyable daily life, QOL improvement, mental support, placebo effect.
How did you encourage her during tough times?
“When bad results or side effects hit, I’d just listen and let her express her emotions. Once she calmed down, I’d step in to discuss next steps—treatment options or how to spend her time. Finding the right words is tricky; there’s no universal solution, as reactions vary by person and moment.”
Keywords: Listening, emotional acceptance, next steps.
Editor’s Reflections and Lessons
In 2018, while visiting Osaka for business, I vividly remember learning of Hiroko Yamashita’s passing through Yahoo News while waiting for lunch with a business partner, a Ritsumeikan University alumnus familiar with Hiroko, a fellow alum. We shared our shock. That year, Tomoki Maeda kindly arranged for me to pay my respects to Hiroko, for which I’m grateful. At the time, I was exploring an online service to support cancer patients through collaborative care, and this interview reinforced those lessons.
Maeda was truly the “commander” of Hiroko’s support team. Meeting by chance during her treatment break, Hiroko was fortunate to have his support for five years. His book mentions maintaining a “poker face,” which aligns with Hiroko’s vibrant media presence and her declaration of “no longer being the good girl.” His humorous remark about being seen as “cold” stood out.
The biggest lesson was his stress-relief approach: using non-ordinary experiences to “overwrite” cancer-related anxiety, evident in their many international trips. Maeda’s strategic role, rooted in his diverse experience, balanced emotion and strategy, teaching the value of complementary support roles. His advice to rely on others for emotional listening felt profoundly insightful. Hiroko was supported by her mother, and many friends.
Maeda also highlighted the need for supporter mental care, addressing burnout among caregivers and the importance of maintaining positivity. Thank you, Tomoki Maeda.
Maeda’s Team Support Steps (Advanced)
- Clarify Roles: Assign roles (e.g., hospital visits, research, emotional care) to reduce the patient’s burden. Example: Mother handled visits; Maeda focused on strategy.
- Prioritize QOL: Keep cancer to 2% of life, focusing 98% on normal activities like shopping or travel.
- Control Emotional Swings: Stay calm during good and bad times to minimize mental strain on the patient.
- Research Treatments: Investigate clinical trials (e.g., Phase 3) and second opinions to identify viable options.
- Encourage Positivity: Promote non-ordinary experiences (travel, new connections) to leverage the placebo effect and maintain hope.
- Plan Strategically: After emotional support, propose next steps for treatment and life priorities.
- Use External Resources: Leverage cancer patient support centers and specialized facilities like particle beam centers, while prioritizing supporter mental health.
Supplementary Notes for International Readers
- Japanese Cultural Context: Japan values group harmony and interdependence, which is reflected in the team-based support system Maeda describes, where family and friends share responsibilities.
- Ritsumeikan University: A prestigious private university in Japan, where both Hiroko and the editor’s business partner studied, fostering a sense of community.
- Burnout Among Caregivers: A universal issue, but in Japan, the cultural emphasis on duty can intensify caregiver stress, making Maeda’s focus on mental care particularly relevant.