Sachiyo Nakatsuka is determined to overhaul the rules to allow members of Tokyo's Setagaya Ward assembly to take a leave to receive medical treatment, raise a child or look after relatives.

Nakatsuka, 44, a cancer survivor re-elected to the assembly in April, became keenly aware of the need for the overhaul after she was castigated for missing assembly sessions in fliers before the election campaign.

“Who are the useless assembly members who neglected their public duty and preyed on taxpayer money?” the flier blared, along with other criticisms. It put her at the top of all 50 assembly members in their number of absences from assembly sessions in the Tokyo ward.

Nakatsuka had to miss most of the sessions from November to December in 2015 to receive treatment for advanced-stage cervical cancer and to recuperate.

The flier, which called itself a “report card” of the assembly members and was distributed in March, listed Nakatsuka as being absent for 10 days. It also showed the rankings of assembly members by the number of questions they posed during the sessions.

The impact of the literature was significant.

Nakatsuka, who was facing re-election for a third time as a member of the Constitutional Democratic Party of Japan, said many voters criticized her during the election campaign between April 14 and April 20.

“You are the most truant from work,” one voter said.

Nakatsuka said voters may think that politicians are taking advantage of taxpayers because they will be fully remunerated even if they do not attend sessions.

Nakatsuka said she juggled her visits to a hospital for radiation therapy and activities as an assemblywoman. But she did not disclose her situation to the public.

She later learned that two other colleagues in the top four absentees on the list were absent from assembly meetings for similar reasons.

She decided to release a flier stating her accountability and declaring her resolve to lay out a system supporting patients to continue working and performing their domestic duties by drawing on her own battle with cancer.

Subsequently, some voters on the street approached her to offer their encouragement and tell her that they, too, were cancer survivors.

The experiences made her realize that having cancer is not uncommon and that patients need assistance so that they can continue working while undergoing treatment.

In the April 21 ward assembly election, Nakatsuka won re-election with 7,140 votes, more than the number she received in the three previous elections.

“I want to begin with reforming the ward assembly so that a system in which assembly members can take a leave for illness, child rearing and nursing care will be set up,” she said.

Nakatsuka envisages a changing of assembly rules to include those personal circumstances as reasons for being absent from assembly meetings.

Nakatsuka also plans to call for a discussion on the size of a pay cut associated with taking such a leave.

Experts say it will help address a slew of social issues if a local assembly is represented by members with diverse backgrounds.

On a national level, Takashi Yamamoto, an Upper House lawmaker and a cancer patient, was instrumental in enacting the law in 2006 aimed at raising the quality of cancer therapies and spreading the concept of informed consent among patients.

“We need to build a society in which we don’t have to feel guilty about taking days off for medical treatments and nursing care,” she said. “Providing support to allow people to do both will have an increasing urgency in the coming years.”