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    Continuous distress in an Oncology Clinic in Turkey: Should we make use of the distress thermometer mandatory as a precautionary measure for physicians?
    (Zerbinis Medical Publ, 2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Abali, Huseyin; Dicel, Umut; Gultepe, Ilhami; Besen, Ali Ayberk; Ozyilkan, Ozgur
    Purpose: To study the data on the distress scale points (DSP) of patients in oncology clinics in relation to age, the reasons for admission to the hospital, the educational status and the family support. Methods: Six hundred and fifty three patients diagnosed with malignancies were enrolled. All of the patients were asked to fill in a questionnaire that included data about their demographic characteristics, diagnoses, the cause of hospital admission and the educational status. The family support of each patient was observed and noted by clinicians and other healthcare providers during the clinical visits. Results: The mean patient age was 54.8 years (+/- SD 13.7). Of the patients 314 (48.1%) were male and 339 (51.9%) female. The median DSP for the group that included patients <35 years of age was 3; this was 5 for the 36-49 age group, 4 for the 50-69 age group and 4.5 for the >70 age group. A statistically significant difference in DSP between these groups was noticed (p=0.035). The DSP for patients <35 years of age was lower than that of the other age groups. The median DSP for the patients presenting to the outpatient clinic for adjuvant therapy was 5; this was 5 for patients presenting for palliative therapy, and 3 in the active surveillance group, and a statistically significant relationship was determined between the DSP and the reason for admission to the outpatient clinic (p<0.001). The patients that had presented to the outpatient clinic for active surveillance had statistically significantly lower DSP compared to the other groups (p<0.05). Conclusions: Distress in oncology clinics seems to be continuous; thus, the use of distress thermometer as a precautionary measure for distress development in patients with malignancies should be mandatory to help medical oncologists understand the psychosocial needs of their patients and start to treat them as a human beings.
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    Öğe
    Neutrophil-to-lymphocyte ratio predicts PSA response, but not outcomes in patients with castration-resistant prostate cancer treated with docetaxel
    (Springer, 2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Abali, Huseyin; Kose, Fatih; Gultepe, Ilhami; Mertsoylu, Huseyin; Muallaoglu, Sadik
    The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammatory response and evidences for the relationship between NLR and the response to treatment gradually increases in cancer patients. In this study, we aimed to investigate the effect of the pretreatment NLR and other factors related to the patient on predicting the outcome of docetaxel + prednisone chemotherapy in prostate cancer patients who become castration resistant. Thirty-three metastatic castration-resistant prostate cancer patients those who were treated between 2009 and 2013 were included in our study. All data of the patients, including pathological, clinical, radiological, biochemical and hematological data, were assessed retrospectively using our database system. The median progression-free survival (PFS) was determined as 23.9 months (range 0.36-118.7) with androgen suppression therapy and 9.5 months (range 1.7-39.4) with docetaxel + prednisone therapy. NLR was found to be correlated with only posttreatment psa levels. In the NLR a parts per thousand currency sign3 group, the PSA levels were statistically significantly lower than the other group (r = 0.002). Furthermore, the relationships between the clinical response and PFS and the other pretreatment parameters of the patients were evaluated in order to predict which group would respond better to docetaxel + prednisone therapy after becoming androgen resistant. No relationship was found between any of the parameters and the response to therapy. Although NLR was found effective in predicting the PSA response in docetaxel + prednisone therapy, neither NLR nor any other clinical parameter was found effective in predicting the outcome and the role of NLR in the future of CRPC is questionable.