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Öğe Being a medical oncologist near the war area(Zerbinis Medical Publ, 2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Tonyali, Onder; Ozturk, Mehmet Akif; Abali, Huseyin; Ozyilkan, Ozgur[Abstract Not Available]Öğe 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, OzgurPurpose: 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.Öğe Gemcitabine plus Platinum Combination Chemotherapy in Patients with Metastatic Cancer who suffer from Severe and Irreversible Hepatic Impairment: A Single Center Experience(H G E Update Medical Publishing S A, 2014) Sezer, Ahmet; Sumbul, Ahmet Taner; Abali, Huseyin; Mertsoylu, Huseyin; Muallaoglu, Sadik; Kose, Fatih; Ozyilkan, OzgurThere is limited information on chemotherapeutic agent doses suitable for patients with metastatic cancer who suffer from and irreversible hepatic impairment and who could potentially benefit from chemotherapy and on their results. In this retrospective study, we aimed to share our center's experience of Gemcitabine + Platinum Combination chemotherapy in these patients. Data of 13 patients matching the criteria were analyzed. In our study the patients were treated with a dose of Gemcitabine + Platinum Combination, 50% of the original dose and the dose was increased gradually on the following days. Thirteen of one patient was given Gemcitabine & Carboplatin protocol and the others were given Gemcitabine & Cisplatin. In 42 chemotherapy cycles in total grade 3-4 thrombocytopenia occure after 7 cycles, grade 3-4 neutropenia was not observed While liver functions in 8 patients improved slightly, no change was observed in 2 patients and in 3 patients they deteriorated. Total survival period was calculate as 3.78 (95CI%: 0,17-7.54) months. As a consequence Gemcitabine + Platinum Combination chemotherapy in patients with metastatic cancer who suffer from severe and irreversible hepatic impairment can be implemented when clinical benefits are expected.Öğe Malignant pleural mesothelioma: A single-center experience in Turkey(Int Scientific Information, Inc, 2014) Sezer, Ahmet; Sumbul, Ahmet Taner; Abali, Huseyin; Mertsoylu, Huseyin; Ozyilkan, OzgurBackground: Malignant pleural mesothelioma is a rare lethal malignancy caused by asbestos exposure. It is more frequently seen in certain regions in Turkey. In this retrospective study, we aimed to analyse demographic, clinical, and pathological data and treatment-related features in 54 patients. Material/ Methods: The study included 54 patients diagnosed with malignant mesothelioma that were followed and treated. Results: Of the 54 patients, 34 (55.6%) were male. The median age in men and women were 60.3 (38.2-77.2) and 65.8 (37.7-77.5) years, respectively. In 35 (64.8%), exposure to asbestosis was present. Epithelial type was found in 27 (50.0%), followed by mixed type in 7 (13.0%) patients, and in 20 (37.0%) patients the subtype could not be determined. The disease was staged as IV in 37 (68.5%) patients. In 28 patients (51.9%), it was right-sided and in 1 (1.9%) it was bilateral. The most frequent metastatic sites (in decreasing order) were lungs, mediastinum, diaphragm, liver, and thoracal wall. Of the 54 patients, 36 (66.6%) received 1st-line chemotherapy and 20 (37%) 2nd-line chemotherapy. Eighteen patients (33.3%) received radiotherapy; 11 (20.3%) with palliative intention and 7 (12.9%) with curative intention. Median overall survival (OS) was 12.03 months (95% CI 7.2-16.8). OS was not affected by sex (p=0.32), smoking history (p=0.51), alcohol consumption (p=0.36), family history (p=0.67), pleural effusion presence (p=0.80), operation (p=0.14), clinical stage (p=0.072), symptom at presentation (p=0.66), having mixed type histology (p=0.079), asbestos exposure (p= 0.06), and type of 1st-line chemotherapy (p=0.161). On the contrary, it may be positively affected by good ECOG PS (0-1) (p<0.01), age below 65 (p=0.03), left-sided disease (p=0.01), receiving chemotherapy (p<0.01), having unilateral pleural effusion (p=0.018), and type of 2nd-line chemotherapy (p=0.025). Conclusions: OS of our patients was better than that found in the literature, seeming to be positively affected by early stages, better ECOG PS, age below 65 years, left side involvement, and having second-line chemotherapy with cisplatin- gemcitabine or 3M. Overall treatment success seems to be comparable to what is currently expected.
