Kanser Hastalarının Hastalıkları ile İlgili Bilgi Düzeyleri ve Onkologlarından Beklentileri

AIM: Cancer is the second most common cause of death in our country like it is in the rest of the world. the purpose of this study is to determine the expectations of cancer patients from the oncologists who undertake their treatment process and the behavior manners that oncologists should use in the relationships they will establish with their patients. METHODS: Patients from 5 different cancer treatment centers in different regions of our country were included in this study. A survey, prepared by researchers, consisting of questions about the socio-demographic characteristics of patients, their behaviors when they were faced with the disease and their expectations from doctors, was made. RESULTS: A total of 220 patients, 103 (47.2%) of whom were female, 117 of whom (52.8%) were male, was included in the study. Fifty-one point eight percent of the patients had a little bit of knowledge about their disease, whereas the ratio of the ones with satisfactory information was 39%. Seventy-two point five percent of the patients indicated they wanted to know their diseases completely, 25.7% of them noted that the physician should have decide on how much information they should know and 1.8% of them told that the disease should not be explained at all. CONCLUSIONS: A good patient-physician relation improves the patient satisfaction and accordingly the adaptation to the treatment. As a result, improving patient orientation will contribute to better treatment results and lower treatment costs.AMAÇ: Kanser tüm dünyada olduğu gibi ülkemizde de ölüm nedenleri arasında kardiyovasküler nedenlerden sonra ikinci sıklıkta görülmektedir. Bu çalışmanın amacı; kanser hastalarının hastalıkları ile ilgili bilgi düzeyleri ve ne kadar bilmek istediklerini, tedavilerini üstlenen onkologlardan beklentilerinin neler olduğunu belirlemektir. YÖNTEM: Bu çalışmaya ülkemizin farklı bölgelerinde kanser tedavisi uygulanan 5 farklı merkezden hastalar alındı. Araştırmacılar tarafından hazırlanan, hastaların sosyodemografik özelliklerini, hastalık ile karşılaştıklarındaki davranışlarını ve doktorlar ile ilgili beklentilerine yönelik soruları içeren soru formu uygulandı. BULGULAR: Çalışmaya 103’ü (%47,2) kadın, 117’i (%52,8) erkek toplam 220 hasta alındı. Hastaların %51,8’i hastalığı hakkında biraz bilgiye sahipken, tatmin edici derecede bilgiye sahip olanların oranı %39 idi. Hastaların %72,5’i hastalığı tamamen bilmek istediğini, %25,7’si ise ne kadar bilgi verilmesi gerektiğine doktorun karar vermesi gerektiğini, %1,8'i hastalığın hiç anlatılmaması gerektiğini belirtti. SONUÇ: İyi bir hasta-doktor iletişimi; hasta memnuniyetinin ve dolayısıyla tedaviye uyumunun artmasını sağlar. Sonuç olarak hastanın hastalarının hastalıkları ile ilgili bilgi düzeyleri ve onkologlarından beklentilerinin bilinmesi, daha iyi tedavi sonuçlarının elde edilmesine ve tedavi maliyetlerinin azalmasına da katkıda bulunabilir

Merkel cell carcinoma in Turkey: A multicentric study

Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin. In this study, we aimed to evaluate the clinicopathologic characteristics, treatment outcomes, and survival of MCC cases in Turkey. Materials and methods: The patients diagnosed with MCC between 1999 and 2018 at twenty different centers in Turkey were included in the study. Patient and tumor characteristics and adjuvant and metastatis treatment outcomes were analyzed retrospectively. Results: The median age of totally 89 patients was 70 (26-93). The most common primary location was lower limbs (n = 29, 32.5%). Immunohistochemically, CK20 positivity was present in 59 patients (66.3%). Only two patients had secondary malignancy. The majority of the patients (n = 76, 85.4%) were diagnosed at the localized stage. Surgery was performed for all patients in the early stage, and adjuvant radiotherapy or/and chemotherapy was applied to 52.6% (n = 40) of nonmetastatic patients. The median follow-up was 29 months. Recurrence developed in 21 (27.6%) of the 76 patients who presented with local or regional disease. Two-year disease-free survival (DFS) was 68.1% and 5-year DFS was 62.0% for localized stage. The 5-year DFS was similar for patients receiving adjuvant treatment (chemotherapy, radiotherapy, or sequential chemoradiotherapy) and without adjuvant therapy (P > 0.05). Two-year overall survival in patients who presented with localized disease was 71.3% and 18.5% in metastatic patients (P < 0.001). In the metastatic stage, platinum/etoposide combination was the most preferred combination regimen. Median progression-free survival (PFS) in first-line chemotherapy was 7 months (95% confidence interval: 3.5-10.5 months; standart error: 1.78). Conclusions: Although MCC is rare in Turkey, the incidence is increasing. Gender, CK20 status, tumor size, lymph node involvement, and adjuvant treatment were not associated with recurrence