Using complementary and alternative medicine in patients with breast cancer diagnosis at Afyon Kocatepe University

AMAÇ: Bu çalışmada Afyon Kocatepe Üniversitesi’nde meme kanseri nedeniyle takip edilmekte olan hastalarda tamamlayıcı ve alternatif tedavi (TAT) kullanım sıklığının ve TAT ile ilgili uygulamaların belirlenmesi ve incelenmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Çalışmamıza Afyon Kocatepe Üniversitesi Tıp Fakültesi Hastanesi, Tıbbi Onkoloji Polikliniği ile Fizik Tedavi ve Rehabilitasyon Ana Bilim Dalı’na başvuran toplam 70 meme kanserli hasta dahil edilmiştir. Hastaların sosoyodemografik özellikleri ile, kullanılan TAT yöntemlerine yönelik sorgulamayı içeren 44 soruluk bir form doldurulmuştur. BULGULAR: Ortalama yaşları 57.5 ± 11.2 yıl olan hastaların en az bir TAT yöntemi kullanma oranı %85.7 (60 kişi) olarak belirlenmiştir. TAT yöntemi olarak en çok dua etmenin (%85.7) ve bitkilerin (%30) tercih edildiği saptanmıştır. TAT yöntemi kullanan meme kanserli hastaların %55’i TAT kullanmaya kendisi karar verirken, %13.3’ü ailesinin etkisiyle TAT kullanmaya başlamış. Çalışmamızda TAT kullanan hastaların sadece %35’inin bu konuda doktoruna bilgi verdiği görülmüştür. TAT kullanan hastaların %32.9’u çok fayda gördüğünü belirtirken, bu hastaların %44.3’ü tanı aldıktan hemen sonra tedavi süreci başlamadan bu yöntemlere başvurduğunu ifade etmiştir. SONUÇ: Hastalarımızın TAT yöntemlerini sık olarak kullandıkları, çoğunlukla da dua ve bitkisel yöntemleri tercih ettikleri saptanmıştır. Ayrıca meme kanserli kadınların TAT kullanımı ile ilgili sağlık çalışanlarına bilgi vermediği, özellikle kemoterapi, radyoterapi/ hormon tedavisi devam edenlerin büyük çoğunluğunun beraberinde TAT kullandığı belirlenmiştir. Ayrıca; sağlık çalışanlarının hastaları TAT kullanma yönünden sorgulamaları, böylelikle bu yöntemlerin kullanımı ile ilgili oluşabilecek yan etkilerin önlenmesine de yardımcı olunabileceğini düşünmekteyiz.OBJECTIVE: We aimed to determine the frequency of complementary and alternative therapy (CAM) usage and CAM related applications in patients with breast cancer at Afyon Kocatepe University. MATERIAL AND METHODS: Our study included a total of 70 patients with breast cancer who applied to the Afyon Kocatepe University Medical Faculty Hospital, Medical Oncology and Physical Medicine and Rehabilitation outpatient clinics. A 44-question form including questionnaires on the sociodemographic characteristics of the patients and the CAM methods used were filled out. RESULTS: Patients with a mean age of 57.5 ± 11.2 years were assigned at least one CAM method as 85.7% (60 people). It was determined that; praying (85.7%) and plants (30%) were as the most preferred CAM method. While 55% of breast cancer patients using the CAM method decided to use oneself, 13.3% of them started to use CAM due to the influence of their family. In our study, only 35% of the patients using CAM were informed about this issue by their doctor. While 32.9% of patients using CAM indicated that they were very beneficial, 44.3% of the patients stated that they applied to these methods immediately after the diagnosis was started. CONCLUSIONS: It has been determined that our patients use CAM methods frequently, mostly they prefer prayer and herbal methods. In addition, breast cancer patients do not inform health workers about the use of CAM, especially the majority of those continuing with chemotherapy, radiotherapy / hormone therapy were using CAM together. As a result; we also think that health professionals can also interrogate patients in terms of using CAM so that they can also help prevent side effects from using these methods

Crizotinib efficacy and safety in patients with advanced NSCLC harboring MET alterations: A real-life data of Turkish Oncology Group

Crizotinib is a multikinase inhibitor, effective in non-small cell lung cancer (NSCLC) harboring mesenchymal-epidermal transition (MET) alterations. Although small prospective studies showed efficacy and safety of crizotinib in NSCLC with MET alterations, there is limited real-life data. Aim of this study is to investigate real-life efficacy and safety of crizotinib in patients with advanced NSCLC harboring MET alterations. This was a retrospective, multicenter (17 centers) study of Turkish Oncology Group. Patients' demographic, histological data, treatment, response rates, survival outcomes, and toxicity data were collected. Outcomes were presented for the study population and compared between MET alteration types. Total of 62 patients were included with a median age of 58.5 (range, 26-78). Major histological type was adenocarcinoma, and 3 patients (4.8%) had sarcomatoid component. The most common MET analyzing method was next generation sequencing (90.3%). MET amplification and mutation frequencies were 53.2% (n = 33) and 46.8% (n = 29), respectively. Overall response rate and disease control rate were 56.5% and 74.2% in whole study population, respectively. Median progression free survival (PFS) was 7.2 months (95% confidence interval [CI]: 3.8-10.5), and median overall survival (OS) was 18.7 months (95% CI: 13.7-23.7), regardless of treatment line. Median PFS was 6.1 months (95% CI: 5.6-6.4) for patients with MET amplification, whereas 14.3 months (95% CI: 6.7-21.7) for patients with MET mutation (P = .217). Median PFS was significantly longer in patients who have never smoked (P = .040), have good performance score (P < .001), and responded to the treatment (P < .001). OS was significantly longer in patients with MET mutation (25.6 months, 95% CI: 15.9-35.3) compared to the patients with MET amplification (11.0 months; 95% CI: 5.2-16.8) (P = .049). In never-smokers, median OS was longer than smoker patients (25.6 months [95% CI: 11.8-39.3] vs 16.5 months [95% CI: 9.3-23.6]; P = .049). The most common adverse effects were fatigue (50%), peripheral edema (21%), nausea (29%) and diarrhea (19.4%). Grade 3 or 4 adverse effects were observed in 6.5% of the patients. This real-life data confirms efficacy and safety of crizotinib in the treatment of advanced NSCLC harboring MET alteration

Analysis of patients hospitalized in our clinic with the diagnosis of acute renal failure

Amaç: Akut böbrek yetmezliği, böbrek fonksiyonlarında hızlı bir azalmayla karakterize ve yüksek mortalite oranına sahip önemli bir klinik sendromdur. Akut böbrek yetmezliğinde mortalite, son yıllardaki yoğun bakım ve renal replasman tedavilerindeki gelişmeye rağmen yüksek kalmaya devam etmektedir. Bu çalışmada kliniğimizde ABY tanısıyla yatan hastaları değerlendirdik. Gereç ve Yöntem: Ocak 2011 ve Aralık 2012 arasında hastanemize Akut böbrek yetmezliği tanısıyla başvuran 145 hastayı retrospektif olarak inceledik. Hastaların kayıtlarından yaşı, Akut böbrek yetmezliği tipi, başvuru şekli, başvurudaki temel bulguları, etyolojisi, zeminde eşlik eden hastalıklar, uygulanan tedavi ve laboratuvar değerleri kaydedildi. Bulgular: Olguların etiyolojisi incelendiğinde en sık nedenler prerenal azotemi (%38,6) ve nefrotoksik ajan kullanımıydı (%30,3). Hastaların %72,6’sı nonoligürik %27,4’ü oligürik idi. Olguların %65,5’ine medikal tedavi uygulanırken %34,5’ine medikal tedaviye ek olarak hemodiyaliz tedavisi uygulandı. Hastaların %86,9’u tedavi sonucu iyileşirken, %13,1’i kaybedildi. Ölen hastaların %63,2’si medikal tedaviye ek olarak hemodiyaliz tedavisi alırken %36,8’i sadece medikal tedavi almıştı. Oligürik hastaların %67,5’i medikal tedavi ve hemodiyaliz, %32,5’i sadece medikal tedavi alırken nonoligürik hastaların %21,9’u medikal tedavi ve hemodiyaliz, %78,1’i sadece medikal tedavi aldı. Sonuç: Akut böbrek yetmezliği etiyolojisinde 40 yıl öncesine göre medikal nedenler ön plana çıkmaktadır. Ayrıca oligoanürik Akut böbrek yetmezliği hastalarında diyaliz gereksiniminin arttığı ve diyaliz tedavisi gereken hastalarda prognozun daha kötü olduğu gözlenmiştir. Bu yüzden bu hastaların daha yakından izlenmesi gerekmektedir.Objective: Acute renal failure, which is characterized by a speedy decrease in renal function, is an important clinical syndrome with a high mortality rate. In spite of advanced intensive care and renal replacement therapies in recent years, Acute renal failure mortality continues to remaining high . In this study, we evaluated patients hospitalized with ARF. Material and Methods: We reviewed 145 patients with a diagnosis of Acute renal failure between January 2011 and December 2012 in our hospital, retrospectively. From the records of the patients, age, Acute renal failure type, application form, application of the basic findings, etiology, concomitant diseases, treatment, and laboratory values were recorded. Results: The most common causes of Acute renal failure etiology in our hospital were prerenal azotemia (38.6%) and nephrotoxic agents (30.3%) . The 72.6%of patients were nonoliguric, while 27.4%were oliguric. Medical treatment was applied to 65.5%of patients and medical management together with hemodialysis therapy was administered to the rest of the patients. The improvement rate of patients was 869% while 13.1%of the patients were lost. The 63.2%of dying patients were treated with hemodialysis treatment in addition to medical treatment, while 36.8%had received medical treatment only. The 21.9%of nonoliguric patients had received hemodialysis and medical treat ment and 78.1%of them received only medical treatment. Conclusion: According to the etiology of Acute renal failure, medical reasons come to the forefront compared with 40 years ago. It is also observed that the need for dialysis in Acute renal failure patients with oligoanuria increased and the patients who require dialysis have worse prognosis. Therefore, these patients should be monitored more closely

Small cell carcinoma of the prostate: Case report

Prostatın küçük hücreli karsinomu oldukça nadir görülür. Klasik prostat adenokarsinomunun tersine klinik seyri agresiftir ve erken tanı konulmazsa prognozu kötüdür. Metastatik hastalıkta bile PSA seviyelerinin normal olması, hormonal tedaviye yanıtsızlık görülmesi ile prostatın küçük hücreli karsinomundan şüphelenmelidir. Burada prostat küçük hücreli karsinom tanısı saptanan 65 yaşında bir olgu sunularak literatür bilgileri gözden geçirilmiş- tir.Small cell carcinoma of the prostate is extremely rare. In contrast to classical prostatic adenocarcinoma, clinical course is aggressive and unless detected in early stage, the prognosis of this cancer is poor. If in a patient with metastatic disease PSA levels are normal and hormone therapy is non-effective, small cell carcinoma of the prostate should be suspected. Here, a 65-year-old patient with a diagnosis of small cell carcinoma of the prostate is presented and the relevant literature is reviewed

Small cell carcinoma of the prostate: Case report

Prostatın küçük hücreli karsinomu oldukça nadir görülür. Klasik prostat adenokarsinomunun tersine klinik seyri agresiftir ve erken tanı konulmazsa prognozu kötüdür. Metastatik hastalıkta bile PSA seviyelerinin normal olması, hormonal tedaviye yanıtsızlık görülmesi ile prostatın küçük hücreli karsinomundan şüphelenmelidir. Burada prostat küçük hücreli karsinom tanısı saptanan 65 yaşında bir olgu sunularak literatür bilgileri gözden geçirilmiş- tir.Small cell carcinoma of the prostate is extremely rare. In contrast to classical prostatic adenocarcinoma, clinical course is aggressive and unless detected in early stage, the prognosis of this cancer is poor. If in a patient with metastatic disease PSA levels are normal and hormone therapy is non-effective, small cell carcinoma of the prostate should be suspected. Here, a 65-year-old patient with a diagnosis of small cell carcinoma of the prostate is presented and the relevant literature is reviewed

Analysis of patients hospitalized in our clinic with the diagnosis of acute renal failure

Amaç: Akut böbrek yetmezliği, böbrek fonksiyonlarında hızlı bir azalmayla karakterize ve yüksek mortalite oranına sahip önemli bir klinik sendromdur. Akut böbrek yetmezliğinde mortalite, son yıllardaki yoğun bakım ve renal replasman tedavilerindeki gelişmeye rağmen yüksek kalmaya devam etmektedir. Bu çalışmada kliniğimizde ABY tanısıyla yatan hastaları değerlendirdik. Gereç ve Yöntem: Ocak 2011 ve Aralık 2012 arasında hastanemize Akut böbrek yetmezliği tanısıyla başvuran 145 hastayı retrospektif olarak inceledik. Hastaların kayıtlarından yaşı, Akut böbrek yetmezliği tipi, başvuru şekli, başvurudaki temel bulguları, etyolojisi, zeminde eşlik eden hastalıklar, uygulanan tedavi ve laboratuvar değerleri kaydedildi. Bulgular: Olguların etiyolojisi incelendiğinde en sık nedenler prerenal azotemi (%38,6) ve nefrotoksik ajan kullanımıydı (%30,3). Hastaların %72,6’sı nonoligürik %27,4’ü oligürik idi. Olguların %65,5’ine medikal tedavi uygulanırken %34,5’ine medikal tedaviye ek olarak hemodiyaliz tedavisi uygulandı. Hastaların %86,9’u tedavi sonucu iyileşirken, %13,1’i kaybedildi. Ölen hastaların %63,2’si medikal tedaviye ek olarak hemodiyaliz tedavisi alırken %36,8’i sadece medikal tedavi almıştı. Oligürik hastaların %67,5’i medikal tedavi ve hemodiyaliz, %32,5’i sadece medikal tedavi alırken nonoligürik hastaların %21,9’u medikal tedavi ve hemodiyaliz, %78,1’i sadece medikal tedavi aldı. Sonuç: Akut böbrek yetmezliği etiyolojisinde 40 yıl öncesine göre medikal nedenler ön plana çıkmaktadır. Ayrıca oligoanürik Akut böbrek yetmezliği hastalarında diyaliz gereksiniminin arttığı ve diyaliz tedavisi gereken hastalarda prognozun daha kötü olduğu gözlenmiştir. Bu yüzden bu hastaların daha yakından izlenmesi gerekmektedir.Objective: Acute renal failure, which is characterized by a speedy decrease in renal function, is an important clinical syndrome with a high mortality rate. In spite of advanced intensive care and renal replacement therapies in recent years, Acute renal failure mortality continues to remaining high . In this study, we evaluated patients hospitalized with ARF. Material and Methods: We reviewed 145 patients with a diagnosis of Acute renal failure between January 2011 and December 2012 in our hospital, retrospectively. From the records of the patients, age, Acute renal failure type, application form, application of the basic findings, etiology, concomitant diseases, treatment, and laboratory values were recorded. Results: The most common causes of Acute renal failure etiology in our hospital were prerenal azotemia (38.6%) and nephrotoxic agents (30.3%) . The 72.6%of patients were nonoliguric, while 27.4%were oliguric. Medical treatment was applied to 65.5%of patients and medical management together with hemodialysis therapy was administered to the rest of the patients. The improvement rate of patients was 869% while 13.1%of the patients were lost. The 63.2%of dying patients were treated with hemodialysis treatment in addition to medical treatment, while 36.8%had received medical treatment only. The 21.9%of nonoliguric patients had received hemodialysis and medical treat ment and 78.1%of them received only medical treatment. Conclusion: According to the etiology of Acute renal failure, medical reasons come to the forefront compared with 40 years ago. It is also observed that the need for dialysis in Acute renal failure patients with oligoanuria increased and the patients who require dialysis have worse prognosis. Therefore, these patients should be monitored more closely

More sunlight exposure may improve the overall survival in patients with pancreas cancer

The protective effect of sun exposure on prognosis of cancer and cancer risk was previously reported in some studies except for melanoma and skin cancer. In presented study we aimed to compare the effect of sunlight exposure on prognosis of patients with pancreatic cancer (PC) in two regions with different sunlight exposure. Totally of 139 patients with PC from Akdeniz University from Antalya (n:103) and Kocatepe University (n:36) from Afyon were analyzed retrospectively. Antalya and Afyon state have different sunlight exposure. Two groups were compared in terms of overall survival (OS). The median OS values were 10,9 [95% CI: 7,8–14,0] and 6,9 [95% CI: 3,9–9,9] months for Antalya and Afyon groups, respectively and it was found a significant difference between groups for OS (p = 0.015). Also, the region and stage were an independent prognostic factor. In conclusion, the patients with PC had better OS in the region with more sunlight exposure

Results of Turkish smoking cessation polyclinics data's analysis (TUSPA study)

Sengezer, Tijen/0000-0002-3200-8926; Er, Mukremin/0000-0001-6842-0587WOS: 000451979407230

The necessity of cytoreductive nephrectomy in patients with metastatic renal cell carcinoma using antiangiogenic targeted therapy after interferon alfa-2b

WOS: 000345547700009PubMed ID: 25022784The effects of cytoreductive nephrectomy (CRN) on prognosis of patients with metastatic renal cell cancer (RCC) using antiangiogenic targeted agents were evaluated. The median overall survival was significantly higher in the group that received CRN (P = .034). We speculate that CRN is still an important part of treatment modalities in patients with metastatic RCC in modern era targeted therapy, which is currently the best systemic therapy. Background: Targeted therapy has improved the survival of patients with metastatic RCC. In the present study, we evaluated whether there was an effect of cytoreductive surgery on prognosis of patients with metastatic RCC using antiangiogenic tyrosine kinase inhibitor (TKI) agents. Patients and Methods: A total of 52 patients with metastatic RCC from Akdeniz University, Afyon Kocatepe University, and Medipol University participated in the study. All the patients had received targeted antiangiogenic therapy after interferon alfa-2b. According to previous CRN, the patients were divided into 2 groups as CRN (+) and CRN (-). Results: The CRN (+) group was younger than the CRN (-) group (P < .001) and the hemoglobin levels were significantly higher in the CRN (+) group (P = .023). The median progression-free survival time from the date of starting TKIs were 8.5 and 3.0 months for the CRN (+) and CRN (-) groups, respectively (P = .104). The median overall survival was 15.1 and 5.4 months for the CRN (+) and CRN (-) groups, respectively (P = .034). Conclusion: We speculate that CRN is still an important part of treatment modalities in patients with metastatic RCC in modern era targeted therapy, which is currently the best systemic therapy. However, the indications of CRN might be limited to good-risk patients with metastatic RCC. Further randomized studies are warranted to clarify the necessity of CRN in patients with metastatic RCC

Platelet to lymphocyte ratio as a new prognostic for patients with metastatic renal cell cancer

Aim: The objective of this study was to evaluate the blood platelet-lymphocyte ratio (PLR) for its prognostic value in patients with metastatic renal cell cancer (RCC). Methods: We retrospectively reviewed 100 patients diagnosed with metastatic RCC previously treated with tyrosine kinase inhibitors from three centers. We assessed the prognostic value of pretreatment PLR and other clinical and laboratory parameters based on univariate and multivariate analyses. Results: Median progression-free survival (PFS) was 7.3 months and median overall survival (OS) was 15.3 months. Multivariate analysis revealed that PFS is significantly affected by ECOG PS (P=0.047), PLR (P=0.029) and calcium level (P=0.023). Median PFS was 13.9 versus 5.3 months in patients with PLR?210 versus PLR>210 (log rank; P=0.001). Median OS was 25.9 versus 10.9 months with PLR?210 versus PLR>210 (log rank; P=0.013). Conclusions: This study shows that increased pretreatment PLR is an independent prognostic indicator in patients with metastatic RCC who use tyrosine kinase inhibitors