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Bülbül Y, Ozlu T, Arinc S, Ozyurek B, Gunbatar H, Senturk A, Bahadir A, Ozcelik M, Yilmaz U, Akbay M, Saglam L, Kilic T, Kirkil G, Ozcelik N, Tatar D, Baris S, Yavsan D, Sen H, Berk S, Acat M, Cakmak G, Yumuk P, Intepe Y, Toru U, Ayik S, Basyigit I, Ozkurt S, Mutlu L, Yasar Z, Esme H, Erol M, Oruc O, Erdoğan Y, Asker S, Ulas A, Erol S, Kerget B, Erbaycu A, Teke T, Beşiroğlu M, Can H, Dalli A, Talay F. Assessment of Palliative Care in Lung Cancer in Turkey. Med Princ Pract 2017; 26:50-56. [PMID: 27780164 PMCID: PMC5588338 DOI: 10.1159/000452801] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 10/24/2016] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To investigate the symptoms of lung cancer in Turkey and to evaluate approaches to alleviate these symptoms. SUBJECTS AND METHODS This study included 1,245 lung cancer patients from 26 centers in Turkey. Demographic characteristics as well as information regarding the disease and treatments were obtained from medical records and patient interviews. Symptoms were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and were graded on a scale between 0 and 10 points. Data were compared using the χ2, Student t, and Mann-Whitney U tests. Potential predictors of symptoms were analyzed using logistic regression analysis. RESULTS The most common symptom was tiredness (n = 1,002; 82.1%), followed by dyspnea (n = 845; 69.3%), appetite loss (n = 801; 65.7%), pain (n = 798; 65.4%), drowsiness (n = 742; 60.8%), anxiety (n = 704; 57.7%), depression (n = 623; 51.1%), and nausea (n = 557; 45.5%). Of the 1,245 patients, 590 (48.4%) had difficulty in initiating or maintaining sleep. The symptoms were more severe in stages III and IV. Logistic regression analysis indicated a clear association between demographic characteristics and symptom distress, as well as between symptom distress (except nausea) and well-being. Overall, 804 (65.4%) patients used analgesics, 630 (51.5%) received treatment for dyspnea, 242 (19.8%) used enteral/parenteral nutrition, 132 (10.8%) used appetite stimulants, and 129 (10.6%) used anxiolytics/antidepressants. Of the 799 patients who received analgesics, 173 (21.7%) reported that their symptoms were under control, and also those on other various treatment modalities (dyspnea: 78/627 [12.4%], appetite stimulant: 25/132 [18.9%], and anxiolytics/antidepressants: 25/129 [19.4%]) reported that their symptoms were controlled. CONCLUSION In this study, the symptoms progressed and became more severe in the advanced stages of lung cancer, and palliative treatment was insufficient in most of the patients in Turkey.
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Affiliation(s)
- Y. Bülbül
- Department of Chest Diseases, School of Medicine, Karadeniz Technical University, Trabzon, Izmir, Turkey
| | - T. Ozlu
- Department of Chest Diseases, School of Medicine, Karadeniz Technical University, Trabzon, Izmir, Turkey
| | - S. Arinc
- Department of Chest Diseases, School of Medicine, Sureyyapasa, Istanbul, Turkey
| | - B.A. Ozyurek
- Department of Chest Diseases, School of Medicine, Ataturk, Ankara, Turkey
| | - H. Gunbatar
- Department of Chest Diseases, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - A. Senturk
- Department of Chest Diseases, School of Medicine, Ataturk, Ankara
| | - A. Bahadir
- Department of Chest Diseases, School of Medicine, Yedikule, Istanbul, Turkey
| | - M. Ozcelik
- Department of Chest Diseases, School of Medicine, Kartal, Istanbul
| | - U. Yilmaz
- Department of Chest Diseases, School of Medicine, Dr. Suat Seren, Izmir, Education and Research Hospitals of, Izmir, Turkey
- *Prof. Yilmaz Bülbül, Department of Chest Diseases, School of Medicine, Karadeniz Technical University, Farabi Cd. No: 66, TR–61080 Trabzon (Turkey), E-Mail
| | - M.O. Akbay
- Department of Chest Diseases, School of Medicine, Sureyyapasa, Istanbul, Turkey
| | - L. Saglam
- Department of Chest Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - T. Kilic
- Department of Chest Diseases, School of Medicine, Inonu University, Malatya, Turkey
| | - G. Kirkil
- Department of Chest Diseases, School of Medicine, Firat University, Elazıg, Turkey
| | - N. Ozcelik
- Department of Chest Diseases, School of Medicine, Karadeniz Technical University, Trabzon, Izmir, Turkey
| | - D. Tatar
- Department of Chest Diseases, School of Medicine, Dr. Suat Seren, Izmir, Education and Research Hospitals of, Izmir, Turkey
| | - S.A. Baris
- Department of Chest Diseases, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - D.M. Yavsan
- Department of Chest Diseases, School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - H.S. Sen
- Department of Chest Diseases, School of Medicine, Dicle University, Diyarbakir, Turkey
| | - S. Berk
- Department of Chest Diseases, School of Medicine, Cumhuriyet University, Sivas, Turkey
| | - M. Acat
- Department of Chest Diseases, School of Medicine, Karabük University, Karabük, Turkey
| | - G. Cakmak
- Department of Chest Diseases, School of Medicine, Haseki, Istanbul
| | - P.F. Yumuk
- Department of Chest Diseases, School of Medicine, Department of Medical Oncology School of Medicine, Marmara University, Istanbul, Izmir, Turkey
| | - Y.S. Intepe
- Department of Chest Diseases, School of Medicine, Bozok University, Yozgat, Turkey
| | - U. Toru
- Department of Chest Diseases, School of Medicine, Dumlupinar University, Kutahya, Turkey
| | - S.O. Ayik
- Department of Chest Diseases, School of Medicine, Katip Celebi University, Izmir, Turkey
| | - I. Basyigit
- Department of Chest Diseases, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - S. Ozkurt
- Department of Chest Diseases, School of Medicine, Pamukkale University, Denizli, Turkey
| | - L.C. Mutlu
- Department of Chest Diseases, School of Medicine, Namik Kemal University, Tekirdag, Turkey
| | - Z.A. Yasar
- Department of Chest Diseases, School of Medicine, Abant Izzet Baysal University, Bolu, Pulmonary Diseases and Thoracic Surgery Education and Research Hospitals of, Izmir, Turkey
| | - H. Esme
- Department of Chest Diseases, School of Medicine, Konya, Konya
| | - M.M. Erol
- Department of Chest Diseases, School of Medicine, Department of Thoracic Surgery School of Medicine, Uludag University, Bursa, Turkey
| | - O. Oruc
- Department of Chest Diseases, School of Medicine, Sureyyapasa, Istanbul, Turkey
| | - Y. Erdoğan
- Department of Chest Diseases, School of Medicine, Ataturk, Ankara, Turkey
| | - S. Asker
- Department of Chest Diseases, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - A. Ulas
- Department of Chest Diseases, School of Medicine, Ataturk, Ankara
| | - S. Erol
- Department of Chest Diseases, School of Medicine, Dr. Suat Seren, Izmir, Education and Research Hospitals of, Izmir, Turkey
| | - B. Kerget
- Department of Chest Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - A.E. Erbaycu
- Department of Chest Diseases, School of Medicine, Dr. Suat Seren, Izmir, Education and Research Hospitals of, Izmir, Turkey
| | - T. Teke
- Department of Chest Diseases, School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - M. Beşiroğlu
- Department of Chest Diseases, School of Medicine, Department of Medical Oncology School of Medicine, Marmara University, Istanbul, Izmir, Turkey
| | - H. Can
- Department of Chest Diseases, School of Medicine, Department of Family Medicine School of Medicine, Katip Celebi University, Izmir, Turkey
| | - A. Dalli
- Department of Chest Diseases, School of Medicine, Katip Celebi University, Izmir, Turkey
| | - F. Talay
- Department of Chest Diseases, School of Medicine, Abant Izzet Baysal University, Bolu, Pulmonary Diseases and Thoracic Surgery Education and Research Hospitals of, Izmir, Turkey
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