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Öğe Assessment of sensorimotor and strength related function of breast cancer patients during systemic drug therapy: a prospective observational study(Bmc, 2023) Tugral, Alper; Aribas, Zeynep; Akyol, Murat; Bakar, YesimBackground Chemotherapy is a well-known risk factor for sensorial and motor disturbances. Chemotherapy induced peripheral neuropathy (CIPN) which predominantly affects sensory nerves might cause a diminished fine motor function. This prospective observational study aimed to assess the sensorimotor functions of breast cancer patients before, during, and after chemotherapy.Methods A total of 56 breast cancer patients were evaluated at three different times as follows: T1 (before chemotherapy), T2 (middle chemotherapy), and T3 (completion of chemotherapy). Motor function was assessed with handgrip strength (HGS), peripheral muscle strength (PMS), and the Minnesota Manual Dexterity Test (MMDT). Semmes Weinstein Monofilament Test (SWMT) was performed to assess the sensory function. Fatigue was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Module Cancer Related Fatigue (EORTC-QLQ-FA12), respectively.Results HGS and MMDT were found significant (chi 2: 11.279, p = 0.004 and chi 2: 9.893, p = 0.007, respectively) whereas PMS was not found significant (F (2,110) = 1.914, p = 0.152). Pairwise comparisons with Bonferroni adjustments revealed that HGS was found significant between T1 and T3, while significant results were obtained between T1 and T2 as well as T2 and T3 in MMDT (p = 0.01 and p = 0.042). There were significant results in some reference points of SWMT, though they were not found after pairwise comparisons with Bonferroni adjustment (p > 0.05). Fatigue was found significantly increased from T1 through T3 (Median: 19.44 vs 27.77, z: -2.347, p = 0.019, Wilcoxon test).Conclusion Our study showed that decreased handgrip strength and fine motor function, as well as increased fatigue, are evident during the chemotherapy. SWMT can be an optional assessment in the context of tracking changes in cutaneous sensation during chemotherapy due to its non-invasive, cheap, and easily repeatable features among cancer patients. To preserve functional capacity as well as independence in daily living, precautions and follow up assessments during the systemic therapy process should be integrated as early as possible to prevent future deteriorations in daily life for patients who undergo chemotherapy.Öğe Assessment of the cardiorespiratory fitness and the quality of life of patients with breast cancer undergoing chemotherapy: a prospective study(Springer Japan Kk, 2023) Akyol, Murat; Tugral, Alper; Aribas, Zeynep; Bakar, YesimBackgroundDiminished cardiorespiratory fitness is a well-known side effect of chemotherapy as well as a risk factor for potential cardiovascular diseases among cancer patients. This study aimed to assess the potential effects of systemic adjuvant (ACT) or neoadjuvant (NACT) chemotherapy on cardiorespiratory fitness and quality of life (QoL) among breast cancer (BC) patients.MethodsDemographic data, cardiorespiratory fitness, health-related QoL domains were assessed with simple data form, six-minute walk test (6MWT), European Organization for Research and Treatment of Cancer quality of life module (EORTC-C30), and Functional Assessment of Cancer Therapy (FACT-B+), respectively. Time1 (T1, prior to chemotherapy), Time2 (T2; interim assessment), and Time3 (T3, final assessment) were set as assessment points.ResultsA total of 42 patients (32 ACT vs 10 ACT) completed all assessments. There were no significant differences of main effect of time and time*group interaction on total walked distance (TWD) after controlling for age and BMI (F(2,28) = 1.309, p = 0.286; F(2,28) = 1.444, p = 0.253). EORTC symptoms subscale was found to be correlated with EORTC and FACT-B+ physical function (PF) subscales (r = - 861, p < 0.001; r = - 0.877, p < 0.001) in T3. The EORTC PF subscale was found to be correlated with the TWD in the baseline (r = 0.411, p = 0.024).ConclusionsThis study showed that the effect of chemotherapy on diminished PF and remarkably increased symptom burden among BC patients. Yet, the type of chemotherapy had no effect on TWD regarding cardiorespiratory fitness. Monitoring potential functional decline regarding cardiorespiratory fitness can be performed via simple field tests such as 6MWT.Öğe The Characteristics of Pain Tolerance in Patients Who Underwent Unilateral Breast Cancer Surgery: The Effect of Handedness and Surgical Site to Assess the Potential Musculoskeletal Symptoms and Function(Cig Media Group, Lp, 2022) Tugral, Alper; Bakar, Yesim; Akyol, MuratDiminished strength and altered musculoskeletal pain characteristics are well-known consequences of breast cancer treatment. This study aimed to assess myofascial pain and strength in breast cancer survivors (BCS). A total of 96 BCS were included. A Strength imbalance was prominent in BCS who underwent surgery in their nondominant site, while the pain tolerance was significantly lower in the surgical site. Background: Breast cancer survivors (BCS) usually experience musculoskeletal pain and strength imbalance between surgical and nonsurgical sites. Material and methods: This study aimed to assess the effect of handedness and surgical site on pain tolerance and upper extremity strength in BCS. A total of 96 female BCS (Mean age and BMI: 51.06 +/- 9.36 years and 27.77 +/- 3.75 kg/m(2)) were included in this study. BCS were categorized as DoS or NoS whether they had surgery on their dominant or nondominant site, respectively. Socio-demographic data, upper extremity strength, pain tolerance, and pain-related function measurements were performed by simple form, manual muscle tester, pain algometer, and Disabilities of Arm, Shoulder, and Hand's (DASH) pain subscale, respectively. Results: Pain tolerances were significantly lower in upper trapezius muscle region in the surgical site (t = -4,263, P <.001 and t = -2138, P = 0.037) while in the deltoid tuberosity, pain tolerance was significantly higher in surgical site (t = 2633, P = 0.011). Mean differences in strength in shoulder flexion and abduction were significantly lower in the DoS group compared to the NoS group (z = -3.166, P =.002 and z = -2.131, P =.033, respectively), whereas the pain subscale was significantly higher in the DoS (P =.013). Conclusion: Pain tolerance decreased in the upper trapezius muscle region on the surgical site irrespective of the handedness. However, in deltoid tuberosity, the effect of handedness was remarkable. Exercise programs should focus to establish a strength balance in nondominant surgery BCS since strength imbalance might be more prominent to affect them to take part in activities in daily living.Öğe Comparison of Alectinib/Crizotinib Data in First-Line Therapy in Patients with Anaplastic Lymphomakinase- Positive Nonsmall Cell Lung Carcinoma with Poor Prognostic Features for Alectinib(Aves, 2023) Katgi, Nuran; Cimen, Pinar; Akyol, Murat; Gursoy, Pinar; Aguloglu, NursinOBJECTIVE: Alectinib has a much better central nervous system transmission than crizotinib in patients diagnosed with anaplastic lym-phoma kinase mutation-positive nonsmall cell lung carcinoma. We aimed to investigate alectinib's efficacy in the treatment and its place in the first-line treatment and report our real-life data. MATERIAL AND METHODS: The data of 38 patients who were diagnosed with anaplastic lymphoma kinase-positive nonsmall cell lung carcinoma in our clinic between 2016 and 2021, who did not receive any treatment before were retrospectively analyzed. RESULTS: Of the 19 patients who received alectinib, 14 had multiple, and 6 had pretreatment brain metastases. No newly emerging brain metastases were detected during the treatment period. The progression-free survival of patients was 23.5 & PLUSMN; 4.2 months, and overall survival was 24.6 & PLUSMN; 4.1 months. Progression was observed in 10 (52.6%) patients. Of the 19 patients who received crizotinib, 7 had multiple metastases, and brain metastases were detected in 1 patient before treatment and 6 patients during the treatment period. Progression-free survival of crizotinib patients was 17.1 & PLUSMN; 4.8 months and their overall survival was 26.5 & PLUSMN; 6.1 months. Progression was observed in 17 (89.5%) patients. The second line of alectinib could be given to 8 of these patients. Overall survival after second-line treatment of alectinib was 18.2 & PLUSMN; 7.0 months. Overall survival of the patients who could not receive second-line treatment of alectinib was 4.0 & PLUSMN; 2.0 months. CONCLUSION: The progression rate was lower in alectinib than the crizotinib patients, although there were more patients with multiple metastases and brain metastases in the alectinib arm.Öğe Comparison of frailty screening tools in predicting length of stay and disability in older patients on internal medicine inpatient wards transferred from the emergency department: A retrospective observational study(Lippincott Williams and Wilkins, 2025) Kocak, Fatma Ozge Kayhan; Şama, Musa Gürsu; Fehimoǧlu, Hüseyin Caner; Emekdaş, Bariş; Akyol, MuratThe aim of this study is to compare frailty screening tools in predicting length of stay (LOS) in older patients on internal medicine inpatient wards transferred from the emergency department (ED). This cross-sectional retrospective study involving 186 subjects aged 65 years or older was conducted at tertiary hospital internal medicine inpatient wards transferred from the ED from September to November 2023. Frailty was defined by the Clinical Frailty Scale (CFS), the identification of Seniors At Risk Tool and the Triage Risk-Screening Tool (TRST). Dependency was defined by Katz Index of Independence in activities of daily living (ADL) and the Lawton instrumental ADL. The presence of frailty according to the CSF and TRST was associated with a long LOS (coefficient of regression β = 0.2 with P<.05). But, in binary logistic regression analysis, there was no association between long LOS and frailty scales. All frailty tools were statistically significant predictors for disability (P < .001). Our findings suggest that, among the tools evaluated, the CFS may be the most robust predictor of both LOS and functional dependency, although its predictive power for actual disability remains limited. Future studies should focus on refining these tools for greater accuracy in predicting functional outcomes and should examine how factors such as polypharmacy and comorbidities impact frailty and hospital outcomes. Additionally, longitudinal studies are needed to establish causative relationships between frailty, LOS, and functional decline. © 2025 the Author(s).Öğe The effect of adjuvant radiotherapy on skin biophysical properties in patients with breast cancer at risk for breast lymphedema: A prospective study(Wiley, 2023) Tuğral, Alper; Akyol, Murat; Bakar, YeşimBreast cancer (BC) is the most common type of cancer among women. Radiotherapy (RT) is one of the main and primary treatment options for BC, especially in breast-conserving surgery (BCS). BC patients who underwent RT experience a wide range of symptoms, in which breast oedema and irritation of the skin take the lion's share. Breast oedema/lymphedema, which is also a prominent side effect after RT should be well determined in earlier settings due to the chronicity of lymphedema. Therefore, this study aimed to analyze the biophysical parameters of skin on the ipsilateral (IL) and contralateral (CL) sites via Tissue dielectric constant (TDC) and Transepidermal water loss (TEWL) methods in terms of oedema and skin barrier function (SBF). The following reference points before and after the RT were measured: (R1: Pectoralis muscle, R2: Upper breast, R3: Lower breast, R4: Lateral site of the thorax). A total of 24 BC patients (mean age and BMI: 52.78 +/- 9.85 years and 28.42 +/- 5.64 kg/m(2)) were evaluated. In the IL site, the SBF was not found significant in R1-R3, whereas significantly lower SBF was observed in R4 after RT (t = -3.361, p = 0.003). A significant increase in TDC was observed in R2 at the 5.0 mm depth (t = -2.500, p = 0.02). We suggest that a longer period of follow-up should be carefully carried out to track changes in terms of SBF and oedema in the irradiated breast. The increased need for early detection of changes associated with breast lymphedema can be achievable via noninvasive, safe, cheap, and easily repeatable devices.Öğe Effect of Postoperative Adjuvant Radiotherapy on Quality of Life, Anxiety, and Depression in Adult Female Breast Cancer Patients(Cureus Inc, 2023) Parvizi, Murtaza; Kut, Engin; Akyol, Murat; Ay, SemraAim: This study aims to identify anxiety and depression caused by adjuvant radiotherapy in breast cancer cases to determine the deterioration in the quality of life and investigate the effect of early treatment. Materials and Methods: In this study, the Beck Depression Inventory, Beck Anxiety Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) Turkish 3.0 forms were evaluated in 63 breast cancer patients before the start of radiotherapy treatment (T1) and at six weeks after the end of radiotherapy treatment (T2). Results: A high level of anxiety was detected in 77.8% of patients, and depression was found in 25.4% of patients in T1. When depressive cases were evaluated with EORTC QLQ-C30 scores, the general health status (p = 0.043), role function (p = 0.027), emotional (p < 0.002), cognitive (p < 0.001), and social (p < 0.0001) scales were statistically lower in T1, whereas pain (p = 0.045) and insomnia (p < 0.0001) symptoms were higher in T1. Anxiety and EORTC QLQ-C30 scores in terms of emotional function (p = 0.015), social function (p < 0.003), and symptoms of insomnia (p = 0.027) were found to be statistically higher in T1 anxious cases. However, anxiety was detected in only 3% of T2 cases, and no depression was found in any of the cases. Anxiety and EORTC QLQ-C30 scores and symptom scales were evaluated in terms of role function (p < 0.0001), emotional (p = 0.041) and social scales (p = 0.014), fatigue (p = 0.028), pain (p = 0.033), insomnia (p = 0.011), and constipation (p < 0.0001); these were found to be statistically significant in T2. Conclusion: This study revealed that early diagnosis and treatment of anxiety before initiating adjuvant radiotherapy reduces the development of long-term anxiety-related depression in the future. Therefore, it is recommended that patients be evaluated for anxiety and depression before starting adjuvant radiotherapy.Öğe PERCEIVED EXERCISE BELIEFS AND BARRIERS AMONG BREAST CANCER SURVIVORS: A DESCRIPTIVE CROSS-SECTIONAL STUDY(2024) Tuğral, Alper; Bakar, Yesim; Akyol, MuratSince the importance of the benefit of physical activity and exercise has been understood especially for cancer patients, efforts are taken to assess belief in exercise to adapt patients to a more physically active environment to create a sustainable health outcome. Thus, this study aimed to assess exercise beliefs and barriers by using a validated metric tool (Exercise Beliefs/Barriers Scale-EBBS) to evaluate beliefs in exercise in breast cancer survivors (BCS). In addition, it was also aimed to assess the relationships among EBBS, sociodemographic, and clinical variables of BCS. A total of 112 BCS were screened and invited to participate in this study. Clinical (type of surgery, adjuvant treatments, etc.), demographic data (age, medication use, etc.), and total sitting time were collected through a simple data form and 7th of the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All patients were requested to fill out EBBS.96 BCS completed this study. Weak but significant correlations were found between time spent after surgery and perceived belief (r=. -273, p=0.009), and perceived barriers (r=-.239, p=0.022), respectively. Perceived barriers were also significantly correlated with age (r=-.212, p=0.042). No significant effects of the type of breast surgery and axillary procedure as well as medications (Tamoxifen) on perceived beliefs and barriers were found. Factors should be thoroughly investigated to provide a sustainable exercise behavior among BCS. Older BCS should be thoroughly monitored to gain regular exercise behavior. This study also highlighted the emerging need for sensitive, specific, and focused tools to assess beliefs in exercise among the cancer population.Öğe The prognostic relationship of 18F-FDG PET/CT metabolic and volumetric parameters in metastatic ALK plus NSCLC(Lippincott Williams & Wilkins, 2022) Agüloğlu, Nurşin; Aksu, Ayşegül; Unat, Damla S.; Akyol, MuratObjectiveThe aim of this study is to determine the role of metabolic and volumetric parameters obtained from 18Fluorine-Fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) imaging on progression-free survival (PFS) and overall survival (OS) in patients with advanced nonsquamous cell lung carcinoma (NSCLC) with anaplastic lymphoma kinase (ALK) rearrangement.MethodsPre and post-treatment PET/CT images of the ALK + NSCLC patients between January 2015 and July 2020 were evaluated. The highest standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values were obtained from pre-tyrosine kinase inhibitor (TKI) basal PET/CT (PETpre) and post-TKI PET/CT (PETpost) images. Total MTV (tMTV) and total TLG (tTLG) values were calculated by summing MTV and TLG values in all tumor foci. The change (Delta) in pSUVmax, pMTV, pTLG, tMTV and tTLG before and after treatment was calculated.The relationship of these parameters with OS and PFS was analyzed.ResultstTLG(pre), tMTV(pre), pTLG(pre), pMTV(pre), increment SUVmax, increment tMTV and increment tTLG values were found to be associated with OS; increment tMTV, increment tTLG, tTLG(pre), tMTV(pre), pTLG(pre) and pMTV(pre) were associated with PFS. The cutoff values in both predicting OS and PFS were calculated as -31.6 and 391.1 for increment tMTV and tTLG(pre), respectively. In Cox regression analysis, increment tMTV and stage for OS and increment tMTV and tTLGpre for PFS were obtained as prognostic factors.ConclusionsMetabolic and volumetric parameters, especially TLG values in the whole body before treatment and change in whole body MTV value, obtained from PET/CT may be useful in predicting prognosis and determining treatment strategies for patients with advanced ALK + NSCLC.Öğe The prognostic value of F-18-FDG PET/CT metabolic parameters in predicting treatment response before EGFR TKI treatment in patients with advanced lung adenocarcinoma(Galenos Publ House, 2022) Agüloğlu, Nurşin; Akyol, Murat; Komek, Halil; Katgı, NuranObjectives: This study makes a retrospective examination of exploring the prognostic value of (18)fluorine-fluorodeoxyglucose (F-18-FDG) positron emission tomography/computed tomography (PET/CT) related metabolic-volumetric variables, nutritional status, and immune and inflammatory markers on progression-free survival (PFS) and overall survival (OS) in advanced adenocarcinoma patients with positive epidermal growth factor receptor (EGFR) mutations undergoing EGFR tyrosine kinase inhibitor (TKI) therapy. Methods: A retrospective examination was made of patients diagnosed with lung adenocarcinoma who underwent F-18-FDG PET/CT imaging for staging maximum four weeks before starting treatment, between January 2015 and July 2020. Included in the study were 68 patients identified histopathologically to have locally advanced/metastatic EGFR mutation-positive adenocarcinoma, and who underwent EGFR TKI therapy. The laboratory data of the patients, obtained 15 days before imaging performed for PET/CT staging, were evaluated. Results: Metabolic tumor volume, modified Glasgow prognostic score and locally advanced disease were identified as independent prognostic parameters for PFS (p= 0.004, p=0.029, p=0.016, respectively). A univariate Cox regression analysis revealed albumin/alkaline phosphatase and tumor size to be significant parameters for prognosis (p=0.033, p=0.043, respectively). A multivariate Cox regression analysis revealed that none of the parameters were predictive or OS. Conclusion: The parameters of F-18-FIDG PET/CT, especially the volumetric parameters, were found to be strong prognostic factors with statistical significance for predicting PFS. We believe that these parameters are important prognostic markers that should be evaluated together in the management and follow-up of patients with EGFR mutation-positive adenocarcinoma.Öğe Quality of life and somatic physical function of patients with colorectal cancer who underwent oxaliplatin-based systemic chemotherapy: a prospective study(Springer, 2024) Tugral, Alper; Kebabci, Eyup; Aribas, Zeynep; Akyol, Murat; Can, Aysegul; Bakar, YesimintroductionThis study aimed to study the potential effects of oxaliplatin-based chemotherapy on cardiorespiratory fitness, handgrip strength (HGS), body composition, and quality of life (QoL) of stages III-IV colorectal cancer (CRC) patients before the first cycle (T0) and after the last cycle of systemic adjuvant/neoadjuvant chemotherapy (T1).MethodsCardiorespiratory fitness, HGS, body composition, and QoL were evaluated with the six-minute walk test (6MWT), hydraulic hand dynamometer, body composition analyzer, and Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire in both T0 and T1, respectively.ResultsTwenty-eight CRC patients were included in this study. The total walked distance (TWD) was found to be decreased from T0 to T1 (499.72 m vs. 488.56 m); however, this change was not significant (z = -.706, p = 0.48). Type of chemotherapy whether adjuvant or neoadjuvant also showed no significant effect on TWD (z = -.1.372, p = .17 vs z = -1.180, p = .238, respectively). The QoL was significantly decreased (T0 = 118.35 vs T1 = 110.77, t = 2.176,p = 0.05). The TWD was significantly correlated with the physical well-being (PWB) subscale of FACT-C (r = .64, p = 0.001) as well as with HGS (r = .46, p = .018) in T0. After controlling for age, type of chemotherapy, and type of regimen, the HGS did not show a significant difference from T0 to T1 (F(1,23) = 1.557, p = .22, eta p2 = .06). However, the effect of time x gender showed significant difference from T0 to T1 (F(1,23) = 4.906, p = .037, eta p2 = .17).ConclusionThis study showed the decreased QoL and physical well-being of CRC patients who underwent oxaliplatin-based treatment. In addition, the gender effect of decreased HGS should be considered further when planning an oncological rehabilitation program.Öğe Real-life comparison of afatinib and erlotinib in non-small cell lung cancer with rare EGFR exon 18 and exon 20 mutations: a Turkish Oncology Group (TOG) study(Springer, 2022) Gursoy, Pinar; Tatli, Ali Murat; Erdem, Dilek; Goker, Erdem; Celik, Emir; Demirci, Nebi Serkan; Sakin, Abdullah; Akyol, MuratObjectives To compare the survival of first- and second-generation tyrosine kinase inhibitors (TKIs) in patients with rare EGFR exon 18 and exon 20 mutation-positive non-small cell lung cancer (NSCLC). Materials and methods We retrospectively evaluated survival characteristics of 125 patients with EGFR exon 18 and exon 20 mutated NSCLC who received erlotinib or afatinib as first line treatment between 2012 and 2021 from 34 oncology centres. Since exon 20 insertion is associated with TKI resistance, these 18 patients were excluded from the study. Results EGFR exon 18 mutations were seen in 60%, exon 20 mutations in 16%, and complex mutations in 24% of the patients with NSCLC who were evaluated for the study. There were 75 patients in erlotinib treated arm and 50 patients in afatinib arm. Patients treated with erlotinib had progression-free survival time (PFS) of 8.0 months and PFS was 7.0 months in the afatinib arm (p = 0.869), while overall survival time (OS) was 20.0 vs 24.8 months, respectively (p = 0.190). PFS of exon 18 mutated arm was 7.0 months, exon 20 mutated arm was 4.3 months, and complex mutation positive group was 17.3 months, and this was statistically significant (p = 0.036). The longest OS was 32.5 months, seen in the complex mutations group, which was not statistically different than exon 18 and in exon 20 mutated groups (21.0 and 21.2 months, respectively) (p = 0.323). Conclusion In this patient group, especially patients with complex mutations are as sensitive to EGFR TKI treatment similar to classical mutations, and in patients with rare exon 18 and exon 20 EGFR mutation both first- and second-generation EGFR-TKIs should be considered, especially as first- and second-line options.Öğe The relationship between thyroid transcription factor-1 positivity and epidermal growth factor receptor mutation in lung adenocarcinoma and its prognostic significance(Kare Publ, 2023) Katgi, Nuran; Cimen, Pinar; Akyol, Murat; Aguloglu, NursinBACKGROUND AND AIM: Thyroid transcription factor-1 (TTF-1) is a good prognostic factor and is also thought to be associated with driver mutations in lung cancer. This study aimed to evaluate the relationship between TTF-1 expression and prognosis and driver mutations in lung adenocarcinomas.METHODS: We analyzed the data of 307 patients who were diagnosed with lung adenocarci-noma and underwent TTF-1 testing in two centers between January 2018 and January 2021. RESULTS: Of the 307 patients included in the study, 231 were TTF-1 positive, 23 were weakly positive, and 53 were negative. There was no statistically significant relationship between TTF-1 positivity and progression-free survival (PFS) (p=0.492). However, overall survival (OS) was significantly longer in TTF-1 positive patients (p=0.005). Both PFS and OS were sig-nificantly longer in TTF-1 positive patients with multiple metastates (p=0.001, p=0.013). Of the 199 patients who underwent epidermal growth factor receptor (EGFR) mutation analysis, EGFR positivity was detected in 62 of them, and 58 patients were found to be in the TTF-1 positive group (p=0.022). CONCLUSIONS: Thyroid transcription factor-1 positivity in lung adenocarcinomas is a good prognostic factor that often accompanies EGFR positivity.Öğe Risk Profiling of Breast Cancer-Related Lymphedema (BCRL) in Patients With Breast Cancer Via Using Body Composition and Tissue Dielectric Constant (TDC) Method: A Cross-Sectional Study(Cig Media Group, Lp, 2024) Tugral, Alper; Akyol, Murat; Colakoglu, Oyku; Bakar, YesimBreast cancer-related lymphedema (BCRL) is one of the most fearsome side effects of breast cancer treatment. Higher body mass index (BMI) is a well-known risk factor for BCRL. A total of 72 patients were included. The fat mass was significantly and linearly correlated with dielectric ratios which might be indicative of preclinical Background: Breast Cancer-Related Lymphedema (BCRL) is one of the most prominent long-term side effects of breast cancer (BC) treatment. Although an increased BMI is a well-recognized risk factor for BCRL, there is a lack of knowledge regarding the potential associations between body composition and the risk of BCRL. Therefore, this study aimed to analyze the BCRL risk profiles of surgically operated BC patients via body composition and the Tissue Dielectric Constant (TDC) method, respectively. Methods: A total of 72 patients were included. Patients' risk for BCRL was assessed with Moisture MeterD (Delfin, Finland) in 4 different probes each has unique penetration depths from 0.5 (10 mm) to 5.0 (55 mm) at both upper extremities. The body composition was analyzed with Tanita-BC-420 (TANITA, Japan). Comparing the dielectric values of extremities and proportioning to one another as TDC ratio (at-risk side/unaffected side) was used to profile BCRL risk. Results: TDC values of the thorax reference point were significantly higher in all four probes on the at-risk side ( P < .05). TDC ratios in the forearm and Thorax points were significantly correlated with fat mass (r = 0.256, P = .030; r = 0.269, P = .022) as well as with visceral fat rating (VFR) (r = 0.340, P = .003; r = 0.466, P < .001). Conclusion: This study highlights the need for further care and investigation in the assessment and prediction of BCRL by considering body composition. Since the risk reduction of BCRL can be maximized by considering the individual features, we can conclude that patients with higher body fat irrespective of the BMI should be followed up regularly.Öğe Shoulder Pain, Kinesiophobia, Emotional State and Muscle Strength in Breast Cancer Surgery Patients: A Cross-Sectional Study(University of Health Sciences, 2024) Sertpoyraz, Filiz Meryem; Akyol, Murat; Altaş, Elif Umay; Kebabçı, Eyüp; Beytorun, Ecem; Arslan, Fatma DemetBreast cancer is the most common type of cancer in women. The life expectancy of patients is increasing with advances in treatment. However, lymphovascular, musculoskeletal, and psychogenic complications are reported to be expected in the follow-up period after breast cancer surgery. Kinesiophobia is the behavior of avoiding movement for fear of increased pain. Research on the frequency and interrelationships of kinesiophobia and other complications in the follow-up period is limited. Aim: We aim to evaluate shoulder pain, kinesiophobia, emotional state and muscle strength in female patients who have undergone breast cancer surgery and are in the follow-up period and to examine the relationship between these factors. Materials and Methods: A total of 50 female patients who underwent unilateral breast cancer surgery and were using aromatase inhibitors were included in this cross-sectional descriptive study. Demographic data, details of the surgical procedure and medical treatment information were recorded from the patient files. Hand grip muscle strength was measured by hand dynamometer, the Beck Depression Scale assessed emotional state, and the Tampa Kinesiophobia Scale assessed fear of movement. A Beck Depression Scale score of 10 and above and a Tampa Kinesiophobia Scale of 37 and above were considered significant. Results: The mean age of 50 female patients was 59.31 ± 11.19 years. Sixty percent of the patients had undergone surgery on the right breast and 40% on the left breast. Shoulder pain (n:31) was present in 62%. There were statistically significant correlations between pain and the Tampa kinesiophobia scale and the Beck depression scale (p:0.042, p:0.038). Kinesiophobia was present in 74% of the patients, and 64% had moderate to severe depression. The mean of the Tampa Kinesiophobia scale was 42.86±8.81, and the mean of the Beck depression scale was 15.19±10.98. When the relationship between kinesiophobia and depression was evaluated, a statistically positive significant relationship was found between them (p=0.005, r=0.410). The hand grip strength was 22.16±5.00 kg on the right and 18.22±5.10 kg on the left in patients who underwent left-sided breast cancer surgery. A significant difference was found in the left- and right-hand grip strength of those who underwent left-sided surgery for breast cancer (pÖğe Sleep quality and sedentary behavior among cancer survivors: is there a possible link?(2024) Tuğral, Alper; Bakar, Yesim; Akyol, MuratPurpose: Disrupted sleep patterns can be frequent in cancer survivors not only during treatment but also during survival. This study aimed to analyze the possible link between sleep quality and sedentary behavior among cancer patients. Methods: Demographic and clinical information was obtained through an assessment form. Sleep quality and physical inactivity level were assessed by the Pittsburgh Sleep Quality Index (PSQI) and Sedentary Behavior Questionnaire (SBQ), respectively. This cross-sectional study was conducted between April and June 2023 in the Medical Oncology unit of Izmir Bakırçay University Faculty of Medicine. Results: This study was completed with a total of 80 patients with most of the types of cancer being breast (n=55). The mean PSQI score was 7.68±4.02. SBQ scores were 8.16±3.90, and 6.85±3.86 hours on weekdays and weekends, respectively. No significant association was observed between PSQI and SBQ total scores (p>.05). Age was correlated with sleep disturbances (r=-.24, p=0.03), daytime dysfunction (r=-.34, p=0.002), and first item of SBQ (watching TV) both on weekdays (r=.35, p=0.001) and weekends (r=.38, p=0.001), respectively. Conclusion: This study showed that there was no significant relationship between sedentary behavior and sleep quality among cancer patients, however, the remarkable rate of poor sleep quality was evident in this sample. However, it might be reasonable to suggest that the increased screen time especially for older cancer patients due to significant associations between screen time and age, should be well managed while sleep hygiene and daytime dysfunction should be considered further among younger cancer survivors.Öğe The Effects of Laughter Therapy on Perceived Stress and Quality of Life in Women With Breast Cancer Receiving Chemotherapy A Parallel-Group Randomized Controlled Pilot Trial(Lippincott Williams & Wilkins, 2024) Karakas, Hacer; Bahceli, Pinar Zorba; Akyol, MuratBackground Women with breast cancer experience various symptoms secondary to chemotherapy that reduce their quality of life and increase their stress levels. Objective To evaluate the effects of laughter therapy on perceived stress levels and quality of life in women with breast cancer receiving chemotherapy using a parallel-group randomized controlled pilot trial. Methods Forty-two women were randomly assigned to intervention and control groups. The intervention group received 40 minutes of laughter therapy twice a week for 8 weeks. The control group received routine treatment. The women in both groups completed the Perceived Stress Scale and SF-12 Health Survey at baseline, week 5, and week 9 after randomization. Results There was a significant decrease in the mean Perceived Stress Scale scores in the intervention group compared with those in the control group at weeks 5 and 9 compared with baseline, and the difference between groups by measurement week was significant (P < .001). Women in the intervention group had higher Physical Component Summary-12 and Mental Component Summary-12 scores in weeks 5 and 9 compared with those in the control group, and there was a significant difference between groups in terms of change in the Physical Component Summary-12 and Mental Component Summary-12 mean scores over time (P < .001). Conclusion Laughter therapy is possible to use as a nursing intervention to reduce the perceived stress levels and increase the quality of life of women receiving chemotherapy for breast cancer. Implications for Practice Nurses can apply laughter therapy in the symptom management of women receiving chemotherapy.Öğe Understanding changes in pulmonary function and functional status in breast cancer patients after systemic chemotherapy and radiotherapy: a prospective study(Bmc, 2024) Tugral, Alper; Aribas, Zeynep; Akyol, Murat; Bakar, YesimBackgroundRespiratory complications in breast cancer (BC) patients after chemotherapy (CT) and radiotherapy (RT) have been well acquainted and these complications should be investigated to prevent secondary problems and/or improve BC patients' clinical outcomes. Therefore, this study aimed to assess the potential acute effect of systemic chemotherapy and radiotherapy on respiratory function and functional status of patients with breast cancer.MethodsA total of 25 BC patients who were candidates for systemic chemotherapy and radiotherapy were recruited after oncological examination and included in this study. Respiratory function and functional status were assessed with the Pulmonary Function Test (PFT) and the Six-Minute Walk Test (6MWT), respectively. Patients were assessed before CT (c0), after CT (c1), and after RT (r1).Results25 BC patients were assessed in c0 and c1 while only 15 out of 25 patients (60%) were assessed in r1. The actual values of Forced vital capacity (FVC) (t = 2.338, p =.028), Forced expiratory volume in 1s (FEV1 (t = 2.708, p =.012), and the forced expiratory flow of between 25% and 75% of vital capacity (FEF25-75%) (t = 2.200, p =.038) were found significantly different after systemic CT. Inspiratory (MIP) and expiratory (MEP) muscle strength also did not show a significant change from c0 to c1. A significant effect of the type of surgery was found (Wilks' lambda, F [1, 19] = 6.561, p =.019, eta p2 = 0.25) between c0 and c1 in actual FVC value. The main effect of time was found significant in FVC (F [2, 28] = 4.840, p =.016, eta p2 = 0.25) from c0 to r1. Pairwise comparisons with Bonferroni correction showed that there was a significant difference between c0 and r1 (p =.037).DiscussionThe present study showed decreased FVC and FEV1 actual values and percent predicted rates from baseline to the completion of treatment. Since the interactional effect of the type of surgery was significant, we suggest that clinical and demographic factors such as age should be considered when interpreting the early changes in PFT. In addition, the significant linear trend of decreasing in some specific outcomes in respiratory function also highlighted the need for continuous monitoring of potential respiratory problems in patients with BC from baseline to the completion of chemotherapy and radiotherapy.Öğe View of Perceived Symptoms Associated with Chemotherapyinduced Peripheral Neuropathy in Patients with Breast Cancer: A Cross-sectional Study(2024) Tuğral, Alper; Akyol, MuratObjective: This cross-sectional study aimed to assess the perceived chemotherapy-induced peripheral neuropathy (CIPN) symptoms in patients with breast cancer who received taxane-based chemotherapy. Methods: A total of 74 patients with breast cancer who underwent taxane-based chemotherapy were screened and invited to participate in this study. Perceived symptoms of CIPN were assessed via the European Organization for Research and Treatment of Cancer-Chemotherapy Induced Peripheral Neuropathy (EORTC-CIPN20) questionnaire after the completion of systemic treatment within a month and a half. Sensory, motor, and autonomic subscale scores were calculated and analyzed for each patient. Results: This study included 52 patients with breast cancer. The mean total exposure dose was 2093.92±1266.22 mg. The rates of adjuvant and neoadjuvant chemotherapy were similar (n=25 vs. n=27). Most patients underwent breast-conserving surgery (65.4%). The types of chemotherapy regimen were combined anthracycline and paclitaxel (n=28), docetaxel (n=14), and combined anthracycline, pertuzumab, trastuzumab, and docetaxel (n=10). Patients who underwent modified radical mastectomy had significantly higher scores in the perceived symptoms of CIPN motor function subscale of EORTCCIPN20 (z=-2.838, p=0.005). The autonomic subscale of EORTC-CIPN20 was significantly correlated with age (r=-0.373, p=0.006) and with the total exposure dose of chemotherapy (r=0.295, p=0.034). Conclusion: The type of surgery, specifically MRM, which has been emphasized as a contributing factor to CIPN, should be taken into consideration for further potential deterioration. By this means, it is reasonable to state that not only ongoing monitoring of the CIPN is of utmost importance, but also potential contributors to the management of the CIPN are of great importance.
