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    Duzce University Medical Oncology Practice in COVID-19 Pandemic
    (Duzce Univ, 2020) Esbah, Onur
    The available data about the COVID-19 (SARS-CoV2) pandemic, which emerged in Wuhan, China, and influenced the whole world, has shown that people with chronic diseases such as active cancer, diabetes,chronic respiratory tract, kidney or cardiovascular diseases have higher risk. Cancer patients have suppressed immune systems and are more prone to infections depending on the treatments such as the disease itself, surgery and chemotherapy. Therefore, they are at a higher risk for COVID-19. In this article, we wanted to explain our own practice in the pandemic process, as Diizce University Faculty of Medicine, Department of Medical Oncology.
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    Paraneoplastic Severe Sensorimotor Axonal Polyneuropathy in Pancreatic Neuroendocrine Carcinoma: A Case Report and Review of the Literature
    (Duzce Univ, Fac Medicine, 2022) Akbaş, Türkay; Coşkun, Sinem Kantarcıoğlu; Torun, Serkan; Öztürk, Ayhan; Esbah, Onur; Önbaş, Ömer
    Objective: Paraneoplastic neurological syndromes (PNSs) are a diverse group of neurological disorders affecting any part of the nervous system before or during cancer. Case: A 78-year-old man first experienced pain and burning in the upper extremity three years previously, to which muscle weakness was added a short time later. The same symptoms developed in the lower extremities one year previously. He was admitted to the intensive care unit due to pneumonia and was conscious but quadriplegic with a modified Rankin score of 5. Abdominal computed tomography showed mass lesions in the liver and pancreas. Biopsies revealed pancreatic small cell neuroendocrine carcinoma. Electrophysiological studies revealed severe sensorimotor axonal polyneuropathy. Paraneoplastic sensorimotor axonal polyneuropathy was diagnosed since other causes of polyneuropathy had been excluded. Palliative care was considered due to the patient's poor functional state. Conclusions: Early diagnosis of cancer is of paramount importance in patients with PNSs if appropriate treatment is to be provided.
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    A Rare Case of Rectal Cancer With Endometrial Metastasis: A Case Report
    (2020) Ipor, Sinem; Esbah, Onur; Coşkun, Sinem Kantarcıoğlu
    Background:Colorectal cancer (CRC) is ranked third in the world in incidence and cancer-related mortality. In this case report, we aimed to present a case of rectum cancer with endometrial metastasis which is rare in the literatüre.Case report:On October, 2014; a 62-year-old woman was admitted to outer clinic with a complaint of rectal bleeding. In the colonoscopy, an ulcerovegetan mass was detected and biopsied. Biopsy pathology was reported as adenocarcinoma and the patient underwent a low anterior resection due to diagnosis of rectal cancer. The adjuvant therapy of the patient was completed and the patient was transferred to our clinic for follow-up. After adjuvant therapy, PET/CT examination was performed due to the fact that the sizes of nodules showed 20% increase according to RECIST criteria by thoracic tomography performed three months intervals. In PET / CT, hipermetabolic foci were detected in nodular lesions in the lung and within the uterine corpus. The patient's lung tru-cut biopsy and biopsy of the endometrial cavity was reported adenocarcinoma.Conclusion:Approximately 20% of patients with CRC have distant metastasis at the time of diagnosis. In general, CRCs metastasize to regional lymph nodes, liver, lung, and less frequently to the bone, brain, and peritoneal cavity. The uterus, which is mostly composed of smooth muscle tissue, is rarely described as the metastatic region of extragenital cancers. Endometrium metastases of CRCs are cases in a limited number in the literature. We emphasize this case because of its rarity and beacuse of importance of differatial diagnosis of primary and metastatic tumors of the uterus.
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    Receptor Tyrosine Kinase Pathway and Infiltrating Urothelial Carcinoma
    (Begell House Inc, 2023) Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Önal, Binnur; Gamsızkan, Mehmet; Cangür, Şengül; Esbah, Onur
    Receptor tyrosine kinase pathway is frequently searched for cancer causing mutations in tumors. Emerg-ing targeted therapies are gleam of hope for them. Infiltrating urothelial carcinoma can have many morphological aspects according to their differentiation/variants. To evaluate KRAS, BRAF, and PIK3CA mutations and HER2, EGFR, and p16 expression, we divided urothelial carcinomas into two groups: differentiated/variants (n = 12) and conventional (n = 12). We compared results with clinical, demographic, histopathologic features and survival rates. No statistically sig-nificant results could be obtained in the comparison of histopathologic properties/survival rates with mutation analysis and EGFR, HER2, and p16 status. Differentiated/variants urothelial carcinoma showed higher EGFR expression (P < 0.001). Glandular differentiation was the most frequent type, followed by squamous and sarcomatoid differentiation. We observed the most common mutation at KRAS with a propensity for urothelial carcinoma with glandular differentiation. More than one mutation/high protein expression was seen in some tumors. Targeted therapies for KRAS mutation can be effective at urothelial carcinoma with glandular differentiation. Heterologous expression of relevant proteins and genes can be a cause for targeted treatment obstacle. The determination of the molecular characters of tumors is a guide in creating targeted treatment algorithms and in choosing the patient.
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    Type and Level of Anxiety Affects the Perception of Pain During Bone Marrow Biopsy
    (Duzce Univ, 2021) Onec, Birgul; Onec, Kursad; Esbah, Ali Umit; Esbah, Onur
    Objective: Bone marrow aspiration and biopsy (BMAB) is an essential tool for diagnosis of hematological disorders. The most frequent complaint after BMAB is pain but the severity of this pain is described very different among patients. We investigated factors predicting this pain focusing on the role of state and trait anxiety. Methods: One hundred and ten adult patients undergoing BMAB, were informed adequately and assessed with The State-Trait Anxiety Inventory (STAI) before the procedure. In this Likert-type inventory, State Anxiety Scale evaluates the current state of anxiety, asking how respondents feel at that moment. The Trait Anxiety Scale evaluates relatively stable aspects of anxiety proneness, including general states of confidence, calmness, and security. After the biopsy, pain was measured with visual analog scale. Results: Most of the patients (71.8%) described mild pain but moderate to severe pain were significantly more frequent in both high state and trait anxiety groups. Pain severity had a positive but weak correlation with trait anxiety but not with state anxiety. The described pain level was associated with older age but was not with indication of biopsy, performance status, comorbidities or previous BMAB experiences. Conclusions: Results of our study made us thought that a good communication with the patient and talking about possible outcomes days before procedure might play a role reducing his or her anxiety but because age and trait anxiety cannot be changed by using fast acting anxiolytic drugs, advantage of premedication with anxiolytics in order of reducing pain, would be limited.