title: Initial experience with delivery of palliative care toterminal cancer patients.
abstract: OBJECTIVE
  We investigated the symptoms and needs of terminal cancer patients in a region where formal palliative care is limited. Here we present the demographic features and symptoms of end-stage cancer patients living in a city in northern Turkey.
  
  
  METHODS
  The study was conducted at Gaziosmanpaşa University (Tokat, Turkey), in 2011 and 2012. End-stage cancer patients admitted or referred by various departments to our outpatient pain unit were included. Demographic data, treatment histories, primary tumor sites, patient complaints, and symptom intensities measured using the Edmonton Symptom Assessment System Scale were prospectively entered into a database.
  
  
  RESULTS
  A total of 107 patients (36 female and 71 male) were included. Gastrointestinal cancer was the most common form of cancer (43%), followed by genitourinary (25.3%) and lung cancer (15%). The most common symptom was fatigue (98.1%). The other symptoms (in decreasing order) were pain (92.5%), insomnia (92.5%), loss of appetite (76.6%), constipation (71%), dyspnea (63.6%), nausea (60.7%), cough (57.9%), and vomiting (48.6%). Eighty-six percent of the patients (n = 92) had metastases. Most lived in the city (59.8%) and 84 (78.5%) lived with their spouses.
  
  
  CONCLUSIONS
  Patients were referred at the late stages of disease with pain as the principal presenting symptom. Family members were the principal caregivers.
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Mustafa
authors: M
authors: Süren
authors: Department of General Surgery, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: İsmail
authors: İ
authors: Okan
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Ziya
authors: Z
authors: Kaya
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Serkan
authors: S
authors: Karaman
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Semih
authors: S
authors: Arici
authors: Department of Anesthesiology and Reanimation, Bağcılar Training and Education Hospital, Ministry of Health, İstanbul, Turkey.
authors: Mevlüt
authors: M
authors: Çömlekçi
authors: Department of Emergency Medicine, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Murat
authors: M
authors: Ayan
authors: Department of Emergency Medicine, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Mehmet
authors: M
authors: Esen
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Serkan
authors: S
authors: Doğru
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Aynur
authors: A
authors: Şahin
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
authors: Tuğba
authors: T
authors: Karaman
keywords: Pain; cancer; palliative care; symptoms