International Patients Expert

Severcan Eralp

İncilay Sabani

Ertan Mehmet

Balloon or botox applications used in the treatment of swallowing difficulties could not offer a permanent solution because they required repeating every 3-6 months.&nbsp;&nbsp;The POEM method, on the other hand, aims to provide a definitive solution by using it in the treatment of diseases that cause swallowing difficulties such as achalasia and diseases that cause delayed gastric emptying.&nbsp;&nbsp;Achalasia disease, which has an important place among the diseases that cause difficulty in swallowing, is manifested by symptoms such as dysphagia after eating, a feeling of getting stuck and stuck in the chest, infections caused by food coming back from the mouth and escaping into the lungs, bad breath and chest pain.&nbsp;&nbsp;The POEM method is also often used in the treatment of achalasia. Patients suffering from this disorder often apply to the physician with difficulty in swallowing. Patients begin to feel difficulty swallowing solid foods. In the future, even swallowing liquid foods is difficult.&nbsp;&nbsp;A burning sensation in the chest, intermittent cough and bad breath are also among the symptoms. Endoscopic examination is performed in patients who apply with such complaints.&nbsp;&nbsp;If the endoscope is caught in the lower part of the esophagus while passing through, achalasia is suspected. If it is seen that the esophagus narrows like an hourglass, a definitive diagnosis is made.&nbsp;&nbsp;Pressures in the muscle layer of the esophagus are measured, and if the pressure in the lower esophagus is high, achalasia is diagnosed again. With the method called esophageal manometry, the working order of the esophagus and the contraction movements during swallowing are measured.&nbsp;&nbsp;Achalasia diagnosis is confirmed by manometric measurement in patients who present to the doctor with swallowing disorder, if no tumor is detected in the endoscopic evaluation, and if there is no sign of reflux.

Overview

With the development of endoscopy, alacsia patients can be treated without any incision marks. By opening a tunnel through the wall of the esophagus, the muscle layer at the bottom of the esophagus is reached.&nbsp;&nbsp;The muscle fibers found here are cut and one goes up through the same hole. The hole opened in the esophagus is closed with small stitches. This procedure, which is performed under anesthesia, takes approximately 45-90 minutes.&nbsp;&nbsp;Patients do not feel pain during the procedure, they need to stay in the hospital for a day or two. A control film is taken the day after the surgery to see if there is any leakage.&nbsp;&nbsp;First, liquid and then solid food intake begins, it is checked again, and after it is determined that there is no leakage, the patient is discharged.

Swallowing difficulties are treated without incisions and scars.

Since the complication rates are low, the POEM method is used in the primary treatment of achalasia in the world. This method offers patients a chance for permanent treatment. It improves the patient's quality of life. There is no incision scar after the operation.&nbsp;&nbsp;One or two days stay in the hospital. The number of sessions in the treatment is decreasing. It can also be used in different diseases. The use of the method other than swallowing difficulty also increases its value.&nbsp;&nbsp;For example, in the disease called "Gastroparesis", since the movements of the stomach are very limited, it takes a long time to empty the intestines.&nbsp;&nbsp;In these patients, the muscle tissue in the exit layer of the stomach is cut with the POEM method, and after the operation that lasts for 45-60 minutes, it is determined that the rate of emptying of the stomach increases.

What are the advantages of the POEM method?

POEM treatment for patients with impaired swallowing function

In this method, which is applied using a Thulium laser, it is entered through the external urinary hole, proceeds through the urinary canal and the abnormally enlarged prostate tissue is reached.&nbsp;&nbsp;The disintegrated prostate tissues are pushed into the bladder. These particles are then removed from the urinary tract with the help of a special device. Thus, less tissue and cell damage is created.&nbsp;&nbsp;Since the prostate tissue is completely removed from its capsule, the complaints of prostate enlargement do not recur for many years. There is no burning or bleeding in the urinary canal after the surgery.&nbsp;&nbsp;Patients are usually discharged within 1-2 days, and they can return to their normal lives after an average of one week of rest.&nbsp;ThuLEP laser surgeries take an average of 1-3 hours, depending on the prostate volume. The length of stay in the hospital is an average of one or two days, depending on the prostate size and the patient's age, comorbidities or use of blood thinners.&nbsp;&nbsp;This laser-applied method can be safely applied to patients of all age groups with prostate enlargement. It can be applied with both general and spinal anesthesia.&nbsp;&nbsp;The person's previous prostate surgery does not prevent the application of this method.&nbsp;&nbsp;It is possible to consume food and liquid 4-6 hours after the application. There is no need for dressing as there is no open wound or incision on the body.&nbsp;&nbsp;After the catheter is withdrawn, the patient urinates and is discharged.

How is the ThuLEP method implemented?

ThuLEP treatment has many advantages in prostate enlargement. While providing rapid recovery of the patient, it minimizes the risks such as bleeding, urinary incontinence and sexual dysfunction.&nbsp;&nbsp;Bleeding is less than conventional surgical methods. Thus, patients who have to use blood thinners are freed from a great risk.&nbsp;&nbsp;The risk of urinary incontinence after surgery is also very low, thanks to the laser shaping and cutting of the prostate tissue, and the protection of the muscles that allow urine retention.&nbsp;&nbsp;Erection quality is preserved because the neural structures that pass around the prostate and affect erection are exposed to less heat energy. In addition, with the preservation of the anatomical structure while the prostate tissue is removed, there is no problem in the semen output after the operation.

What are the benefits of the method?

This method is applied much more successfully, especially for large prostates. It is also used in patients with bladder stones accompanying prostate enlargement, and in people who have a catheter inserted because they cannot urinate.&nbsp;&nbsp;Lazar therapy ThuLep is also used as a safe method for those who have cardiovascular diseases, who have had a bypass, who have a stent inserted, and who use anticoagulants due to vascular occlusion.

For which patients ThuLEP more suitable?

The method that treats prostate enlargement with laser: ThuLEP

Before the application of hot chemotherapy (HIPEC), evaluations are made to determine whether the patients are suitable for this treatment.&nbsp;&nbsp;If it is found to be suitable, the appropriate dose of chemotherapy drug prepared in varying doses according to the tumor type of each patient is determined.&nbsp;&nbsp;All tumors that have spread into the abdomen are removed with surgery.&nbsp;Then, the prepared chemotherapy drug is emptied into the abdomen with the help of a special machine. The drug is expected to circulate in the abdomen for close to an hour.&nbsp;&nbsp;After this process is completed, the patient is taken to an intensive follow-up and treatment program. In patients receiving standard chemotherapy for cancer treatment, treatment can be started after surgery and healing of the wounds.&nbsp;&nbsp;However, in the application of hot chemotherapy, hot chemotherapy is applied during the operation in tumors that are not visible during surgery and cannot be surgically removed.&nbsp;

Since it is accepted that hot chemotherapy is not effective in cancer patients with non-abdominal and distant metastases, it cannot be used in these patients.&nbsp;&nbsp;In intraperitoneal membrane cancers such as Hot Chemotherapy (HIPEC), large intestine-rectum cancers, ovarian cancer, appendix cancer, some stomach cancers and malignant mesothelioma, all tumors are removed by surgery.&nbsp;&nbsp;Small tumor cells that cannot be seen with hot chemotherapy are destroyed by poisoning with chemotherapy.

At which patients can Hot Chemotherapy (HIPEC) not be used?

Although very high doses of chemotherapy are given to the body in the treatment of HIPEC, there is no toxic effect because the drugs are not given to the bloodstream.&nbsp;&nbsp;Chemotherapy drugs are heated to about 42 degrees. Since cancerous cells are more sensitive to heat than healthy cells, drugs can enter cells more easily due to high temperature. This helps the treatment to be applied better.&nbsp;&nbsp;The HIPEC procedure is a procedure that should be performed by specialist physicians in the hospital setting. HIPEC is performed under general anesthesia.&nbsp;&nbsp;First, the general surgeon cuts out the tumorous organ and organs where it has spread into the abdomen and the peritoneum. This step is called cytoreductive surgery or CRS. It is then filled with heated fluid containing chemotherapy drugs into the abdomen to target any remaining cancerous cells.&nbsp;&nbsp;Oncology specialists in the operating room during the surgery decide on the exact combination of drugs and the duration of stay in the body. This time is usually between 30-90 minutes. The surgical team places a drain in the appropriate position so that the drugs are distributed in the abdomen.&nbsp;&nbsp;Warm chemotherapy is applied to the abdomen with the help of the HIPEC device through these drains. After sufficient time has passed, the drugs are discharged from the abdomen.&nbsp;&nbsp;The patient's body temperature is monitored by anesthesiologists by administering appropriate fluid therapy during the operation. The effectiveness of HIPEC treatment varies depending on the type of cancer and the extent of its spread to the peritoneum.&nbsp;&nbsp;This treatment can be very effective in ovarian, appendix and peritoneal tumors.

HIPEC has no toxic effects on the body

HIPEC 'warm chemotherapy' for advanced cancer patients

In TARE treatment, the tumor located in the liver is shrunk and made to be treated with surgery. By destroying cancerous cells, the patient gains time for organ transplantation.&nbsp;&nbsp;Since some cancer patients cannot benefit from chemotherapy, this method provides relief of symptoms. In TARE treatment, microspheres pass through the vessels and reach the tumor area in the liver.&nbsp;&nbsp;The radioactive substance in the microspheres does not harm healthy parts of the body to reach cancer cells, as in other radiation treatments.

The most important factor in cancer treatments is which treatment method will be applied to which patient. Before all treatments, the patient's history is taken in detail, and necessary examinations and tests are performed.&nbsp;&nbsp;The decision of TARE treatment is made by the meeting of physicians from various branches. In this evaluation, which we can describe as a multidisciplinary approach, physicians in the branches of oncology, nuclear medicine, radiology, general surgery, gastroenterology and pathology evaluate patients.&nbsp;&nbsp;Before the treatment, the first angiography procedure is performed by an interventional radiologist. During this procedure, the vessel or veins that feed the tumor are detected. It is checked whether the liver tumor has spread to other organs.&nbsp;&nbsp;In addition, calculations of the Y90 microsphere dose to be given to the patient are made. In this procedure, a dye called contrast and a substance called Tc-99m MAA are given by nuclear medicine specialists.&nbsp;&nbsp;Afterwards, scintigraphy film is taken to calculate the required dose in the Nuclear Medicine Department. Thus, the Y90 microsphere dose is calculated.

Which patients are suitable for the TARE method?

In order to apply the TARE method, two separate angiograms are performed. 10-15 days after the first angiography, in the second angiography, the inguinal region is anesthetized and a small incision is made.&nbsp;&nbsp;By entering through the artery through this incision, the liver artery is reached, and from there the artery feeding the tumor is reached. With the help of the catheter, Y90 microspheres are sent into the cancerous tissue.&nbsp;Y90 microsphere radioactive material is dispersed in the tumor tissue, but it has very little effect on normal liver tissue, that is, it does not harm healthy tissues. This method, which is applied for the target, can take 1-3 hours.&nbsp;&nbsp;The duration of the procedure is determined by how many tumors are treated and the location of these tumors. After the treatment, the patient is kept under observation in the hospital for 1 night, and the next day, blood tests are checked and discharged, and then he is called for control in about 10 days.&nbsp;&nbsp;One month after the TARE application, blood tests are performed as well as examinations such as CT, MRI or PET-CT, and the response to the treatment is evaluated. Since this procedure can only be applied to one lobe of the liver, if it is necessary to treat the other lobe, a separate planning is made.&nbsp;&nbsp;After the procedure, patients may experience fatigue, fever, nausea and vomiting, groin pain or bruising, and mild abdominal pain.&nbsp;&nbsp;However, with the application of treatments to eliminate these side effects, improvement is achieved within a week.&nbsp;&nbsp;After TARE treatment, patients can return to their daily lives within 1-2 days.

How long does the process take?

'Microsphere' therapy with TARE in liver cancer

TrueBeam is defined as a revolutionary new generation beam therapy technology in cancer treatment.&nbsp;&nbsp;In this system, many technical innovations are used together with robotic imaging, automatic patient positioning, motion management and a structured control system to dynamically manage the treatment.&nbsp;&nbsp;Thanks to the method, many types of cancer can be treated, including lung cancer, breast, prostate cancer, head and neck, which are among the most common cancer types. TrueBeam provides advantages to patients with its fast therapeutic power and precise dose rates.&nbsp;&nbsp;At the same time, it enables the integrated use of advanced treatment methods such as intensity modulated radiotherapy (IMRT), stereotactic body radiotherapy (SBRT) and volumetric modulated arc therapy (VMAT).&nbsp;&nbsp;To put it briefly, imaging and radiotherapy systems are used in an integrated manner in this method.

One of the most important advantages of this method is that the patients can be rapidly irradiated to the cancerous tissue by following the respiratory tract.&nbsp;&nbsp;Since the irradiation can be done by monitoring the respiratory movement, high treatment dose can be given directly to the area where the tumor is located.&nbsp;&nbsp;Thus, it is possible for the patients to stay on the treatment table for a shorter time, to reduce the tumor movement and thus to protect the healthy tissue at the highest level. Compared to other radiotherapy devices, it shortens the treatment time five times.&nbsp;&nbsp;In addition, it allows the treatment of small but risky tumors that are adjacent to important organs in the patient's body, while protecting healthy tissues at the highest level.

Decreased movement for cancerous tissue

The main feature of this linear accelerator-based method called TrueBeam is that it is a device that can apply the treatment sensitively to the movements of the patient and can only irradiate the tumor, no matter how small its size. Very small tumors in the brain can be easily treated.&nbsp;&nbsp;Thanks to the 'Vision Art' feature integrated into the system, since the patient's superficial body image is taken before the treatment, the treatment can be stopped at the slightest movement of the patient during the treatment.&nbsp;&nbsp;This feature provides an important comfort in the treatment of breast and lung patients. Because patients can breathe easily during irradiation. While the patient is breathing, the device monitors the patient's breathing or body movements, the device stops irradiation as the target area changes.&nbsp;&nbsp;Since only high-dose radiation can be given directly to the relevant tumor, the number of treatment days is limited to 3-5 days.&nbsp;&nbsp;Some cancer patients cannot be operated on because the location of the tumor and their general health conditions do not allow it. Cancerous tissue is destroyed with the help of TruBeam when it is located in vital organs and there is no possibility of surgery due to the location.

Provides precision treatment around critical organs

Fast and precise treatment with pinpointing the tumor

In the classical chemotherapy procedure, the drug is given to the patient through the arm vein. In the TAKE method, a two-stage application is performed, namely chemotherapy and embolization.&nbsp;&nbsp;Unlike the classical chemotherapy method, higher-dose chemotherapy drug is injected directly from the inguinal region into the vessels feeding the tumor formed by cancerous cells.&nbsp;&nbsp;Thus, all the drug reaches the cancerous tissue. Since healthy tissues are protected, side effects seen in classical chemotherapy do not occur. The aim of the chemoembolization (TAKE) procedure is to prevent the blood supply of the cancerous area and to ensure the destruction of cancer cells by administering chemotherapy drugs directly into the tissue.&nbsp;&nbsp;Since the microspheres used during this process remain in the cancerous tissue and prevent the tissue from being fed with blood, the death of cancer cells is accelerated.&nbsp;&nbsp;In the embolization process, which is the second part of the treatment, the blood flow to the cancerous tissue is cut off and the feeding of the cancerous tissue is prevented.

At which patients is it used?

In order to perform the TACE procedure, the patient is hospitalized and taken to the angiography room. In order to prevent pain and reduce anxiety, relaxing drugs are given through the arm vein.&nbsp;&nbsp;Then, the angiography procedure is started by entering through the groin. A thin tube called a catheter is inserted into the hepatic artery and angiography of all the vessels of the liver is drawn. In this way, the vessels that feed the cancerous tissue in the liver are determined.&nbsp;&nbsp;Through a thinner catheter, microspheres, that is, drugs contained in special particles, are given to the tissue that feeds the tumor. Microspheres, which allow chemotherapy drugs to reach cells, reach the tumor formed by cancer cells and close the vessels that feed the tissue.

How is it applied?

After the completion of the TAKE procedure, the patient needs to rest in the hospital for 4-6 hours. After the chemoembolization procedure, the patient may develop 'postembolization syndrome' with abdominal pain, weakness, fatigue, nausea, vomiting and fever. While this situation lasts for a short time in some patients, it can last for 3-4 days in others.&nbsp;&nbsp;Complications such as abscess formation and liver failure may occur rarely. Various treatments are applied to eliminate these problems. In the first month after the chemoembolization procedure, a control examination is made and the liver is examined. After 3 months, CT, MR or PET-CT are taken to understand how well the tumor responds to the treatment.&nbsp;&nbsp;Some special blood tests are also performed to monitor liver enzymes.

Patients stay in hospital for only one night

The method that cuts the path of cancerous cells: TAKE

CyberKnife device is used in the treatment of benign and malignant brain tumors, metastases, tumors in and around the eye, abnormalities in arteries and veins, and some functional diseases.&nbsp;&nbsp;Apart from these, this method is also used in the treatment of lung cancers, head and neck cancers, prostate cancers, spinal cord and spine tumors, pancreatic cancers, liver tumors, and some rare metastases that cannot be treated with other methods.&nbsp;&nbsp;CyberKnife, a linear accelerator placed on robots used in industry, is based on the principle of delivering high doses of radiation by entering coordinates in three dimensions. It is possible to apply this treatment in more than one session.&nbsp;&nbsp;It can also be used in tumors that have received radiotherapy before but where the disease reappears in the same area. During this treatment, there is no need to use an invasive frame to prevent movement in the head or body, and tumor follow-up can be performed.

Before the CyberKnife application, a plastic mask is placed on the patient's face. Then, during the treatment, they are placed on a robot-controlled table that can move in 6 directions.&nbsp;&nbsp;In this method, an image capture system is used that determines the location of the tumor, monitors the changes that will occur in the tumor and changes the patient's position.&nbsp;&nbsp;Thus, tumors in the lung and liver displaced by respiration can be treated. During the treatment, the patient does not need to hold their breath or breathe regularly.&nbsp;The system compares the patient's Computed Tomography (CT) and Magnetic Resonance (MR) images taken before the treatment with the snapshots taken during the treatment. The tumor coordinates obtained from here are evaluated instantly with the help of computers and the radiation dose is adjusted.&nbsp;&nbsp;In this way, it is ensured that the treatment is not affected by the patient's small movements. While the treatment is limited to the tumor, healthy tissues around the tumor are also preserved.&nbsp;&nbsp;With the CyberKnife device, which uses a computer-controlled robot, the treatment is completed by making turns around the patient and irradiating it from hundreds of angles.

In the CyberKnife radiosurgery system, patients feel no pain. Since no surgical incision is made, the wound does not occur. Since it is not an invasive method, anesthesia is not required. Since it is an outpatient treatment method, no hospitalization is required.&nbsp;&nbsp;It protects the healthy tissues and organs surrounding the tumor with high accuracy rates, so it has low side effects. Patients do not need to experience stress by holding their breath during the treatment.&nbsp;&nbsp;This method is usually applied as 5 sessions, but the application time is longer than conventional radiotherapy.

What are the advantages of CyberKnife method for the patient?

CyberKnife destroys hard-to-reach tumors

Gamma Knife is applied using a technique called "stereotactic radiosurgery" and ensures that the coordinated diseased brain tissue is destroyed with gamma rays.&nbsp;Thanks to this system, gamma rays from 192 globally located and separate sources are transferred onto the diseased brain tissue and this tissue is removed.&nbsp;First of all, the stereotactic frame is fixed on the patient's head in order to create the necessary coordinates for the treatment and to prevent movement during the procedure.&nbsp;&nbsp;This is vital so that the treatment can be carried out correctly and that the radiation is delivered exactly where it is needed. By applying the stereotactic frame to the patient, the exact location of the tumor is determined, and the patient is kept in the required position inside the device.&nbsp;&nbsp;During this procedure, local anesthesia is applied to the areas where the frame is placed on the head so that the frame does not cause pain, while the patient feels a pressure. After the image of the diseased area is taken, the necessary dose planning is made, and then radiation therapy is started.&nbsp;&nbsp;After each beam is given to the right place for the required time, the frame on the patient's head is removed and then monitored in the ward. Thanks to high technology, nowadays, patients can be treated with the mask method without wearing a frame on their heads.&nbsp;&nbsp;However, it is the specialist physicians who decide which patient will be treated with the frame method and which with the mask method.

This treatment does not require surgery and patients do not require a surgical incision. In particular, the treatment of tumors in the brain is done without opening the skull. After the treatment, patients can return to their normal daily life and work life one day later.&nbsp;&nbsp;This method makes it possible to treat patients who cannot undergo open surgery. The fact that the hospital stay is extremely short, there is no need for intensive care, and the patient's ability to return to work immediately reduces health-related costs.

What are the advantages of Gamma Knife therapy?

The preparation process before the Gamma Knife operation can take approximately 1.5-2 hours. The duration of the patient's stay in the machine may take an average of 1.5-2 hours, depending on the size of the lesion.&nbsp;&nbsp;After the procedure, the patient is given an analgesic by adding a serum, and he is usually discharged on the same day. The possibility of treatment by wearing a mask instead of the frame attached to the head of the patients in the treatment also provides easier access to tumors that press on the optic nerve.

How long does radiation therapy take?

Brain metastases are the most common diseases in which this method is used. It is also used in the treatment of 'meningiomas', which originate not from the brain itself, but from the cerebral cortex, grow over time and mostly damage the brain tissue.&nbsp;&nbsp;Although these are benign tumors, they need to be treated as they can damage the brain tissue. Apart from this, it is also used in the treatment of trigeminal neuralgia, which causes very severe facial pain, and acoustic neuroma, which can cause hearing and balance loss.&nbsp;&nbsp;Tumors that originate from the auditory and balance nerves in the brain and are generally benign are called acoustic neuromas. Lesions less than 3.5 cm are especially suitable for the Gamma Knife method.&nbsp;&nbsp;Although open surgical methods are primarily preferred in pituitary adenomas, radiation therapy is also used to reduce the risk of recurrence of the disease.

In which diseases is it used more?

Radiation therapy from 192 points for tumors that cannot be operated

Surgical methods are used as the first choice in the prevention and treatment of cancer. In people who are genetically predisposed to some types of cancer, conservative surgery is performed if high risk is determined as a result of the tests.&nbsp;&nbsp;The surgeon may also remove several lymph nodes to determine if the cancer has spread. In cases of breast cancer, the entire breast tissue can be removed, and only the part containing the cancerous tissue and the surrounding tissue can be removed.&nbsp;&nbsp;In cases of lung cancer, too, physicians may remove part of the lung (lobectomy) or an entire lung (pneumonectomy).

There is more than one surgical method in the treatment of cancer diseases, and these methods are being developed day by day. Among the commonly used methods in cancer surgery, apart from classical surgery, are the following:

Which techniques are used in cancer surgery?

Without the need for large surgical incisions in the body, instruments with a camera at the end and operating instruments are inserted through small incisions to view the operated area. Since the image of the operated area is also viewed on the screen, the risk of error is minimized.&nbsp;&nbsp;Since large incisions are not made as in classical surgery, patients can recover in a shorter time. Laparoscopic surgery is used for cancer diagnosis, staging, treatment and alleviation of symptoms.

Laparoscopic surgery

In robotic surgery, the surgeon uses special robotic instruments to describe how the robot must maneuver with surgical instruments to perform the operation, by watching a screen that reflects a three-dimensional view of the operating field. Robotic surgery not only helps the surgeon perform operations in hard-to-reach areas, but also contributes to shortening the healing process.

Robotic surgery

Laser surgery, which is applied in the treatment of many types of cancer, is applied by using high-intensity beams to shrink or vaporize cancer cells.

Laser surgery

It is applied to remove cancerous tissues in sensitive areas of the skin and areas close to the eyes and to evaluate the depth of the cancer. In this method, cancerous tissues are removed layer by layer with the help of a scalpel, and each layer is examined under a microscope until it is ensured that abnormal cells are not completely left.

Mohs surgery

It is applied to the cancerous tissue using a very cold material such as a liquid nitrogen spray or a cold probe. For example, cancer cells in the cervix or cells that tend to form cancer can be frozen and destroyed with this method.

Cryosurgery

Cancerous cells can be removed by applying a high frequency electrical current. It is mostly used on the skin and lips.

Radiofrequency Ablation (RFA)

Cancer surgery is applied for both preventive and therapeutic purposes.

Adult idiopathic scoliosis, which is painless in childhood, can cause pain problems in adults. Patients apply to the doctor by noticing the deformity and balance problems in their bodies.&nbsp;&nbsp;At the same time, he can notice the curvature with findings such as shortening in height, lack of clothes or not standing well on him.&nbsp;&nbsp;In particular, patients who have problems in their daily life due to low back pain and disability also experience problems such as severe pain in the intermediate joints, respiratory functions due to excessive deformity that may occur in the rib cage.&nbsp;&nbsp;Since adult degenerative scoliosis develops with the aging of the spine, it usually occurs above the age of 50, and its frequency increases considerably over the age of 60-65.

Respiratory functions are impaired

Spinal curvature can also occur due to osteoporosis. Since osteoporosis is the weakening of the bone seen with a decrease in calcium in the bone, it causes the curvature of the spine to increase further. Although degenerative scoliosis, which occurs with wear, mostly affects the waist region, it also causes complaints in the neck and back region.&nbsp;&nbsp;Since the spine curves sideways and rotates around itself, deviations cause asymmetrical appearances around the waist, hips and shoulders.

Bone loss also causes spinal curvature

For more detailed imaging of the bone, physicians may request 'Computerized tomography (CT) - MyeloCT' examination. MyeloCT is performed to better visualize the spinal cord and nerves in patients who have had previous surgery and have metallic implants in their spine.&nbsp;&nbsp;Apart from these, this test is also performed to understand the level of pressure on the nerves, especially in patients with pain in their legs.&nbsp;

How is it diagnosed?

In surgical treatment, it is aimed to correct the curvature of the spine to the extent that it provides body balance. This can be achieved by fusing the vertebrae and eliminating nerve compression.&nbsp;&nbsp;The 'decompression' process can be applied at different levels and to different parts of the spine. The doctor decides the level of surgery to be performed. After the surgery, the patients are kept in the intensive care unit for the first night. Then the patient is given leg exercises.&nbsp;&nbsp;The patient starts walking the day after the surgery. Depending on the size of the surgery, the patient needs to be monitored in the hospital for about a week.&nbsp;&nbsp;After discharge, it is aimed to return to normal life by taking an exercise program. Apart from the surgery option, corset treatment can be given to suitable patients.&nbsp;Corset treatment is given to eligible patients However, corset treatment should be considered as an adjunct to exercise and physical therapy and should be considered in the short term.&nbsp;&nbsp;Long-term use of corsets can do more harm than good. Along with physical therapy and exercise therapy, patients are also given painkillers to help with pain control. Non-steroidal anti-inflammatory (NSAID) drugs can also be added to the treatment to relieve the irritation caused by nerve compression.&nbsp;&nbsp;These treatments, other than the surgical option, can be applied individually or together. A detailed examination is required to determine which treatment is appropriate for which patient.

What is done during the treatment?

Curvature of the spine causes pain and respiratory disorders

PET-CT and MR imaging methods, which are used separately in the diagnosis and treatment of diseases, were combined. 3D PET-MR technology, which combines these two methods in a single device, provides very important advantages in the early diagnosis and treatment of diseases such as cancer, Alzheimer's, dementia and heart infarction.&nbsp;&nbsp;Thanks to this device, it is possible to stage cancers correctly and to detect even the smallest cancer spreads that cannot be detected by other methods. The method, which allows early diagnosis in Alzheimer's and dementia, also provides advantages in the diagnosis of prostate cancer. The radioactive material used for imaging the brain in PET-CT can also glow in brains without tumor problems, which can lead to misdiagnosis.&nbsp;&nbsp;The same goes for the kidneys, bladder and pancreas. The new system, which combines PET-CT and MR in a single device, is extremely important in terms of accurate diagnosis, and also offers the possibility of precise diagnosis of cancer in the form of a point-and-shoot.

Fighting cancer diseases is a tiring and time-consuming process for patients, as well as for health institutions and health professionals who provide treatment services to them, and their relatives. Patients who have to undergo many tests and examinations due to their diseases have difficulty in enduring this exhausting process.&nbsp;&nbsp;Thanks to the successful work of the technology world in the field of medicine, the use of systems and methods that shorten this tiring process in favor of patients also saves time in treatment. Thanks to the scans made with PET-MR devices, detailed information about the dimensions, stages and other details of the diseases is obtained.&nbsp;&nbsp;A very small amount of radioactive material is given to the patient through the vein and the shooting is performed. It can be determined whether the tumor formed in the body has spread beyond the organ and spread to other organs. Tumors in the bodies of pediatric patients are investigated, and it is possible to obtain detailed information on this subject.

What are the advantages of PET-MR extraction?

In this method, which is applied for the early diagnosis of cancer, Alzheimer's and heart diseases, the radiation rate of the patients decreases by 70 percent. This is especially important for children and young patients. This technology, which is also used effectively in Alzheimer's, dementia and heart diseases, gives the chance to catch Alzheimer's and dementia at a very early stage.&nbsp;&nbsp;Early diagnosis of diseases contributes to the economy of both individuals and countries. Thus, unnecessary surgical procedures and drug treatments are prevented. Due to the application of some surgical operations, some problems that will develop in the later periods are also prevented. Patients stay away from the problems that develop due to long-term hospitalization and long-term drug use.

The rate of radiation exposure is reduced by 70 percent

Early diagnosis of cancer and heart diseases with PET-MR

These transplants are usually performed with the cornea donation from deceased patients. Experts state that the cornea to be transplanted should be removed within the first 24 hours, while the ideal time is the first 6 hours.&nbsp;Cornea transplant surgeries have been performed in Turkey for many years. Although it is possible to obtain it from deceased patients without requiring permission, since it is a tissue by law, corneal transplant centers find it more appropriate to obtain permission from the families of deceased patients. &nbsp;&nbsp;However, since there are not enough donations, many patients are waiting with hope to get a cornea transplant.

Experts provide the following information about medical conditions that require corneal transplants:- Damage to the cells that keep the cornea transparent after eye surgery- Clouding of the cornea as a result of this damage- Conical shape of the corneal layer- Some inherited corneal diseases- Formation of scar tissue and new vascularization as a result of corneal infections- Stains and scars on the cornea after injury- Rejection and clouding of the transplanted cornea by the body after corneal transplantation

In which cases is a corneal transplant required?

Corneal transplant operations can be performed under general or local anesthesia. During this surgery, after the eyelids and their surroundings are cleaned properly, a small instrument is inserted to keep the eyelids open.&nbsp;&nbsp;The eye surgeon determines the diameter of the cornea to be used for corneal transplantation. &nbsp;&nbsp;&nbsp;The damaged part of the cornea is carefully removed. If cataract surgery is also required, the cataract is removed first and the intraocular lens is placed. The transparent corneal layer taken from the donor is placed on the bed and sutured to the bed using microsurgical methods. &nbsp;&nbsp;At the end of the operation, antibiotic ointment is applied to the eye and the eye is closed with a protective cover.

Corneal Transplantation is Performed Under General or Local Anesthesia.

- Take care to use the medicines given by your doctor carefully.- Be careful not to press or scratch your eye.- Use protective caps or goggles as recommended by your eye doctor.- Do not forget to wait patiently as it will take a few months to remove the stitches after the surgery.- Generally, all sutures are removed in the first year of transplant surgery.- It is necessary to be hopeful as vision will gradually improve within a year after the operation.- Take care not to enter the crowds, try not to hit your head.

What should we be careful about after the transplant?

The First 24 hour is Vital for Corneal Transplant 

Since the sternum of the patients was cut before the heart surgery performed with classical surgery, the recovery took longer after the operation and the patients faced difficulties in their daily lives. &nbsp;&nbsp;&nbsp;They had to be careful to spend the postoperative period at home, to stay away from crowds, and not to bump into something even while walking around the house. Moreover, since the sternum was cut, they had to show patience in wound healing. Thanks to robotic heart surgery, it is possible for patients to return to their normal lives shortly after the surgery.

Robotic surgery operations are frequently used in the repair or replacement of mitral and tricuspid valve diseases in the heart, in the treatment of atrial fibrillation that causes heart rhythm disorders, cryoablation also called freezing. &nbsp;&nbsp;In addition, surgeries can be performed with robotic surgery technique in coronary artery surgery, in the treatment of intracardiac tumors called myxoma, and in the treatment of congenital heart holes called atrial septal.

Which surgeries are done with robots?

There is a technical distinction between heart surgery performed by robot and heart surgery performed by open surgery. In open surgery, direct hands and hand held instruments are used. In robotic surgery, the physician performs the intervention using the tool held by the robot. &nbsp;&nbsp;The arms of the robot can move 540 degrees. In other words, there is a much wider range of motion than a normal human wrist. In addition, it is possible to enlarge the image of the surgical field 10-12 times. Since heart surgery operations take too long, the risk of the surgeon getting tired and therefore shaking hands is eliminated. &nbsp;&nbsp;Although the surgeon's hand trembles, the tool held by the robot eliminates this tremor through a computer program. Thanks to the robotic arms, a comfortable operation is provided for the patient and the physician on a very sensitive organ such as the heart.

What are the advantages of robotic surgery?

Thanks to robotic surgery, mistakes to be made due to human hands in surgical interventions in very risky areas are greatly reduced. In addition, the blood loss is much less in the surgeries performed with the robotic surgery system.&nbsp;&nbsp;Since the surgical operation area is entered with smaller incisions, bleeding is also less.&nbsp;&nbsp;&nbsp;Since surgeons usually stand during heart surgery operations, fatigue occurs in cases where the operation takes longer than normal.&nbsp;&nbsp;In surgeries performed with robotic surgery, the surgeon is in a sitting position and since he manages the operation with the help of the console opposite, muscle pain due to physical fatigue is also reduced, and the surgeon can perform the operation more easily because he is under less stress.&nbsp;&nbsp;Since the surgeon's focus on the surgery increases, there is no question of making any mistakes.

Makes a big difference in risky areas

Was Developed for Astronouts, Became Vital for Our Well-Being

For this reason, experts state that it is absolutely necessary to have a general health check at least once a year in accordance with conditions such as age group, gender and current familial risks.

Regular and regular health check-ups prevent some health problems before they occur. Early diagnosis of some diseases is effective in obtaining successful results by shortening the treatment process.&nbsp;&nbsp;For this reason, even if individuals do not have any complaints, it is important that they consult a doctor at regular intervals and obtain information about their general health status.&nbsp;&nbsp;Although it is recommended to undergo a general health check-up once a year on average, this frequency varies according to the age, gender, various diseases in their families and the risk factors related to these diseases.&nbsp;&nbsp;For example, it is possible to detect cancers of the cervix, ovary, breast, prostate and large intestine at an early stage with tests to be performed every 6 months.&nbsp;&nbsp;Early and accurate diagnosis of many diseases such as coronary artery diseases, cancer and hypertension, which are the diseases of our age, is extremely important in terms of life expectancy and quality.

These 5 Diseases can be Determined Early

Early diagnosis and regular treatment are of great importance in diseases such as hypertension, high cholesterol and diabetes, which cause damage to vital organs such as the heart, brain and kidneys, which usually progress insidiously without causing any symptoms and without causing any complaints in the patient.&nbsp;&nbsp;Early diagnosis of some common cancers such as liver disease, breast, uterus, large intestine, bladder and prostate is also possible thanks to regular check-ups.

Take precautions against insidious diseases that do not show any symptoms

Women between the ages of 20-40:&nbsp;They should have a general doctor examination, basic blood tests, urine analysis, chest X-ray, breast control, gynecological control every two years.&nbsp;Women after the age of 40:&nbsp;Women should have a general doctor examination, basic blood tests and urine analysis, EKG, chest X-ray, mammography, stool occult blood test, gynecological control and smear test once a year, starting from the age of 40.&nbsp;Men between the ages of 20-40:&nbsp;They should pay attention to have a general doctor examination, basic blood tests, urinalysis and chest X-ray every two years.&nbsp;Men after the age of 40:&nbsp;It is important for men to have a general doctor's examination, basic blood tests and urine analysis, ECG, chest X-ray, stool occult blood test, urological control and PSA test every year from the age of 40.&nbsp;Both men and women after the age of 50: In addition to the above, both women and men should have colonoscopy and endoscopy, and regularly monitor their health according to the results, even if they do not have any complaints. &nbsp;&nbsp;&nbsp;In addition, it is recommended that people who smoke, have a family history of chronic diseases, and have health problems such as diabetes or high blood pressure should have an exercise ECG and cardiology check every 2 years after the age of 40 at the latest.

What checks should be done at what age?

Have a Check-up Once a Year to Learn about the Hidden Diseases in Advance

Among these diseases, blood sugar irregularities, rhythm disorders that disrupt the working order of the heart, vascular occlusions that affect the blood supply of the brain, some eye problems, changes in the blood table and some intracranial tumors also cause vertigo.&nbsp;When vertigo occurs, individuals report feeling dizzy, having difficulty maintaining balance, and feeling as if the ground is slipping under their feet. &nbsp;&nbsp;&nbsp;There is a very complex mechanism that keeps our body in balance. In order to achieve this balance, the signals coming from the balance channels in the inner ear, the eye and the musculoskeletal system need to harmonize in the balance center of the brain. If this harmony is disturbed, dizziness problems arise.&nbsp; &nbsp;While sitting in a place or lying in bed, the person may experience a constant dizziness, as if traveling on a ship caught in a storm.

Experts state that there are 2 types of vertigo disease, 'peripheral' and 'central'. In peripheral vertigo, balance problems are experienced due to diseases caused by the 6 balance channels in the inner ear. In central vertigo, it includes all disorders that cause vertigo outside the inner ear canals. &nbsp;&nbsp;&nbsp;These disorders include many diseases such as blood sugar irregularities, arrhythmias that disrupt the working order of the heart, vascular occlusions that disrupt the blood supply of the brain, some eye disorders, changes in the blood table, and some intracranial tumors.

There are 2 Main Types of Vertigo

Since central vertigo includes many diseases, it is of interest to ear nose and throat physicians as well as medical branches such as neurology, ophthalmology, internal medicine, cardiology, neurosurgery and psychiatry. &nbsp;&nbsp;&nbsp;For example, dizziness can occur even with the side effects of antidepressant drugs used in the treatment of psychiatric diseases. Dizziness may occur during the initiation and discontinuation of these drugs.

Vertigo is Dealt in 7 Different Health Branches 

The first evaluation of patients with vertigo is made by otolaryngologists. During the examination, it is investigated whether the disease is caused by the inner ear or other diseases. &nbsp;&nbsp;&nbsp;If it originates from the inner ear, it is being tried to determine which type of inner ear disease it occurs. If there are central causes, investigations are made for the suspected disease. In cases of vertigo of neurological origin, the disease can be detected by neurological examination and brain MRI. &nbsp;&nbsp;&nbsp;Cause-oriented treatments are given in vertigo clinics in some hospitals. If there is a condition originating from the inner ear, it should be accompanied by dizziness and nausea. It is very important to find the cause for an effective treatment in vertigo. For this, some laboratory tests specific to the disease are performed.&nbsp; &nbsp;As a result of these tests, two situations usually arise: the first is the movement of the crystals in the inner ear, and the second is ear pressure called Meniere's. &nbsp;&nbsp;When the direction of the crystal play is determined, these structures, which have come out of their own channel with maneuver treatment, are sent to where they belong. If there is ear pressure called Meniere's, medication and diet therapy are applied. Contrary to popular belief, vertigo is not a lifelong disease.&nbsp;&nbsp;If the cause is treated, patients can regain their health and return to their daily lives.&nbsp;

First, the Type of Vertigo is determined

Not Only One, Many Diseases Cause 'Vertigo' 

Many of the orthopedic problems that occur in adulthood are caused by childhood orthopedic diseases that were not diagnosed in childhood, were not adequately treated and followed up properly. For this reason, these diseases can be diagnosed while still in the womb, thanks to advanced technological facilities and detailed tests.&nbsp;Orthopedic problems that arise in children at birth or during developmental stages worry families. However, identifying problems at an early stage also increases the success of treatment.&nbsp;Although the orthopedic diseases seen in this period are very diverse, the treatment of each requires different approaches. &nbsp;&nbsp;Among the orthopedic disorders seen in children, it is possible to count the following: "Structural disorders and shortness of the bones, orthopedic problems caused by neurological diseases, congenital and developmental extremity anomalies, pediatric foot and ankle problems, hip problems, fractures and problems related to fractures, spinal problems, genetic and metabolic bone diseases."&nbsp;

As we have listed above, a wide variety of congenital orthopedic problems occur in children. However, some are more common. We can say the following about the most common congenital orthopedic problems and treatment approaches:

Congenital orthopedic diseases can be treated

Children with congenital hip dislocation walk late. Early diagnosis is very important in the treatment of hip dislocation. If treatment is started from the moment of diagnosis in the first months after birth, the problem is solved with the help of simple devices and bandages.

Hip dislocation

It is predicted that the foot will take its normal shape after 3-4 years of age in children. In children born with congenital flat feet, the feet appear longer than they are because there is no arch of the foot. It is much easier to treat at an early age. If the problem still persists in adolescence, it is important to consult a physician for treatment.

Flat feet

The congenital inward pressing problem of children's feet can usually resolve spontaneously until the age of 8 years. If it does not improve, the problem can be resolved with surgical treatment.

Inward pressing of the foot:

The orthopedic problem, which usually occurs with complaints such as limping and limping, definitely requires treatment. If there is constant pain and limping in the hip or knee of the child, it is important to consult a pediatric orthopedic specialist as soon as possible.

Perthes disease

In children with clubbed feet, the toes and heel turn inwards. In addition to this deformity in the foot, the legs are also thinner and shorter than normal. Crooked feet can be completely healed with the appropriate treatment method.

Clubfoot problem

It is understood when the baby's neck is tilted to one side at the time of birth. In the initial treatment, special exercises are performed several times a day. The head is turned to the opposite side and the neck is tilted to the opposite side. &nbsp;&nbsp;&nbsp;In this way, the length of the muscle is elongated. With appropriate exercise treatments, this problem is usually expected to resolve within a year. If there is no improvement, it can be corrected surgically.

Curved neck surgery

Congenital orthopedic diseases are diagnosed during pregnancy

Epilepsy can occur at any age, starting from the newborn. In the treatment of the disease, the first recommendation of physicians is drugs. &nbsp;&nbsp;&nbsp;In this case, the option of surgical operation comes to the fore with the joint evaluation of physicians from more than one branch. However, the surgical option should not be viewed as the only solution. &nbsp;&nbsp;&nbsp;Because despite the surgical application, there may be patients who have seizures, although not very often. Here, it is important to determine the patients who will undergo surgery very well.

Although the treatment of epilepsy is mainly drug therapy, some patients do not get results despite drug therapy. &nbsp;&nbsp;&nbsp;It is thought that these patients have a focus that is absent in other patients. If this focus is detected and surgically removed, results can be as successful as drug treatment. &nbsp;&nbsp;&nbsp;It is not possible to give the same success rate for all epilepsy patients who underwent surgical operation. However, if it is considered that patients have constant seizures despite using two or three drugs, the success of surgery by more than 50 percent reduces the number of seizures and improves the quality of life of the patients.&nbsp;In order for these operations to be performed on a patient with epilepsy, he must have received drug therapy for at least two years before the operation, and yet his seizures continued. &nbsp;&nbsp;&nbsp;About 70 percent of people with epilepsy can control their seizures with medication. 30 percent of patients continue to have seizures despite medical treatment. However, additional testing is required to determine whether a patient is a candidate for surgery. Thanks to this surgery, the part of the brain that causes seizures is removed.&nbsp;

First choice drug in the treatment of epilepsy

Epilepsy surgery has many different application methods. For this reason, when deciding which surgery will be applied to which patient, the type of seizures and where they start in the brain are looked at. &nbsp;&nbsp;Epilepsy surgery works best for people who have seizures in a particular area of ​​the brain. Before the surgery, the area in the brain where the seizures started is determined. &nbsp;&nbsp;&nbsp;For this purpose, besides imaging methods, many tests are performed. It is also necessary to make sure that the area where the seizures begin is not involved in important brain functions including speech, movement or memory. &nbsp;&nbsp;&nbsp;With the help of epilepsy surgery, it is possible to successfully and safely stop seizures in most cases by removing the seizure focus in the brain. Some patients may need a secondary surgery. However, many patients are permanently free of seizures or have significantly reduced seizures after surgery. This increases the quality of life.&nbsp;As with any surgical treatment, epilepsy surgery has its own risks. One of the most feared risks is the continuation of seizures despite surgery. There are also risks associated with surgery and anesthesia. Apart from the absence of seizures, the most feared point is the risk of permanent damage to the brain. &nbsp;&nbsp;&nbsp;For this reason, when making decisions in epilepsy surgeries, patients should be handled with a multidisciplinary approach by physicians working in different branches by specialist physicians.

The surgery is more successful in those who have seizures in a certain part of the brain

Surgery offers hope to patients of drug-refractory epilepsy

TARE "Trans-Arterial Radio Embolization" treatment is among these treatments. In this method, irradiating microspheres are sent by entering the artery feeding the cancer tissue through the artery. &nbsp;&nbsp;&nbsp;Radioembolization therapy is administered with irradiating microspheres called Yttrium-90 (Y-90) into the artery feeding liver cancer and is a newer treatment method than chemoembolization.&nbsp;This method, which is mostly used in liver cancers, is performed with angiography, just like chemoembolization treatment. However, it is not yet used in the treatment of other types of cancer.&nbsp;Radioembolization therapy is generally applied among the last options in the group of patients who cannot be treated surgically and who have not benefited from standard chemotherapy.&nbsp;Since the drugs used in the chemoembolization process are limited, some tumors do not respond to these drugs and the drugs become ineffective. &nbsp;&nbsp;In the radioembolization process, very small diameter particles (microspheres) that emit radiation directly, not drugs, are given with angiography.&nbsp;&nbsp;Radiation is applied in the 5 mm area around the vein where these globules are given. &nbsp;&nbsp;&nbsp;Tens of thousands of these microspheres are injected into the tumor tissue. Since its area of ​​influence is very limited, it does not affect any tissue other than the liver. In this treatment method, angiography is performed twice.&nbsp;&nbsp;&nbsp;First of all, the distribution and volume of the tumor in the liver are calculated by methods such as computed tomography or magnetic resonance imaging.&nbsp;

Radioembolization angio method is defined as a treatment method applied to cancers in the liver, cancers such as large intestine, pancreas, spread to the liver. &nbsp;&nbsp;In the radioembolization procedure, angiography is performed twice, with an interval of 15-20 days. In the first, the entire vascular system of the liver is displayed. &nbsp;&nbsp;&nbsp;By applying a special test drug to the tumor area, it is monitored how much of these particles are directed to the lungs. If a large amount of particles goes to the lungs, it can be decided not to do the treatment.&nbsp;&nbsp;In the second angiography to be applied during the treatment, it is expected that 15 days will pass. Since the life of the microspheres used in the treatment is very short, they must be used on the day they are produced. &nbsp;&nbsp;The second angiography, that is, the treatment angiography, usually takes a shorter time than the first. The hepatic vein is reached with a thin plastic angio catheter by entering through the inguinal vein. &nbsp;&nbsp;&nbsp;From here, films showing the tumor vessels are taken again. By determining the tumor tissue and the artery feeding it, the radioembolizing substance (radiating particles) prepared during the procedure is given in the vessel feeding the tumor.

Angiography is performed twice in this method

Since the procedure is performed under local anesthesia like any angiography, the patient does not feel pain. &nbsp;&nbsp;&nbsp;Since angiography is performed only twice, it needs to be applied approximately 15-20 days apart. The first angiography is called preparatory angiography, and the second is called treatment angiography. &nbsp;&nbsp;&nbsp;Each of these procedures, together with the stages of local anesthesia, both angiograms are easy and comfortable procedures for the patient. Each of these procedures takes 45-60 minutes. &nbsp;&nbsp;&nbsp;After the first angiography, patients can go home the same day. After the second angiography, it is usually necessary to stay in the hospital for one day.Tedaviden sonra bir ya da ikinci ayda PET tomografi, tomografi ya da emar görüntüleme ile kontroller yapılması gerekiyor.

It is done with local anesthesia

Liver cancer is being treated with microspheres

Cartilage damage, which can occur in the joints for different reasons, causes wear, pain and eventually calcification, especially in the knee and hip joints. &nbsp;&nbsp;Since cartilage is a very special structure, it cannot renew itself when the cartilage cell dies, so it is necessary to stop this damage in the joints and prevent its progression.

Stem cells in the human body are prepared from bone marrow or adipose tissue and transferred to the damaged area of ​​the knee with the help of an injection.&nbsp;&nbsp;In case of damage to the knee cartilage, it is necessary to ensure that the stem cells act only in the damaged area without spreading into the knee. Stem cells specially prepared for this purpose are given to the damaged area, while collagen or hyaluronic acid-based carriers provide targeted effects. &nbsp;&nbsp;&nbsp;Stem cells are the main cells that have the potential to transform into all cells in the body. Stem cells, which are divided into two as embryonic stem cells and adult stem cells, have the ability to regenerate adult tissues in adults, so they allow the body to be repaired.

Stem cells are collected from bone marrow and adipose tissue

Stem cells are obtained from adipose tissue and bone marrow. Local anesthesia is applied in order to prevent the patients from feeling pain during the cell removal process. Stem cells in the adipose tissue taken from the pelvis or umbilicus are subjected to filtering and separation under sterile conditions. &nbsp;&nbsp;&nbsp;After the completion of the stem cell preparation process, which takes approximately 20-30 minutes, the pure stem cells obtained are given to the patient by injection. &nbsp;&nbsp;&nbsp;In order for stem cell therapy to be successful, patients must be selected correctly and stem cells must be obtained with the appropriate technique. In order for stem cell therapy to be long-lasting, patients need to make some permanent changes in their lives and apply them throughout their lives. &nbsp;&nbsp;&nbsp;Losing excess weight, if any, following healthy eating rules for the rest of life, and regular exercise affect the success of the treatment significantly.

How are stem cells obtained?

Stem cell therapy for joint damage in the knee

HIFU, a non-surgical treatment method, is widely used in the treatment of prostate cancer. HIFU technology, which uses high-intensity ultrasound waves, is applied as a point-targeted treatment without surgery in prostate cancer. &nbsp;&nbsp;This method is seen as a more suitable treatment option for young patients who do not want to have urinary problems and who have an active sexual life.With the widespread use of screening tests, the incidence of prostate cancer has been increasing in recent years. &nbsp;&nbsp;&nbsp;Prostate cancer is the second most common type of cancer in men and can be successfully treated thanks to early diagnosis. High-intensity localized ultrasonography, or HIFU technology, has been used in the treatment of prostate cancer in recent years. &nbsp;&nbsp;&nbsp;With this technology, only the cancerous tissue and its surroundings can be treated without destroying the entire prostate. Urinary incontinence and erection problems can be seen after prostate surgery.&nbsp; &nbsp;Especially in young patients, this can lead to financial and moral problems. Since there is no need to completely remove the prostate with HIFU technology, the incidence of these problems is also reduced. In open surgeries, patients stay in the hospital for 3-4 days. &nbsp;&nbsp;&nbsp;Radiotherapy treatment takes 30 days. The patient has to come to the hospital every day. The HIFU procedure, on the other hand, is a one-session procedure and patients stay in the hospital for only one night. Since the harmful effects of radiation are not exposed and the surrounding tissues are not damaged, the complication rate is also low.&nbsp;

The HIFU method is mostly applied in the early stages of prostate cancer, in small and non-invasive patients, as well as in patients whose age or general condition is not suitable for prostate cancer surgery, those who prefer minimally interventional treatment against radical surgical treatment methods, and patients who have had previous abdominal surgeries.

For which patients is the HIFU method more suitable?

Prostate cancer treatment with HIFU is done by giving a light dose of anesthesia. High-power ultrasound waves are sent to the cancerous area of ​​the prostate by entering the anus with a probe. &nbsp;&nbsp;With the absorption of these, there is an increase in temperature of 85-100 degrees, so only cancerous cells are destroyed. In addition, targeted treatment is carried out by protecting the healthy prostate tissue around the cancerous tissue. &nbsp;&nbsp;HIFU prevents sexual dysfunction as well as provides urinary control. The application takes one session. Patients can return to their homes after staying in the hospital overnight. When the procedure is applied in the morning, patients can go home in the evening of the same day. &nbsp;&nbsp;&nbsp;The risk of complications is also low, as it provides the chance to interfere with the cancer tissue without damaging the surrounding organs and tissues. Patients are not exposed to the harmful effects of radiation.&nbsp;

How is HIFU being applied?

HIFU method delights patients with prostate cancer at a young age

As a result of this, controls are made and it is decided which of the couples has a problem, the degree of this problem and the treatment methods to be applied. If it is decided to do IVF, it is time to choose the right center.Couples often do not know what conditions should be present in an IVF centre, and which is the right IVF centre. The opening of many centers as a result of the widespread use of IVF treatments in recent years makes this choice difficult for couples. &nbsp;&nbsp;&nbsp;Choosing the right IVF center is important in terms of both the patient's health and the financial possibilities of the couples. Due to the mistakes made by the IVF center, couples are hesitant to try these treatments again, and their financial means are also decreasing. &nbsp;&nbsp;&nbsp;For this reason, it is possible to list the main points that patients who are decided to have IVF treatment should pay attention to before choosing the right center:&nbsp;- What is the live birth rate in the IVF center?- How long has the IVF center been in operation?- How long has the team been working together?- Do they inform you accurately and in detail?- Do they do embryo freezing?- What are the pregnancy rates?- What is the success rate in frozen embryos?- Does the IVF center have its own genetic laboratory?- Does your center have Turkish and foreign standard work certificates such as ISO?&nbsp;Apart from all these, the doctors who perform the IVF application in the IVF center you will go to must be embryologists who are experts in their field. &nbsp;&nbsp;It is also important to be able to meet with people who have received IVF treatment in this center before, and that the center is close to where you live. The full documentation and physical qualifications of the said IVF center should be among the criteria sought. &nbsp;&nbsp;&nbsp;Since the couples will have placed all their hopes on the treatment service they will receive from the center, investigating all the conditions to the smallest detail and the comments of the couples who reported positive opinions after the IVF application will also help to make this choice.

One of the features you should pay attention to when choosing an IVF center is that the IVF center is close to your home and easily accessible. In addition to the cost of IVF, this is also important in order not to add travel costs and to overcome conditions such as traffic jams. &nbsp;&nbsp;The proximity to your home will be an advantage as you will have to visit these centers frequently for examinations, vaccines, vitamins and injection supplements required for treatment.

The IVF Center Should be Located Near to Where you Stay 

Choose the right IVF center to relieve the longing for a child

Symptoms of the disease, which are not very obvious in the early period, lead to different health problems in the later periods. Therefore, it is important to know the symptoms of the disease well. Among the main symptoms of scoliosis, we can count the following:&nbsp;"Spine bending to the right or left side, visible curvature of the spine, asymmetry in the shoulders and hips, difficulty in standing upright, shortness of breath, problems in walking, back, waist and shoulder pain, clothes not fitting properly."Families have the most important role in understanding scoliosis and not missing its symptoms. Parents need to carefully observe their children. &nbsp;&nbsp;&nbsp;For this, the back and waist of the children should be looked at, it should be monitored whether the spine goes straight down, whether there is a hump, whether there is a low shoulder, whether the waist and shoulder alignment is correct. &nbsp;&nbsp;&nbsp;In addition to all these, it is important for families to check whether their children's spine protrusions are a single line in the midline, and to observe walking balance. Scoliosis disease can also manifest itself with back and low back pain. In the early stages, the patient may not be able to feel these symptoms. &nbsp;&nbsp;For this reason, it is necessary to perform a spinal examination at an early age, as well as visual and hearing examinations for children. In addition to the examination, having a spine X-ray for children makes early diagnosis possible. &nbsp;&nbsp;&nbsp;As the curvature progresses in a neglected spine patient, problems in lung capacity and heart development increase. This situation adversely affects the respiratory and circulatory system of the person.

Pre-planning in scoliosis surgery also helps to know which part of the spine will be intervened. During this surgery, the spine is straightened by placing screws. In scoliosis surgeries, surgical teams use systems called neuromonitors.&nbsp; &nbsp;These monitors provide instant messages about the nerves in the spine. In scoliosis surgeries, it is of great importance not to damage the spinal nerves, as well as to straighten the patient's spine. &nbsp;&nbsp;&nbsp;On the first day after the operation, the patient is allowed to walk, if he cannot walk on the same day, he is carried out the next day. Then an X-ray is taken by keeping him standing upright. &nbsp;&nbsp;&nbsp;It is checked once again whether the screws are inserted in the right places by tomography. Shoulder balance and hip balance are checked. Then the patient is discharged within 5 days.

Scoliosis treatment is done with surgical methods

Since scoliosis is a health problem caused by the curvature of the spine, it also negatively affects the physical appearance. &nbsp;&nbsp;&nbsp;For this reason, the most important effect after the operation is the improvement of the patient's spine, as well as some lengthening of the patient's height. Performing scoliosis surgery with a neurosurgeon and orthopedic specialist creates confidence in the patient. &nbsp;&nbsp;&nbsp;After the surgery, the process of fusing the screws attached to the spine to the bones begins. Over time, there may be complications, breakage and loosening of the screws. Depending on the strain, the pelvic (hip) setting of the person may deteriorate. &nbsp;&nbsp;&nbsp;To prevent this, patients should pay attention to their weight balance, do not lift heavy loads, stay away from compelling exercises, do exercises to relax their muscles, and avoid sudden movements. If these are done, it is possible to maintain the healthy appearance of the spine provided by surgery for many years.

Patients get taller after the surgery

Spinal control in children enables early diagnosis of scoliosis

In patients who are faced with the fact that breast tissue is removed as a result of breast cancer, the nipple and breast skin are preserved, and the breast tissue damaged by cancer is removed, and the breast is reconstructed by placing a prosthesis.&nbsp;Today, both the tumor is removed and the prosthesis is placed in a single operation. Thus, after breast cancer, patients lose both their aesthetic appearance and the breast tissues necessary for the healthy posture of the spine, so they can get through the process more easily without feeling depressed. &nbsp;&nbsp;In classical mastectomy surgery, the entire breast skin and breast tissue are removed, so a straight line is formed in the chest. This causes some aesthetic concerns in women. Now, this method of mastectomy is applied only in cases where the tumor has invaded the entire breast skin. &nbsp;&nbsp;Therefore, it is very important to detect breast cancer at an early stage. If it is caught at an early stage, after the tumor is removed, women can also have aesthetic breast surgery.&nbsp;Catching breast cancer at an early stage and performing breast-conserving surgery also affect women's breastfeeding. Since the breast tissue is not damaged after the breast prosthesis is placed for aesthetic purposes only, there are no problems with breastfeeding. &nbsp; &nbsp;&nbsp;However, since breast integrity cannot be preserved in patients whose cancerous breast tissue is removed by mastectomy, breastfeeding is affected whether or not a prosthesis is placed. Today, in patients with early diagnosis, since only the affected part of the breast tissue is removed by preserving the nipple, it is possible for patients with prosthesis to breastfeed.

Patients can see how the breast will look after the surgery, digitally in 3D before the surgery. This also reduces stress for them. &nbsp;&nbsp;&nbsp;After the pre-operative planning is made, the general surgeon and plastic surgeon go into the operation together. General surgeon performs nipple and breast skin sparing mastectomy. &nbsp;&nbsp;&nbsp;Sampling of lymph nodes from the armpit is then performed. If the result is clear, it means that the patient will not receive radiotherapy. If they will not receive radiotherapy and the breast will be protected, prosthesis is applied to these patients.

The patient is able to see the new breast in 3D before the operation.

After the surgery, the patients only have scars as if they had a breast reduction or lift surgery. It is important for patients to rest for a week, after about 3 weeks, it is possible to return to their daily work, and they can do sports within 6 weeks.&nbsp; &nbsp;For this reason, it is necessary to prepare for the age of 40 with breast examination and ultrasound examinations after the age of 20. It is important to come to the age of 40 with ultrasound and examination from the age of 20, and to have examination, mammography and ultrasonography once a year at the age of 40-50. &nbsp;&nbsp;&nbsp;Since the risk increases 17 times in women with a family history of breast cancer, examinations should not be delayed from a very young age.

It is possible to return to daily life 3 weeks after the operation.

During breast cancer treatment, a new breast is made to the patient within the same session.

Whole body MR imaging is suitable for people in the risk group for cancer, cancer patients and people who want to have a general purpose body scan. With this method, tumor formations in the body are diagnosed at an early stage in patients who are in the risk group for cancer. It is possible to evaluate the stage of the disease and to determine whether it has metastasized with the whole-body MRI, which is also preferred by cancer patients. In addition, it is also used in the evaluation of responses to treatment in patients undergoing cancer treatment. People who want to have their general health checked once a year can also have many procedures covered by general health screening done in a single session, thanks to whole-body MRI. This method, which analyses the entire body in approximately 50 minutes, helps diagnose tumors in many organs at an early stage. With MRI, a wide area is examined, including the brain, rib cage, trunk, neck, spine and legs up to the knee. But there are also cases where this method cannot be used. For example, whole body MRI technique cannot be used in the evaluation of joints such as knees and shoulders, imaging of the breast and prostate, and evaluation of neck, back and waist hernias, as special shots are required in these cases.

Who should get a whole-body MRI?

There is no radiation exposure to the body in MRI examinations, it can be used safely in children and pregnant women after 3 months of gestation. Thanks to this method, the whole body can be imaged in a single session, no radiation is taken, and no contrast material is used during the examination. &nbsp;&nbsp;There is no need for entering the examination with an empty stomach and there is no need to drink plenty of water to ensure bladder congestion before the exam. While the areas scanned with classical radiological methods are limited, a wide area can be examined with the whole-body MRI. Early detection of tumors and tumor-like lesions is ensured. It can be applied to all age groups as it carries no risk and side effects.&nbsp;During this examination, the person is dressed in a metal-free clothing suitable for MRI. A device with receiving antennas is placed on the patient, and while the person is stationary, shots are taken in sequence, starting from the brain, to other regions, thanks to the moving table of the MRI device. &nbsp;&nbsp;The person needs to lie still on the MRI table for 50 minutes. During the shooting of the abdomen and chest regions, the person undergoing the MRI is asked to hold their breath for no more than 20 seconds.

Is the patient exposed to radiation during the Whole-Body MRI?

Whole-body MRI provides detailed imaging of tumors

Breast cancer, which is seen in one of every 8 women today, is one of the leading causes of cancer-related death in women. The diagnosis of breast cancer, which is treatable and can be cured when detected at an early stage with regular screening, can be diagnosed using technological diagnostic methods. Digital mammography, which is one of the scanning methods, allows to see nodules that are too small to be touched, and enables the masses that cannot be seen even in ultrasound to be marked and removed. &nbsp;&nbsp;&nbsp;<img src="http://res.cloudinary.com/dxqhh15dp/image/upload/v1705045505/softawepost/qdfa2ak5x11f2gwcivdt.webp" width="2212" height="1250">Images obtained from digital mammography, taken with a lower dose of radiation compared to normal mammography, can be examined in much more detail on the screen, since they are done in a very high resolution. Digital mammography is a low-dose X-ray imaging method used in breast cancer screening and early detection. Thanks to digital mammography, cancerous cells can be detected when they are very small and at a stage that can be easily treated. Despite all its advantages, small masses cannot be seen with digital mammography in those with dense breast tissue. In these cases, the radiologist may request additional imaging methods such as ultrasonography, tomosynthesis and breast MRI.

If a woman notices a palpable mass in the breasts, if there is a collapse in the nipple, if the breast skin is hard, if there is fluid coming from the breast and if there is a breast implant, mammography can be performed for diagnostic purposes. If there is a family history of breast cancer, it is important to have it done at an earlier age. &nbsp;&nbsp;&nbsp;The advantages of digital mammography include the high resolution of images, the detection of cancer cells microscopically, the detection of calcification areas, the detection of nodules that are too small to be palpable, and the ability to mark and remove masses that cannot be seen even on ultrasound.&nbsp;<img src="http://res.cloudinary.com/dxqhh15dp/image/upload/v1705045550/softawepost/om2kjjuqsidfovftxw0s.webp" width="708" height="400">&nbsp;Among the advantages of digital mammography are the high resolution of the images, the detection of cancer cells microscopically, the detection of calcification areas, the detection of nodules that are too small to be palpable, and the ability to mark and remove masses that cannot be seen even on ultrasound.&nbsp;&nbsp;During this examination, images of each breast are obtained from the front and the side in two different positions. If there is a suspicious finding, some additional images can be taken for diagnosis. In people with sensitive breast tissue, digital mammography should not be performed in the premenstrual period as it will increase the pain because the breast is compressed. It is important to take a bath before the mammography examination, and not to use occlusive substances such as deodorant, talcum powder and lotion on the armpits. Before the examination, it is necessary to inform about the diseases in the family, whether there is a history of surgery, the possibility of pregnancy, and previous breast scan images must be shown to the doctor too.&nbsp;

For which patient group is digital mammography applied?

A pressure may be felt in the breast during the digital mammogram procedure. There is no ongoing pain after the procedure. The reason for this feeling of pressure is due to the compression of the breast tissue between the two plates of the mammography device. &nbsp;&nbsp;<img src="http://res.cloudinary.com/dxqhh15dp/image/upload/v1705045637/softawepost/qdjavcehzd8avacuuz5w.webp" width="708" height="400">Performing the compression process accurately and sufficiently increases the diagnostic value. Adequate compression provides a clearer imaging opportunity, especially in women with dense breast structure, by allowing the tissue layers to separate one from another.&nbsp;

Is digital mammography a painful procedure?

Women over 40 should undergo a mammography once a year

In order to expand this practice, patients with living donors but whose blood groups do not match apply to the transplant center, thus expanding the patient pool, and the difficulties in finding organs for transplantation can be overcome more easily.&nbsp;<img src="http://res.cloudinary.com/dxqhh15dp/image/upload/v1705045244/softawepost/riyiybh3ggkarwxapnzf.webp" width="2212" height="1250">&nbsp;In our country, cross-over transplantation is carried out according to the "Organ and Tissue Transplant Services Regulation" published in the Official Gazette dated 1/6/2000 and numbered 24066. It entered into force by being published in the Official Gazette on March 5, 2010, by adding the regulations regarding cross-over transfer to the regulation. We can briefly summarize the arrangement in the regulation as follows: "Living donor organ transplantation can be made from the spouse of the recipient, with whom he has been living for at least two years, blood relatives up to the fourth degree (including the fourth degree) and it can be made from blood relatives and relatives in law. &nbsp;&nbsp;&nbsp;Cross-over transplant is a type of transplant in which suitable donors of two patients awaiting organ transplant give organs to each other's recipients. Cross-over transplants can be done between patients registered at any organ transplant center with mutual consent, without applying to the commission. The transplant center sends the documents related to the cross-over transplants to the Ministry of Health within one week at the latest.

Any healthy organ can be donated. In our country; Organs such as heart, liver, lung, kidney, pancreas, heart valve, transparent corneal layer of the eye, muscle and bone marrow tissues can be transplanted successfully. In order of frequency in Turkey; kidney, liver, heart, pancreas, small intestine and lung transplants are performed. There are two kidneys in the human body except those who are born with one kidney.&nbsp;&nbsp;The liver also has a structural self-renewal feature. While having double kidneys makes it possible to transplant from a living donor, it is also possible to transplant from a living donor due to the liver's ability to regenerate itself. Since the most common organ transplants are kidney and liver transplants, patients waiting for these transplants are more than those waiting for other organs.&nbsp;<img src="http://res.cloudinary.com/dxqhh15dp/image/upload/v1705045329/softawepost/gstyzz4tmvljj2e1vmuj.webp" width="708" height="400">

Remedy when blood type does not match: Cross-over Transplant

These risk factors include obesity, cigarette consumption, a diet poor in fruits and vegetables, a sedentary lifestyle, and use of alcohol. In particular, tobacco use is an important risk factor for cancer and accounts for 22 percent of cancer deaths. Hepatitis and HPV virus, on the other hand, account for about 25 percent of cancer cases in low and mid-income countries. Today, 30-50 percent of cancer cases can be prevented by avoiding risk factors and by early diagnosis. However, early diagnosis and subsequent treatment is possible with joint evaluations and treatments of multiple branches.&nbsp;More than one branch or discipline plays a role in the diagnosis and treatment of certain diseases, especially when it comes to cancer. This is called a "multiple branch" or "multidisciplinary approach". Physicians of the relevant surgical branch, radiotherapist, medical oncologist, pathology specialist and radiology specialist are among the branches that must be present in the councils, called tumor councils, where there are specialists from different branches.&nbsp;&nbsp;Particularly in the treatment of cancer, it has become a necessity to involve more than one branch in the treatment process because cancer treatment has taken a very different and complex form compared to the past. The division of cancer patients into many subgroups, the rapid change in diagnosis and treatment approaches, the fact that cancer patients live longer than before, and problems that were not seen before in this process have made it impossible for cancer patients to be managed by a single doctor.&nbsp;Taking all these problems into account, nowadays, modern oncology centers have a cancer team consisting of oncologists, surgeons, radiotherapists, nuclear medicine and radiology specialists, interventional radiologists and other related physicians. These teams also handle patients holistically and ensure that the most appropriate treatment options are offered and applied.&nbsp;<img src="http://res.cloudinary.com/dxqhh15dp/image/upload/v1705038401/softawepost/tr5zronwdruw6odxpdnk.webp" width="2212" height="1250">

Classic treatment methods in oncology include chemotherapy, radiotherapy and surgery. In some types of cancer, one of these methods may be sufficient, while in others it may be necessary to use some or all of these methods at the same time or in a certain order. Interventional radiological methods have also played an important role in cancer treatment, especially after the 2000s. These methods, which are also called "interventional oncology”, make it possible to enter the skin with a needle and destroy the tumors. In addition, interventions made via an artery are also in use.&nbsp;&nbsp;Interventional oncological methods, like radiotherapy and surgery, are used as an alternative in some patients because these are effective treatments in a certain part of the body. Since cancer treatments take a long time, many patients need to use interventional oncological methods among themselves or in combination with classic methods such as surgery, chemotherapy and radiotherapy.

POEM treatment for patients with impaired swallowing function

Severcan Eralp

The method that treats prostate enlargement with laser: ThuLEP

Ertan Mehmet

HIPEC 'warm chemotherapy' for advanced cancer patients

İncilay Sabani

Gastroenterology

POEM treatment for patients with impaired swallowing function

Urology

The method that treats prostate enlargement with laser: ThuLEP

Oncology

HIPEC 'warm chemotherapy' for advanced cancer patients

Oncology

'Microsphere' therapy with TARE in liver cancer

Oncology

Fast and precise treatment with pinpointing the tumor

Oncology

The method that cuts the path of cancerous cells: TAKE