TR

©2016 Er-Kim İlaç Sanayi ve Ticaret A.Ş.
[Disclaimer] | The information in this site is not intended to replace the advice of a doctor or a pharmacist.

OVERVIEW

genel_bakis_en

PERFORMANCE MANAGEMENT

To be successful in work life; being willing to take more responsibility, adopting promptly to changes and taking lessons from the experience are necessary. From the beginning of your career journey to higher levels, tracking your performance management is one of the key points to be succeeded.

We measure the contributions made to its mission by our employees at each level by using a contemporary performance evaluation and management system, and allow them to improve their performance by providing the required training, exchange of experience, support and guidance.

You have to be positive and willful to own your career path. We can help you to have an unique career plan and it is important to remember that the key point starts from yourself, your vision and your motivation.

Through the performance management you are able to observe how you proceed, where you are today and where you want to be tomorrow. We do our best to match your individual success with the corporate aims.

Focusing on humanitarian values, honesty, transparency, making decisions based on shared wisdom, “open door” management, exploring new ways of working more efficiently and accurately, focusing on opportunities and determination to learn and develop further are the key culture of our organization.

Starting is an important step. Career is not a target to achieve, it is a life-long journey.

TRAINING AND DEVELOPMENT

We value our employees and give importance to their development. Although instant changes and challenging situations encountered today are much more than in the past, our employees can pursue personal and professional growth as well as a long term career with us.

Within the framework of establishing long term career with our employees, we strive for assigning our mid-level and senior managers by promoting our own employees who have fully demonstrated their contribution, proven their competencies and compliance to the corporate culture.

This approach has played a major role in our successful history of 35 years. To continue on this path, we value our “Management Trainee Program”. Within this scope, a 6-steps program is implemented and contributes to the development of our employees with respect to Er-Kim’s Values, Personal Management, Customer Management, Team Management, Sales Performance Management, Challenge Management to meet the possible needs for managers and to maximize the level of our success in the pharma sector.

Along with on-the-job training, dual feedback and guidance, we provide trainings to our manager candidates on the below topics as well:

•  presentation skills,
•  social styles,
•  emotional intelligence,
•  personal image management,
•  field management (targeting, segmentation, planning, inspection, reporting),
•  budgeting and budget use, leadership, conflict management,
•  negotiation skills,
•  management under pressure and stress,
•  change management

Through these steps we expect our employees who are included in the Management Trainee Program, to improve their managerial and professional competencies.

In today’s conditions, it is very important for individuals to develop themselves in every challenge and be fully confident of themselves. Of course trainings are important and valuable, on the other hand it is proven by scientific data that “we learn best by practicing” and analyzing how we reach to a point rather than ending up that point.

JOB APPLICATION FORM

Welcome to Er-Kim Pharmaceuticals’ employment site. Thank you for considering us as a potential employer. The Er-Kim team is dedicated to meeting the company's goal - to enhance the quality of life patients through bringing novel therapies into Turkish market. If you are interested in joining our team, please fill the form below:

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CAREER

Welcome to the Er-Kim Ilac’s Career page.

Er-Kim Ilac aims to bring new treatments into the Turkish market and to reach its mission by improving the patients’ quality of life.

Er-Kim Ilac is proud to be one of the companies with the highest rate of long-term employees.

We give importance to corporate culture factor and gaining experience together, and as a general principle, our aim is to establish long-term business relationships with our employees

You can have access to company’s organizational structure, performance management, training and development pages, and fill the employment application form if you’d like to.

Er-Kim Ilac Sanayi ve Ticaret Anonim Sirketi

a. Levazım Mahallesi Koru Sokak
No:2 Zorlu Center D Blok T-3 Katı, D:344
34340 Beşiktaş, İstanbul

t. +90 [212] 275 3968
e. erkim@erkim-ilac.com.tr

  • Regional Offices+
  • Istanbul Regional Office
    +90 (212) 275 39 68
  • Ankara Regional Office
    +90 (312) 427 19 97
  • Izmir Regional Office
    +90 (232) 374 28 55

ALL PRODUCTS

LEADERSHIP

Er-Kim Ilac Sanayi ve Ticaret A.S. is a privately owned company established in 1981 by Seval Family.

Er-Kim Ilac was the first company to bring imported finished form oncology products to Turkey and has continued to be one of the strongest players of this segment for many years.

Er-Kim Ilac, known as the “Company of Firsts”, has imported and introduced many specialty products for physicians’usage in order to fulfill the “unmet needs” in Turkey and has taken a leading part in the treatment of important diseases during the 35 years it has existed in the Turkish pharmaceutical industry.

Over the years, Er-Kim Ilac has presented to the Turkish market life-saving original/patented products of many international companies that bring great value to patients’ lives and has distinguished itself with a consistent record of success. These successes led the way for the main companies to establish their own organizations in Turkey and grow even further.

“Introducing new and cost-effective treatment alternatives to Turkey” being its key mission, Er-Kim Ilac plans and executes all its activities based on this quest. Er-Kim Ilac puts on great effort to introduce the unavailable treatment alternatives in Turkey into the service of healthcare professionals and thereby patients, and also contributes to public healthcare savings by adding the affordable equivalents of the products to its portfolio within the scope of domestic contracted manufacturing agreements.

Er-Kim Ilac has achieved remarkable successes and presented many new concepts with the innovative products that it has introduced especially in the fields of Hematology and Oncology.

Currently, with its diversified portfolio, it covers a wide range of different therapeutic areas such as Immunology, Neurology, Urology, Gynecology & Obstetrics, Orthopedics, Physiotherapy, Gastroenterology, Infectious Diseases, Transplantation, Dermatology, Endocrinology, Ophthalmology and Intensive Care.

Er-Kim Ilac continues to present imported Rx-only pharmaceutical products into the service of Turkish Medicine while also endeavoring to look after added values for patients/physicians and extends its portfolio with generics, medical devices, food supplements and over-the counter products.

Er-Kim Ilac has decided to enlarge its business in nearby countries through using the knowledge, experience and human resources it has gained until now and has already taken the first steps on this aim.

As of today, continuing to be the exclusive distributor of the drugs, medicinal devices and over-the-counter products of 11 international companies and having introduced its domestically manufactured products into the Turkish market, Er-Kim Ilac strives to meet the needs of the medicine and pharmaceutical industries and continues to take firm steps forward to bring added value to human life.

NEWS

Pharmetic_S33

Er-Kim Ilac General Manager Dr. Sabri Oncel told about Er-Kim Pharmaceuticals and ErKim Life Group on the interview with 33rd issue of Pharmetic Health magazine.

06 Jul 2017

When we asked Sabri Öncel regarding Er-Kim Pharmaceuticals, ErKim Life Group and 36 year sustainable success of the company, we received sincere and faithful answers … Click to continue.

1

Er-Kim Ilac’s Red Team Performed a Business Trip to LFB Les Ulis Manufacturing Facility for Observation and Training Purposes

05 Apr 2017

The Red Group sales and marketing staff of Er-Kim Ilac visited Les Ulis / Paris manufacturing facility of its French business partner LFB Biomedicaments to observe the manufacturing processes and product quality procedures and to participate in the trainings. Predominantly active in the immunology and hemostasis fields, the French LFB Biomedicaments company, one of the […]

6Web Sitemiz

“Er-Kim Life” Team is on the Scene…

03 Apr 2017

Er-Kim Pharmaceuticals decided to reflect its 36-years long marketing experience to the OTC market and recently established a new team; Er-Kim Life. As the new team becomes functional, Er-Kim also initiated the expansion of its pharmacy products’ portfolio. With its products in 3 major groups; immunity support products, probiotics and diabetes support products, Er-Kim Life […]

Coşkun Aral Fotoğraf Kolaj

ErKim Ilac Hosted Mr Coskun Aral and Enjoyed His Pleasant Presentation Together With Its Employees

28 Mar 2017

ErKim Ilac A.S. hosted famous photographer, traveler, educator, documentary producer Coskun Aral on the first day of its cycle meeting in January. Mr Coskun Aral answered the questions directed to him by ErKim employees and shared his own life experiences and knowledge about the struggle for survival, cultures, lives, wars of humanity. Coskun Aral, who […]

7

Epidemilogy Study Of Neuromuscular Diseases

01 Dec 2016

Having provided service in the health sector trustfully for 35 years, Er-Kim İlaç supported the planning, execution and successfully completion of many clinical trials and investigations in Turkey over the importance it attaches to the development of Turkish medicine and to science. Epidemiological studies are those where health information was, interpreted and used for improving […]

1

Er-Kim İlaç’s Headquarters Relocated

07 Nov 2016

Having been active in the pharmaceutical sector for 35 years and provided services in its Balmumcu Office for almost 25 years, Er-Kim İlaç moved to its headquarters office to Zorlu Center as of November 2016. The head office address of Er-Kim İlaç Sanayi ve Ticaret A.Ş. registered in İstanbul Chamber of Commerce and its pharmaceutical […]

8

The 14th National Algology Congress – Abstral Satellite Symposium

06 Nov 2016

Between November 03 and 06, 2016 the 14th National Algology Congress was performed in Antalya. Participating in this convention for the first time, Er-Kim İlaç became the silver sponsor of the convention and performed a satellite symposium for its product named Abstral which was newly introduced to the market. Great interest was shown to the […]

2

Cinvex and Abstal, the new products of Er-Kim İlaç, were introduced to the market

26 Jun 2016

Er-Kim İlaç obtained approval reimbursement for “Cinvex 250 mcg/5 ml vial”, its first local manufacturing product, with the active ingredient of palonosetron which is used in the treatment of chemotherapy induced nausea and vomiting, and started to supply the product to wholesalers as of May 2016. “Abstral Sublingual Tablets”, another new product of Er-Kim İlaç, […]

3 Yeni

SIPPET: Pre-and Post-Study Hemophilia Meeting Ongoing evaluation of the 5-year study

09 May 2016

Organized by Er-Kim İlaç A.Ş., the series of meeting named “SIPPET: Pre-and Post-Study Hemophilia” is continuing. While the first of the meeting series titled“SIPPET: Pre-and Post-Study Hemophilia”was performed in İzmir, the second was in Adana and the third was in Ankara with the participation of pediatric hematologists. In the meetings performed under the presidency of […]

ErKimBasinBulteni-1603 20160307

Er-Kim Ilac Sanayi ve Ticaret A.S. Has Reestablished the Corporate Website

25 Apr 2016

The new website of Er-Kim Ilac, who is present in the Pharmaceutical Sector more than 35 years, has been alive on March 14th, the Medicine Day. The new website emphasizes long-established, dynamic and prestigious structure and reveals “new concepts in medicine” mission of Er-Kim Ilac. The new website has been created within about 3 month […]

ErKimBasinBulteni-1601 20160307

Er-Kim Ilac Sanayi ve Ticaret A.S. Celebrates Its 35th Anniversary

25 Apr 2016

Er-Kim Ilac has been founded in 1981 and began its operations in Turkey as being the 1st company who imported the oncology products. This year, it celebrates its 35th anniversary. Er-Kim Ilac, known as the “Company of Firsts”, has imported and introduced many specialty products for physicians’ usage in order to fulfill the “unmet needs” […]

ErKimBasinBulteni-1602 20160307

Er-Kim Ilac Sanayi ve Ticaret A.S. Celebrates 8th March Women Day of Women Employees

08 Mar 2016

Er-Kim Ilac, who is present in the Pharmaceutical Sector more than 35 years and whose %45 of its human resources are women, celebrated March 8th International Women’s Day of woman employees with a special event. Er-Kim Ilac gives great importance to humanitarian aspects and ethical values in the working principles. On the purpose of respecting […]

4

SIPPET: Pre-and Post-Study Hemophilia Meeting

25 Feb 2016

Organized by Er-Kim İlaç A.Ş., the series of meeting named “SIPPET: Pre-and Post-Study Hemophilia” was performed successfully on February 19, 2015 in İzmir Key Hotel under the presidency of Prof. Dr. Kaan Kavaklı, lecturer in Ege University and Prof. Dr. Bülent Zülfikar lecturer in İstanbul University, with broad participation of pediatric hematologists. The meeting, in […]

Pharmetic_S33

Er-Kim Ilac General Manager Dr. Sabri Oncel told about Er-Kim Pharmaceuticals and ErKim Life Group on the interview with 33rd issue of Pharmetic Health magazine.

06 Tem 2017

When we asked Sabri Öncel regarding Er-Kim Pharmaceuticals, ErKim Life Group and 36 year sustainable success of the company, we received sincere and faithful answers …

Click to continue.

1

Er-Kim Ilac’s Red Team Performed a Business Trip to LFB Les Ulis Manufacturing Facility for Observation and Training Purposes

05 Nis 2017

The Red Group sales and marketing staff of Er-Kim Ilac visited Les Ulis / Paris manufacturing facility of its French business partner LFB Biomedicaments to observe the manufacturing processes and product quality procedures and to participate in the trainings.

Predominantly active in the immunology and hemostasis fields, the French LFB Biomedicaments company, one of the leading plasma fractionation and biotechnolgy companies in the world, manufactures Tegeline, Factane, Betafact, Ivhebex and Vialebex products in its Les Ullis manufacturing facilities, for which the sales and marketing activities are carried out by Er-Kim Ilac in Turkey.

Founded in 1993 for the purpose of fulfilling the need for blood products in France, LFB Biomedicaments, the only plasma fractionation company with the nature of public economic organization, is active in 40 different countries throughout Europe, Africa, Middle East and America, including Turkey

Through this visit carried out to learn the manufacturing technology of the products of Betafact, Factane, Ivhebex and Vialebex and especially of Tegeline, which have been marketed in Turkey by Er-kim Ilac for more than 20 years, and to observe the entire manufacturing process from the plasma pools obtained from healthy volunteer donors to the “ready-for-final-use” status, the Er-kim sales team has increased their knowledge and experience on the products.

In the LFB Biomedicaments Les Ullis / Paris facility, manufacturing, quality control, international marketing and medical department managers shared the product and manufacturing related information with the Er-Kim Ilac staff. LFB executives announced that the manufacturing capacity of the 3 existing manufacturing facilities would be increased and that the construction of the new manufacturing facility is continuing.

Mr. Okan Iscan, Er-Kim Ilac Red Group Product Manager, shared with the sales team that the LFB and Er-Kim Ilac has long been in cooperation and that the LFB would provide its products subjected to ongoing clinical trials and other LFB products, which were not yet available in Turkey, to the Turkish market thus they would include the new LFB products in Er-Kim portfolio.

Mr. Muhammed Dursun, Er-Kim Ilac Sales Manager, shared his assessment with the sales team that thanks to the visit to LFB Les Ulis / Paris facility, they had more knowledge and they gained in trainings consolidated by seeing the facilities, that this experience gained would contribute greatly to products’ marketing activities and that they would communicate the information required about the products and facilities in detail and correctly to the healthcare professionals.

For detailed information about the LFB Biomedicaments: http://www.groupe-lfb.com/en/

2

 

6Web Sitemiz

“Er-Kim Life” Team is on the Scene…

03 Nis 2017

Er-Kim Pharmaceuticals decided to reflect its 36-years long marketing experience to the OTC market and recently established a new team; Er-Kim Life. As the new team becomes functional, Er-Kim also initiated the expansion of its pharmacy products’ portfolio. With its products in 3 major groups; immunity support products, probiotics and diabetes support products, Er-Kim Life team started to work in major cities of Turkey and in the near future, it intends to expand its geographical coverage and its product portfolio with innovative food supplements and consumer healthcare products which will enhance the quality of life of end-users.2Web Sitemiz

Coşkun Aral Fotoğraf Kolaj

ErKim Ilac Hosted Mr Coskun Aral and Enjoyed His Pleasant Presentation Together With Its Employees

28 Mar 2017

ErKim Ilac A.S. hosted famous photographer, traveler, educator, documentary producer Coskun Aral on the first day of its cycle meeting in January. Mr Coskun Aral answered the questions directed to him by ErKim employees and shared his own life experiences and knowledge about the struggle for survival, cultures, lives, wars of humanity.

Coskun Aral, who mentioned that lifelong curiosity, interrogation and continuous will for learning will develop and advance people and society, conveyed his thoughts about questioning life, value of knowledge and touching the lives of others by giving examples from his professional experiences.

Coskun Aral’s facebook page about this event can be found on the link below.

https://www.facebook.com/habercicom/posts/1302265159819825

7

Epidemilogy Study Of Neuromuscular Diseases

01 Ara 2016

Having provided service in the health sector trustfully for 35 years, Er-Kim İlaç supported the planning, execution and successfully completion of many clinical trials and investigations in Turkey over the importance it attaches to the development of Turkish medicine and to science.

Epidemiological studies are those where health information was, interpreted and used for improving health and decreasing the diseases. These studies in which health of the society was aimed and disease data was analyzed are very valuable at scientific level.

For the first time in Turkey, an epidemiological study is being conducted for Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Multifocal Motor Neuropathy (MMN), important diseases in Neurology, by the Turkish Neurology Association Neuromuscular Working Group.

In the 52nd National Neurology Congress took place between November 25 and December 01, 2106 in Antalya, a satellite symposium titled “The Retrospective Registry Study to Determine the Number of Patients with Chronic Inflammatory Demyelinating Polyneuropathy and Multifocal Motor Neuropathy Consulted to 3rd and 4th Line Health Institutions in Turkey”.

In the satellite symposium under the moderation of Prof. Dr. Mehmet Ali Akalın, the Head of the Turkish Neurology Association Neuromuscular Diseases Study Group, Prof. Dr. Özden Şener shared information about the content, criteria, analysis process and the latest situation of the registry study whereas Prof. Dr. Feray Karaali Savrun and Prof. Dr. Necdet Karlı performed presentations related to CIDP and MMN. While in the symposium which attracted great interest from the neurology physicians it was stated that the results of the registry study was waited excitedly, the physicians discussed their experiences, cases and the current data in diagnosis and treatment and stated that generalizing this kind of valuable studies throughout Turkey would be promising with respect to the field of Neurology and Turkish Medicine.

1

Er-Kim İlaç’s Headquarters Relocated

07 Kas 2016

Having been active in the pharmaceutical sector for 35 years and provided services in its Balmumcu Office for almost 25 years, Er-Kim İlaç moved to its headquarters office to Zorlu Center as of November 2016.

The head office address of Er-Kim İlaç Sanayi ve Ticaret A.Ş. registered in İstanbul Chamber of Commerce and its pharmaceutical warehouse address registered in the Ministry of Health are as follows, and there is no change in the contact information except for the postal address.

Headquarters                                                                           Pharmaceutical Warehouse
Er-Kim İlaç Sanayi ve Ticaret A.Ş.                                            Er-Kim İlaç Sanayi ve Ticaret A.Ş.
Levazım Mah. Koru Sok.                                                          Gaziumurpaşa Sokak
Zorlu Center No:2, D-Blok T3 Katı, D: 344                              Bimar Plaza No: 38 Daire: 1-2
34340 Beşiktaş, İstanbul                                                          Balmumcu 34349 Beşiktaş, İstanbul

8

The 14th National Algology Congress – Abstral Satellite Symposium

06 Kas 2016

Between November 03 and 06, 2016 the 14th National Algology Congress was performed in Antalya. Participating in this convention for the first time, Er-Kim İlaç became the silver sponsor of the convention and performed a satellite symposium for its product named Abstral which was newly introduced to the market.

Great interest was shown to the satellite symposium performed under the presidency Prof. Dr. Gül Köknel Talu from İstanbul University with Prof. Dr. Meltem Uyar from Ege University Medical School as the debater. In the symposium where, following the definition of breakthrough cancer pain, the treatment and Abstral’s place was discussed along with a case presentation, an important gap was expressed to be filled in this field in the feedbacks from the physicians, and furthermore physicians who used Abstral on their patients shared their positive experiences.

2

Cinvex and Abstal, the new products of Er-Kim İlaç, were introduced to the market

26 Haz 2016

Er-Kim İlaç obtained approval reimbursement for “Cinvex 250 mcg/5 ml vial”, its first local manufacturing product, with the active ingredient of palonosetron which is used in the treatment of chemotherapy induced nausea and vomiting, and started to supply the product to wholesalers as of May 2016.

“Abstral Sublingual Tablets”, another new product of Er-Kim İlaç, is a drug produced by the cooperating company Kyowa Kirin with fentanyl as active substance. Used for the management of breakthrough pain in adult patients using opioid therapy for chronic cancer pain, Abstral Sublingual Tablets in packs containing 10 tablets of 100 mcg, 200 mcg, 400 mcg and 800 mcg dosage forms were approved for reimbursement as of January 20 2016 and introduced to market for use in June 2016.

3 Yeni

SIPPET: Pre-and Post-Study Hemophilia Meeting Ongoing evaluation of the 5-year study

09 May 2016

Organized by Er-Kim İlaç A.Ş., the series of meeting named “SIPPET: Pre-and Post-Study Hemophilia” is continuing.

While the first of the meeting series titled“SIPPET: Pre-and Post-Study Hemophilia”was performed in İzmir, the second was in Adana and the third was in Ankara with the participation of pediatric hematologists.

In the meetings performed under the presidency of Prof. Dr. Kaan Kavaklı, lecturer in Ege University and Prof. Dr. Bülent Antmen from Adana Acıbadem Hospital, the results of the 5-years SIPPET (Survey of Inhibitors in Plasma Product Exposed Toddlers) Study comparing plasma derivative factor VIII (pdFVIII) products with recombinant factor VIII (rFVIII) preparations, and its influence on the current hemophilia treatments were discussed in depth.

 While in Adana Meeting Prof. Dr. İlgen Şaşmaz presented France Hemophilia guidelines and Dr. Defne Ay Tuncel the British hemophilia guidelines, in Ankara Meeting, Doç. Dr. Selin Aytaç presented the studies carried out using the guidelines.

In the second part of the meetings, a platform was generated with the active participation of attendees on what kind of approach would be shown in future in hemophilia treatment in the light of the SIPPET Study information presented in American Society of Hematology (ASH) Congress in December 2015 and in the European Association for Hemophilia and Allied Disorders (EAHAD) Congress in February 2016.

The issue of the need of reevaluation of treatment approaches and guidelines by specialty associations regarding the “inhibitor issue”, the most important issue in the field of hemophilia treatment as the result of the SIPPET Study, was discussed by the physicians participated in the meeting.

SIPPET – Survey of Inhibitors in Plasma Product Exposed Toddlers

In the SIPPET Study that continued for over five years with participation of 42 centers from 15 countries with three centers from Turkey, severe hemophilia patients who had not previously been treated with factor III (PUPs: Previously Untreated Patients) were included. According to the results obtained from the SIPPET Study in which the risk of inhibitor development, currently the most important issue in hemophilia, was reviewed, it was shown that the rate of inhibitor development in patients using recombinant FVIII was higher compared to those using plasma derivative FVIII.

ErKimBasinBulteni-1603 20160307

Er-Kim Ilac Sanayi ve Ticaret A.S. Has Reestablished the Corporate Website

25 Nis 2016

The new website of Er-Kim Ilac, who is present in the Pharmaceutical Sector more than 35 years, has been alive on March 14th, the Medicine Day. The new website emphasizes long-established, dynamic and prestigious structure and reveals “new concepts in medicine” mission of Er-Kim Ilac.

The new website has been created within about 3 month intensive development process. It contains several information for patients and health professionals in accordance with Regulation on Promotion Activities of Medicinal Products and “Good Promotional Practices” published by IEIS and AİFD. One can access a wide range of information about history, products, business partners and career opportunities of Er-Kim Ilac, both in English and Turkish.

Er-Kim Ilac carried out this project in collaboration with the Scope Digital who is the winner of Golden Spider Web Award and have received industry awards such as international Awwwwards Award with its successful business. As well as having a modern and innovative design, the website has been created with the standard screen resolution, HTML5 animations and “responsive” software techniques which enables perfect display in all mobile devices. The new website aims that visitors may reach information quickly and seamlessly with its user-friendly interface.

ErKimBasinBulteni-1601 20160307

Er-Kim Ilac Sanayi ve Ticaret A.S. Celebrates Its 35th Anniversary

25 Nis 2016

Er-Kim Ilac has been founded in 1981 and began its operations in Turkey as being the 1st company who imported the oncology products. This year, it celebrates its 35th anniversary.

Er-Kim Ilac, known as the “Company of Firsts”, has imported and introduced many specialty products for physicians’ usage in order to fulfill the “unmet needs” in Turkey and has taken a leading part in the treatment of important diseases during the 35 years it has existed in the Turkish pharmaceutical industry.

Over the years, Er-Kim Ilac has presented to the Turkish market life-saving original/patented products of many international companies that bring great value to patients’ lives and has distinguished itself with a consistent record of success. These successes led the way for the main companies to establish their own organizations in Turkey and grow even further. Er-Kim Ilac has been the exclusive distributor of 7 companies which have activities with their names in Turkey market today and are AIFD member.

As of today, Er-Kim Ilac continues to be the exclusive distributor of the drugs, medicinal devices and over-the-counter products of 11 international companies and has introduced its domestically manufactured products into the Turkish market.

“Introducing new and cost-effective treatment alternatives to Turkey” being its key mission, Er-Kim Ilac plans and executes all its activities based on this quest. Er-Kim Ilac puts on great effort to introduce the unavailable treatment alternatives in Turkey into the service of healthcare professionals and thereby patients, and also contributes to public healthcare savings by adding the affordable equivalents of the products to its portfolio within the scope of domestic contracted manufacturing agreements.

Er-Kim Ilac has achieved remarkable successes and presented many new concepts with the innovative products that it has introduced especially in the fields of Hematology and Oncology. Currently, with its diversified portfolio, it covers a wide range of different therapeutic areas such as Immunology, Neurology, Urology, Gynecology & Obstetrics, Orthopedics, Physiotherapy, Gastroenterology, Infectious Diseases, Transplantation, Dermatology, Endocrinology, Ophthalmology and Intensive Care.

Er-Kim Ilac continues to present imported Rx-only pharmaceutical products into the service of Turkish Medicine while also endeavoring to look after added values for patients/physicians and extends its portfolio with generics, medical devices, food supplements and over-the counter products.

Er-Kim Ilac has decided to enlarge its business in nearby countries through using the knowledge, experience and human resources it has gained until now and has already taken the first steps on this aim.

Er-Kim Ilac strives to meet the needs of the medicine and pharmaceutical industries and continues to take firm steps forward to bring added value to human life.

 

ErKimBasinBulteni-1602 20160307

Er-Kim Ilac Sanayi ve Ticaret A.S. Celebrates 8th March Women Day of Women Employees

08 Mar 2016

Er-Kim Ilac, who is present in the Pharmaceutical Sector more than 35 years and whose %45 of its human resources are women, celebrated March 8th International Women’s Day of woman employees with a special event.

Er-Kim Ilac gives great importance to humanitarian aspects and ethical values in the working principles. On the purpose of respecting to Prof. Dr. Turkan Saylan, on this special day, Er-Kim Ilac distributed the famous author Ayse Kulin’s book “Turkan” as a gift to all women employees. This book is about the life of Prof. Dr. Turkan Saylan who has made great contributions to Turkey’ medical community, exterminated leprosy being a public health problem and devoted her life to the girls’ education.

Er-Kim Ilac, who celebrates 35th anniversary in the sector with interoperate activities and various social responsibility projects, is also known as a company that pays maximum attention to all the social rights of female employees in employment policy.

4

SIPPET: Pre-and Post-Study Hemophilia Meeting

25 Şub 2016

Organized by Er-Kim İlaç A.Ş., the series of meeting named “SIPPET: Pre-and Post-Study Hemophilia” was performed successfully on February 19, 2015 in İzmir Key Hotel under the presidency of Prof. Dr. Kaan Kavaklı, lecturer in Ege University and Prof. Dr. Bülent Zülfikar lecturer in İstanbul University, with broad participation of pediatric hematologists.

The meeting, in which the long-awaited SIPPET (Survey of Inhibitors in Plasma Product Exposed Toddlers) study comparing plasma derivative factor VIII (pdFVIII) products with recombinant factor VIII (rFVIII) preparations was discussed in depth, took place in two parts as Pre-SIPPET Study Hemophilia Treatment and Post-SIPPET Study Hemophilia Treatment.

Following the opening in which Prof. Dr. Bülent Zülfikar presented Turkey demographic data in the field of hemophilia, debater physicians found the opportunity to review the approaches physicians in different countries and related specialty associations to hemophilia care under also the direction of Prof. Dr. Bülent Zülfikar.

In the session in which Dr. Özlem Tüfekçi shared the Italian guidelines, Dr. Barış Malbora British guidelines and Dr. Yılmaz Ay French guidelines, the debaters expressed that all existing guidelines had been prepared before the SIPPET Study and shared the issue of the need of update of all country guidelines following the results of the SIPPET Study.

In the second part of the meeting, up-to-date information about the SIPPET Study, the preliminary results of which were explained by Dr. Peyvandi in the annual congress of the American Society of Hematology performed in December 2015 and then in the annual congress of European Association for Hemophilia and Allied Disorders (EAHAD), was presented by Dr. Kaan Kavaklı.

The issues such as if the hemophilia treatment would change after SIPPET and if so what would change, what would have to be done, what were the difficulties that would be faced, method to be followed, and the course of actions that would be taken by specialty associations and associations working groups were thoroughly discussed.

Stating that this meeting that was performed in the field of hemophilia was highly important regarding that it set the ground for the discussion of updated scientific information, the participants expressed the necessity of the attempts led by the specialty associations based on the inhibitor development, the most important issue of hemophilia.

SIPPET – Survey of Inhibitors in Plasma Product Exposed Toddlers

In this study, severe hemophilia patients who had not previously been treated with factor III (PUPs: Previously Untreated Patients) were included. According to the results obtained from the SIPPET Study in which the risk of inhibit development, currently the most critical issue in hemophilia treatment, was evaluated, more inhibitor development was reported to be seen in rFVIII than those of pdFVII originated.

SIPPET IN BRIEF…
SIPPETSurvey of Inhibitors in Plasma Product Exposed Toddlers
– 5 continents
– 14 countries
– 42 centers
– 3 centers from Turkey
– İstanbul – Prof. Dr. Bülent Zülfikar
– İzmir – Prof. Dr. Kaan Kavaklı
– Adana – Prof. Dr. Bülent Antmen
– 303 PUPs participated in the study.
– The first randomized, controlled, prospective clinical trial

DISCLAIMER

The information in this site is not intended to replace the advice of a doctor or a pharmacist. In the case that the information and references being misused in this site, errors and absences in the content and in any conditions that will be formed as a result of using the site, Er-Kim Ilac does not take the legal responsibility. The information in the site is directed only to the target users, these information cannot be distributed, copied, forwarded to the third persons/groups by other persons. Use without permission of the officially registered brands and the texts mentioned in the site is forbidden. For the update of the site Er-Kim Ilac works carefully but cannot give any engagement and guarantee. For the use of the site the users are considered to have agreed on the legal warning above totally and without reservation.

The information in the site that are connected by the links that take part in this site is out of the responsibility of Er-Kim Ilac. The activities in these sites may not be conformed to the regulations set out by the Republic of Turkey and the information may be different from the texts that are approved by the Republic of Turkey Ministry of Health.

COMMUNICATION FORMS

To apply for a career at Er-Kim İlaç, please fill out the application form on our Career page.

We advise you to consult your physician or pharmacist about the medications you take, your diseases and the treatment options. We would like to inform you that we will not be able to answer your questions about these subjects, according to the Turkish Ministry of Health’s regulations.

If you are concerned that you have had a suspected adverse reaction to a medicine, you may consult your physician or your pharmacist. You can select “Adverse Reaction Notification Form” below to report us.

You may also report your adverse reaction directly by using “Drug Adverse Reaction Notification” link that was linked under Turkish Ministry of Health’s web site www.titck.gov.tr or by calling directly at + 9 0 800 314 00 08. In emergency situations, you may contact Delta PV, the Drug Safety authority of Er-Kim Ilac, at number + 9 0216 385 93 33 or you may report by e-mail at pv@deltapv.com

Please feel free to contact us by choosing appropriate subject on the below forms regarding your comments, recommendations and business development.

Please choose one of the following.

Form options

Adverse Event Reporting Form

General Inquiry Form

BUSINESS DEVELOPMENT

Being a distributor firm, business development is one of the strategic backbones of our company.

With more than 35 years of experience, we have made great collaborations, and we still continue to develop new partnerships.

From America to Europe, from Japan to Turkey, Er-Kim has worldwide partners and is committed to enlarge its portfolio through engaging further.

You may find our current and previous partnerships as below.

To contact us relating to business development, please send us an e-mail at bd@erkim-ilac.com.tr

PREVIOUS BUSINESS PARTNERS
  • American Home Products (AHP) – USA
  • Biocodex Ltd. Şti. – Turkey
  • Biosyn Arzneimittel GmbH – Germany
  • Biromedicina – Hungary
  • Bristol-Myers Squibb Company – USA
  • Cyanamid Inc. – USA
  • Ferring International – Denmark & Sweden
  • Gilead Sciences – Ireland & United Kingdom
  • Inpa SA – Greece
  • Inversion Laboratories – Belgium
  • Leiras Oy – Finland
  • Lundbeck – Denmark
  • Medimmune Oncology Inc. – USA
  • Nexstar Inc. – USA
  • Novendia – Greece
  • Novo Nordisk – Denmark
  • Nycomed Pharma AS – Norway
  • Pharmachemie BV – The Netherlands
  • Pharmion GmbH – Switzerland
  • Pierre Fabre İlaç – Turkey
  • Pierre Fabre Medicament SA – France
  • Pinnacle Biologics Inc. – USA
  • Proel SA – Greece
  • Santen Oy – Finland
  • Schering Alman Ltd. Şti. – Turkey
  • Schering-Plough Inc. – USA
  • Servycal SA – Argentina
  • TTY Biopharm Co. – Taiwan
  • United Pharmaceuticals SA – France
  • Vestar Inc. – USA
  • Wyeth – USA
  • Wyeth Lederle – USA

VISION · MISION · VALUES

Since its foundation, Er-Kim Ilac adopted a transparent approach philosophy with its product portfolio and works for the health of Turkish citizens. It ensures that innovative products, high biotechnology products and innovative food supplements are accessible in the Turkish market.

Existing for more than 35 years, Er-Kim Ilac has brought many important and supportive products into Turkey by introducing new treatment options, and continues to take firm steps forward to achieve its aim of improving human health as a company that invests in the future of health and offers transparent and innovative services.

Er-Kim Ilac’s management system depends on open communication and gives particular importance to humanitarian values.

Er-Kim Ilac integrates each experience it has gained to the future to develop plans to work more productively and effectively and to change its organizational structure if necessary, and has set out its principles to differentiate itself by working in accordance with its company philosophy that continuously analyses the market dynamics and needs to adapt accordingly and values its employees’ opinions. Adopting a management system that is open to change and improvement, Er-Kim Ilac has been quite successful in managing the internal and external customers and also each step of the interactive process chain in accordance with today’s conditions.

TIME TRAVEL

2016
2016_2

Obtained the registration approval of its first contract-manufactured local pharmaceutical product.

2015
img-travel

Launched three OTC products and two medical device products.

2014
2014

Launched its first narcotic analgesic product.

2013
img_5

Included OTC and medical device products to its product portfolio.

2012
img_4

Turnover rate is at top quartile among Turkish pharmaceutical companies.

2008
img6

Reached ~100 million $ ex-company turnover.

2004
2004

Implemented the first Risk Management Program in Turkey for a teratogenic pharmaceutical product.

2002
2002

Started to provide marketing & sales services to another Turkish company.

1998
1998-3

Launched the first radio-protective pharmceutcial product into the Turkish market.

1997
1997

Introduced human plasma derived biotechnology products.

1997
1997-2

Changed its name to Er-Kim Ilac Industry and Trade Inc. Co.

1996
1996_2

Entered to the In-vitro Fertilization (IVF) market with imported finished form human originated biological products.

1994
1994

Started import and market hormonal products.

1993
1993

Introduced the first liposomal pharmaceutical product into the Turkish market.

1992
Mumessil

Granted the representative pharmaceutical warehouse authorization certificate.

1990
Erkim İşyeri

Set up the Ankara Regional Office for market access and regulatory services.

1989
img_3

Decided to focus solely on finished form pharmaceuticals.

1988
1989_2

Started to import and market interferons.

1986
1986

Launched imported insuline products.

1985
1985

Started to import and sell first radiopaque products.

1983
1983

Introduced the first imported oncology pharmaceutical products into the Turkish market.

1982
img_1

Started to import and sell medicines, agricultural pesticides and chemicals.

1981
1981_2

Er-Kim was established as the licensee of American Cyanamid Inc.

2016

2016_2

Sözleşmeli üretim yöntemiyle ürettiği ilk yerli ürünün ruhsatını almıştır.

2015

img-travel

Üç OTC ürünü ve iki tıbbi cihaz ürünü lansmanı yapmıştır.

2014

2014

İlk narkotik analjezik ürününü piyasaya sunmuştur.

2013

img_5

Ürün portföyüne OTC ve tıbbi cihaz alanlarında ürünler eklemiştir.

2012

img_4

İş hacmi büyüklüğünde Türkiye’deki ilaç şirketleri arasında ilk çeyrekte yer almıştır.

2008

img6

Yaklaşık 100 milyon $’lık
satış cirosuna ulaşmıştır.

2004

2004

Türkiye’de ilk kez teratejonik bir ilaç için Risk Yönetimi Programı uygulamaya sokmuştur.

2002

2002

İlk kez bir Türk firmaya pazarlama ve satış hizmetleri sunmaya başlamıştır.

1998

1998-3

Türkiye ilaç pazarındaki ilk radyo-protektif ürünü piyasaya sunmuştur.

1997

1997

Plazma türevi biyoteknoloji ürünlerini piyasaya sunmuştur.

1997

1997-2

İsmini
Er-Kim İlaç Sanayi ve Ticaret A.Ş.
Olarak değiştirmiştir.

1996

1996_2

İthal ettiği ürünlerle Tüp Bebek (IVF) pazarına girmiştir.

1994

1994

Hormon ürünleri ithalatı ve pazarlamasına başlamıştır.

1993

1993

Türkiye ilaç sektöründe ilk lipozomal ürünü piyasaya vermiştir.

1992

Mumessil

Mümessillik ecza deposu yetkisi almıştır.

1990

Erkim İşyeri

Pazara erişim ve ruhsatlandırma hizmetleri için Ankara Ofisini açtı.

1989

img_3

Yalnızca bitmiş ithal ilaç pazarlamasına odaklanma kararı almıştır.

1988

1989_2

İnterferon ürünlerini ithal etmeye başlamıştır.

1986

1986

İthal insülin preparatlarını piyasaya sunmuştur.

1985

1985

İlk radyo-opak ürünleri ithal etmeye başlamıştır.

1983

1983

Türkiye’de ilk ithal onkoloji ilaçlarını piyasaya sunmuştur

1982

img_1

İlaç, tarım pestisitleri ve kimyasallar ithal etmeye ve satmaya başlamıştır.

1981

1981_2

Er-Kim İlaç kurulmuş ve Cyanamid Inc. firmasının lisansörü olarak faaliyete başlamıştır.

TREATMENT AREAS

treatment2
Hematology
treatment1
Oncology
immunoloji
Immunology
treatment3
Neurology
treatment4
Urology
kadin2
Gynecology & Obstetrics
treatment7
Orthopedics – PMR
treatment5
Gastroenterology
treatment8
Infectious Diseases
transplantasyon
Transplantation
treatment9
Dermatology
treatment10
Endocrinology
eye_by1
Ophtalmology
yogun_bakim
Intensive Care
algoloji2
Algology

Hematology

What is Myelodysplastic Syndrome?

Myelodysplastic Syndromes (MDS) are a group of diverse bone marrow disorders where the bone marrow cannot produce enough healthy blood cells. Although MDS primarily occur in the elderly, younger individuals can also be affected.

Low blood cell counts, referred to as cytopenias, are the most common sign of MDS; infections due to low white blood cell counts, anemia due to low red blood cell counts, and spontaneous bleeding or easy bruising due to low platelet counts can be seen in patients with MDS.

The treatment of MDS is determined based on the symptoms, disease stage, disease risk category, patient’s age and co-morbidities. Although various treatments are available for MDS, not all of them are appropriate for each patient.

New drug therapies (hypomethylating agents) targeting biological mechanisms that play a role in the development of myelodysplastic syndrome have yielded successful treatment results during recent years.

What is Multiple Myeloma?

Multiple Myeloma is a malign disease that develops as a result of uncontrolled growth of the plasma cells. Malignant plasma cells that form in multiple myeloma are called myeloma cells. Myeloma cells produce an abnormal antibody of a single type (monoclonal). Multiple Myeloma causes anemia, infections, weak bones and kidney damage.

Treatment is planned considering the patient’s age, physical condition, organ functions and personal preferences. The “new drugs” now available for treatment and stem cell (bone marrow) transplantation recently yielded improved results in the treatment of this disease.

What is Hemophilia?

Hemophilia is an inherited blood disorder which presents with continuous bleeding due to life-long absence or deficiency of the blood factors responsible for clotting, namely factor 8 (VIII) and factor 9 (IX). Factor 8 deficiency and factor 9 deficiency are called Hemophilia A and B respectively.

Hemophilia is inherited, not contagious. It occurs in male family members while females are carriers.

In hemophilia patients, excessive bleeding occurs in various parts of the body. The extent of bleeding varies according to the blood levels of factor 8 and 9. Male children before the age of 2 usually experience bruises on arms and legs, and painful swelling of joints such as knees and elbows due to bleeding following bumps and falls. Prolonged nose bleeding, gum bleeding, bleeding following circumcision and delayed wound healing are the other significant complaints.

Depending on disease severity, bleeding remains for life in patients with hemophilia. Clinical presentation can be severe based on the factor level. Patient’s history and laboratory tests are essential for diagnosing hemophilia.

The main treatment approach in such patients is factor replacement therapy to ensure that sufficient levels of Factor 8 or Factor 9 are maintained in the plasma. The treatment is life-long.

The current high quality standards and product safety methods significantly reduce the risks relating to the products that are used in the replacement therapy, the most important issue being development of inhibitors against the products that are used in the treatment of hemophilia patients. Inhibitor development occurs when the body recognizes the given coagulation factors as a foreign substance and produces antibodies that neutralize them. Hemophilia patients who develop inhibitors respond only to high doses of in some cases do not respond to the treatment.

What is Idiopathic Thrombocytopenic Purpura?

Immune Thrombocytopenic Purpura, also called ‘Idiopathic Thrombocytopenic Purpura’ (ITP), is an autoimmune disease characterized by abnormal clotting and tendency for bleeding. In ITP, the antibodies accidentally produced in the body against the platelets (thrombocytes or clotting cells) damage the platelets and cause tendency for bleeding.

There are acute (sudden onset) and chronic (persistent) types of ITP. Acute ITP typically develops following infections and usually resolves within six months. Acute form is commonly seen in children. Disease persisting more than six months is called Chronic ITP, which is more often seen in adults.

The patients may present with skin bruises, petechias (pinpoint-sized bleeding spots that do not fade by pressing on the skin or in mouth), prolonged bleeding, nose bleeding, gum bleeding, heavy menstrual bleeding, blood in urine or in stool.

Diagnosis is established by the patient’s medical history, physical examination, complete blood count and peripheral blood smear. The majority of child patients recover spontaneously within 6 months, only few progress to the chronic type. Most of adult patients are chronic and require treatment.

What is Secondary Immune Deficiency?

The immune system defends the body against the harmful effects of microorganisms that may cause infections, such as bacteria, viruses, fungi or parasites. Immune deficiencies develop as a result of a deficiency in one or more components of the immune system.

Immune system deficiencies defined as Secondary Immune Deficiencies (SIDs) are a group of disorders that secondarily develop due to conditions such as some chronic diseases other than hereditary causes, cancers, use of drugs that are toxic to bone marrow, prolonged use of corticosteroids, infections affecting the immune system such as AIDS, interventions such as bone marrow transplantation, some metabolic disorders, severe hepatic failure, severe malnutrition, uremia, severe or large burns.

The most important diseases leading to secondary immune deficiency include Multiple Myeloma (MM) and Chronic Lymphocytic Leukemia (CLL).

Multiple Myeloma is a malign disease that develops as a result of uncontrolled growth of the plasma cells. Malignant plasma cells that form in multiple myeloma are called myeloma cells. Myeloma cells produce an abnormal antibody of a single type (monoclonal).

Leukemia is a type of cancer that presents with abnormally increased blood cells, particularly the white blood cells. CLL is the most common type of leukemia in adults. CLL is seen more often in people older than 60 years. CLL is a slow-growing cancer, therefore it generally does not cause much clinical signs at early stages, it is asymptomatic. The most common finding on physical examination is swelling of the superficial lymph nodes. Sometimes fever, weight loss, weakness and fatigue can be seen. The spleen and liver can be enlarged in later stages.

The most common cause of morbidity and deaths in CLL patients is infections while the most common cause of infections is hypogammaglobulinemia resulting from immune deficiency. In advanced stages, infections associated with immune deficiency, bone marrow infiltration, chemotherapy and neutropenia due to hypersplenism occur frequently.

What is Iron Deficiency Anemia?

Iron is located in the hemoglobin of the red blood cells. Iron deficiency anemia is defined as hemoglobin levels in the blood below the normal range according to the age and gender due to reduced iron levels in the body.

Iron deficiency anemia occurs in cases of insufficient dietary intake of iron or malabsorption of iron despite sufficient dietary intake, in cases where the need to iron is increased such as pregnancy or childhood, or in cases of blood loss in the gastrointestinal system or other systems.

Symptoms such as weakness, loss of appetite, persistent headache, numbness in the limbs, shortness of breath, palpitations, burning sensation in the mouth and tongue, cracking at the edges of the mouth or dysphagia can be seen in iron deficiency anemia. Severe iron deficiency anemia can lead to cardiac problems, infections, growth or development problems in children and other complications. It can cause conditions such as preterm or low-weight delivery or blood transfusion need after delivery.

Iron deficiency anemia is mainly treated by applying a proper diet and iron replacement therapy with iron-containing pills.

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Oncology

Medical Oncology

What is Bone Metastasis?

Bone metastasis is the spread of cancer cells from the primary tumor to the bone. In general, cancers of prostate, breast, lung, thyroid and kidney are most likely to spread (metastasize) to the bones. Clinical presentation of bone metastases is variable; most common findings are bone pain, fractures and spinal cord compression.

Hormone therapy, radiotherapy, chemotherapy, targeted therapies can be used. Bisphosphonates can reduce bone degradation. Surgical treatment, certain orthopedic procedures to prevent or stabilize the fracture can be applied.

What is Breakthrough Pain in Cancer Patients?

While the incidence of pain among cancer patients is 38% in early phases of the disease, this ratio increases up to 85% as the disease progresses and the quality of life is diminished. Although the chronic cancer pain can be controlled successfully with opioid analgesics in patients with medium or severe cancer pain, a great number of patients may experience a sudden onset of transient breakthrough pain associated with movement, which may be repeated several times a day.

Studies have shown that breakthrough pain may occur frequently in cancer patients and has an impact on the quality of life. A study has demonstrated the incidence of breakthrough pain as 64% among cancer patients. Breakthrough pain is the transient pain attack that flares up although the patient is on regular pain treatment. Usually the pain has a sudden onset and subsides within a few minutes to a few hours. Many patients experience multiple instances of breakthrough pain within the day.

Breakthrough pain may result from the cancer or the cancer therapy or may occur during a certain activity (like walking, dressing or coughing). However, it may also occur unexpectedly and without a reason. Breakthrough pain usually requires stronger painkillers with a more rapid effect than the chronic pain management medication.
Although this pain is directly linked with the invasion and compression of the tumour (85%), it is also associated with the tumour treatment in 17%, with the tumour in 9% and non-tumour causes in 9%.

In conclusion, cancer pain occurs in the form of continuous or intermittent pain or flares (sudden increase in pain intensity – breakthrough pain). Breakthrough pain observed in 2/3 of the cancer patients occurs especially during swallowing, coughing, defecation or micturition and it is severe, short-lived and difficult to control. Pain medication with short-term effect in addition to the basic medical therapy of the patient may help the pain relief.

What is Chemotherapy Induced Nausea and Vomiting?

Nausea and vomiting are among the most common side effects of the chemotherapy medication used in cancer. The nausea and vomiting occur due to the cellular damage caused by the chemotherapy agents on the digestive system.

The potential of the chemotherapeutic agents used in cancer treatment to cause nausea and vomiting, the dose of these drugs and the individual differences determine the clinical condition of the patient.

Nausea and vomiting due to chemotherapy has different types: Acute nausea and vomiting (within the first 24 hours after the administration of the chemotherapy), late-onset nausea and vomiting (observed between 24-120 hours or the 2nd to 5th days) and the learned or anticipatory nausea and vomiting. The patient’s anticipation after a nausea and vomiting experience following a previous chemotherapy session may increase the incidence of nausea and vomiting in that patient.

Medical treatment is of utmost importance in the optimum control of the nausea and vomiting due to chemotherapy. There are currently various agents used to prevent or treat nausea and vomiting. Prevention of nausea and vomiting is equally important as their treatment. In order to prevent the occurrence of nausea and vomiting, the patient receives prophylactic treatment before the chemotherapy session. The characteristics of the chemotherapy agent inducing nausea and vomiting, any previous medications that have caused nausea and vomiting in the patient and the efficiency of these therapies are factors that need to be considered in the planning of the treatment against nausea and vomiting.

Radiation Oncology

What are Head and Neck Tumors?

Head and neck tumors are treatable if diagnosed early. The majority of head and neck tumors present with symptoms in the early stages. Smoking, chewing tobacco, alcohol consumption and poor diet are the primary causes for head and neck cancers.

Treatment of head and neck cancers generally requires multidisciplinary approach. The first option is surgical treatment in head and neck cancers. However, radiation therapy (radiotherapy) is also an effective option for many head and neck cancers.

Radiation therapy can cause both early (acute) and late (chronic) complications.

Acute complications of radiation occur as a result of damage to the rapidly dividing cells in the treated area. The most commonly seen complication is damage of salivary glands during therapy to head and neck and associated xerostomia (reduced salivation) which leads to difficulty swallowing, chewing, mouth sores and tooth and gum problems and impairment of the patients’ quality of life.

A radioprotective drug approved by the US and European health authorities for protection of the normal tissues during the therapy can reduce such complications occurring due to xerostomia.

What is Secondary Immune Deficiency?

The immune system defends the body against the harmful effects of microorganisms that may cause infections, such as bacteria, viruses, fungi or parasites. Immune deficiencies develop as a result of a deficiency in one or more components of the immune system.

Immune system deficiencies defined as Secondary Immune Deficiencies (SIDs) are a group of disorders that secondarily develop due to conditions such as some chronic diseases other than hereditary causes, cancers, use of drugs that are toxic to bone marrow, prolonged use of corticosteroids, infections affecting the immune system such as AIDS, interventions such as bone marrow transplantation, some metabolic disorders, severe hepatic failure, severe malnutrition, uremia, severe or large burns.

Patients with Secondary Immune Deficiencies are vulnerable to infections. Such patients get infectious diseases more frequently and simple infections such as influenza can be very severe.

What is Radiation Burn?

Radiotherapy is a cancer therapy method using ionising radiation. The aim of radiotherapy is to destroy the tumorous tissue while preserving the healthy tissue.

Radiotherapy uses high-energy rays to cure the disease in the body. However, these rays need to pass the through the skin in order to reach the targeted cells, which may damage the healthy skin cells on their path and cause them to die. Thus, the skin may get dry and sensitive with itching and rashes leading to the condition called radiation burn.

Skin toxicity, which is a side effect of radiotherapy, may affect the patient’s therapy plan and reduce the quality of life. The skin’s reaction to ionising radiation depends on the size of the radiated area, administered dose and the radiosensitivity of the tissue. If the skin is highly damaged, the radiotherapy may need to be suspended.

The skin repairs itself rapidly. However, if radiotherapy is repeated frequently and over long periods, the skin cells may not have enough time to heal themselves between the radiotherapy sessions. In these cases, supportive care may help the skin to bounce back.

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Immunology

What is Primary Immune Deficiency?

The immune system defends the body against the harmful effects of microorganisms that may cause infections, such as bacteria, viruses, fungi or parasites. Immune deficiencies develop as a result of a deficiency in one or more components of the immune system.

Immune system deficiencies defined as Primary Immune Deficiencies (PIDs) are a group of hereditary diseases. The expected frequency in Turkey is higher than Europe or USA due to higher frequency of kin marriages.

The common clinical signs of primary immune deficiencies are increased susceptibility to infections and having frequent infections. Long lasting infections, unusually frequent infections, infections that show incomplete response to treatment, recurrent skin rash, developmental delay, long lasting diarrhea, recurrent abscess (wounds) are signs that suggest immune deficiency. This diagnosis should be considered in children who have such features in their history.

Early diagnosis and treatment are essential procedures regarding morbidity and mortality. In such patients, the most important treatment approaches are to strengthen the body, to protect the body from infectious agents and to replace the missing immune components using plasma derivatives obtained from healthy individuals.

 

What is Secondary Immune Deficiency?

The immune system defends the body against the harmful effects of microorganisms that may cause infections, such as bacteria, viruses, fungi or parasites. Immune deficiencies develop as a result of a deficiency in one or more components of the immune system.

Immune system deficiencies defined as Secondary Immune Deficiencies (SIDs) are a group of disorders that secondarily develop due to conditions such as some chronic diseases other than hereditary causes, cancers, use of drugs that are toxic to bone marrow, prolonged use of corticosteroids, infections affecting the immune system such as AIDS, interventions such as bone marrow transplantation, some metabolic disorders, severe hepatic failure, severe malnutrition, uremia, severe or large burns.

The most important diseases leading to secondary immune deficiency include Multiple Myeloma (MM) and Chronic Lymphocytic Leukemia (CLL).

Multiple Myeloma is a malign disease that develops as a result of uncontrolled growth of the plasma cells. Malignant plasma cells that form in multiple myeloma are called myeloma cells. Myeloma cells produce an abnormal antibody of a single type (monoclonal).

Leukemia is a type of cancer that presents with abnormally increased blood cells, particularly the white blood cells. CLL is the most common type of leukemia in adults. CLL is seen more often in people older than 60 years. CLL is a slow-growing cancer, therefore it generally does not cause much clinical signs at early stages, it is asymptomatic. The most common finding on physical examination is swelling of the superficial lymph nodes. Sometimes fever, weight loss, weakness and fatigue can be seen. The spleen and liver can be enlarged in later stages.

The most common cause of morbidity and deaths in CLL patients is infections while the most common cause of infections is hypogammaglobulinemia resulting from immune deficiency. In advanced stages, infections associated with immune deficiency, bone marrow infiltration, chemotherapy and neutropenia due to hypersplenism occur frequently.

What is Kawasaki Disease?

Kawasaki disease (KD) is a self-limiting systemic vascular disease (vasculitis) with acute onset that causes inflammation in the walls of arteries, which can lead to aneurysms (balloon-shaped bulging of the vessel) in vessels of the heart (coronary vessels).

Eighty-five percent of patients who have Kawasaki disease are younger than 5 years. Kawasaki disease is more frequent in male children.

Key symptoms are remittent fever persisting for 1-2 weeks and other symptoms such as conjunctivitis, lesions of mouth and lips, rashes in hands and feet, and enlarged lymph nodes.

Since the cause of the disease is not well known, diagnosis is possible with the patient’s history and clinical findings. Unexplained fever lasting minimum 5 days and the other clinical findings are essential for diagnosis. Electrocardiography (ECG) and echocardiography should be obtained if Kawasaki disease is suspected.

Development of coronary artery (vessels that supply the heart) abnormalities in 20-25% of untreated patients indicates the importance of the disease. Risk of coronary artery abnormalities can be reduced by early diagnosis and treatment.

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Neurology

What is Guillain-Barré Syndrome?

Guillain-Barré Syndrome (GBS) involves the nervous system and is an autoimmune nervous system disease associated with abnormal functioning of the immune system. It occurs when the immune system is triggered immediately after a viral infection causing destruction and loss of the myelin sheath of nerve cells. It most commonly develops after upper respiratory infections (flu) or intestinal infections (diarrhea), occasionally it can be triggered by a vaccine.

Anyone can get GBS but it is slightly more common in older age. Nerve conduction decreases and slows down in GBS. Guillain-Barre Syndrome usually has a sudden onset, with muscle weakness, which is the primary finding, starting from the lower part of the body that progress upwards. Occasionally, first signs of the disease can be abnormal sensations such as pain, ache, numbness or tingling. Weakness is mild at the start, rapidly progresses to involve legs, arms and face in a few days or hours. Patients have difficulty holding objects such as comb, pen or buttons due to weakness and numbness on hands and fingers.

Neurological examination, nerve conduction tests (EMG) and collection of cerebrospinal fluid (CSF) with the lumbar puncture (LP) procedure is essential for diagnosis.

Treatment should be initiated immediately once the diagnosis is confirmed.

What is Myastenia Gravis?            

Myastenia Gravis (MG) is a chronic, complex, autoimmune disease characterized by muscle weakness and fatigue. MG is usually seen in women at 20-30 years of age and men over 50.

Typical signs and symptoms are muscle weakness that is increased by exercise and late afternoon and decreased by resting. Initial symptoms are usually double vision, drooping eyelids, difficulty swallowing, chewing and talking. In 1-3 years of onset, weakness involves respiratory, trunk, arm and leg muscles in majority of the patients. Patients should be treated in an intense care unit if the serious clinical form called “Myasthenic crisis” occurs. Infections and fever, excessive physical activity, thyroid gland diseases and pregnancy can trigger and worsen MG.

The significant findings on neurological examination are difficulty maintaining muscle movements and fatigue. Additionally, ACh antibody tests and abnormalities related to the thymus gland are investigated.

Majority of the patients can maintain a normal life with a well-informed, close follow-up and treatment.

What is Chronic Inflammatory Demyelinating Polyradiculoneuropathy?

Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) is a disease that affects the peripheral nerves, which conduct signals for movement and sensations such as touch, pain or heat. CIDP occurs when the immune system attack the myelin sheath of nerve cells. What causes this process is not yet known.

It can be observed at any age, including children and elderly. However, it occurs most frequently in men aged 40-60 years.

The disease presents with progressive, two-sided, symmetric loss of sensations and muscle weakness. If the weakness and sensation loss are progressive and persist more than 8 weeks, CIPD should be considered. The slow progression differentiates CIDP from GBS. Face and neck muscles can be involved, tingling and numbness can occur on hands and feet. Instability can be seen in many cases. Muscle weakness progress with attacks of worsening following periods of temporary improvement. It has two clinical patterns; chronic progressive and relapsing-remitting.

Patient’s history, physical examination findings, laboratory tests and electrophysiological tests are essential for diagnosis.

What is Multifocal Motor Neuropathy?

Multifocal Motor Neuropathy (MMN) is a progressive neuropathy with asymmetric, slow onset weakness. MMN is a chronic, rare and underdiagnosed disease. It occurs less frequently compared to GBS and CIPD. Average age of onset is the mid-fifties. Men are more likely to be affected.

It occurs more frequently in the arms than legs. Weakness commonly begins in the distal arm. As the condition worsens, muscle atrophy occurs besides nerve damage and weakness becomes more symmetric and generalized. Reflexes in the affected regions diminish in time. Sensory symptoms and findings are generally absent or clinically insignificant.

Patient’s history, physical examination and EMG (Electromyography) are essential for diagnosis.

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Urology

What is Overactive Bladder?

Overactive bladder is sudden and involuntary contracting of the bladder as the bladder is filled with urine from the kidneys. It is characterized by frequent voiding and nighttime voiding (with or without leakage).

Incontinence (urine leakage) does not necessarily occur in every patient with overactive bladder. Incontinence is a condition seen in 25% of all women over 30 years.

Treatment options are behavioral, medical and surgical therapies. The primary element of behavioral therapy is Kegel exercises aimed to relax the bladder. Medical therapy includes anticholinergic drugs that provide relaxation of the bladder. Certain antidepressants can also be used to treat OAB. In more resistant cases, Botox can be used for bladder relaxation. Surgical treatment is considered only for seriously affected patients who do not respond to medical treatments.

What is Benign Prostatic Hyperplasia?

Benign Prostatic Hyperplasia (BPH) is a benign enlargement of the prostate gland. The two main factors for prostate enlargement are age and the male hormone. Patients often present with complaints of frequent voiding at night, weak or interrupted voiding, straining to urinate, split stream during voiding, difficulty starting to urinate, blood in urine, feeling of incomplete emptying of bladder, incontinence (urgency or dribbling) or inability to urinate.

Medical treatment involves two drug groups: alpha reductase inhibitors; they reduce the size of the prostate by blocking an enzyme in the prostate but their effects are relatively slow. Alpha-receptor blockers mainly affect the smooth muscles of the prostate; prostate contains extensive smooth muscle cells, which have a role in the prostatic enlargement. This drug group acts faster. However, currently TUR-P operation, also known as closed prostate operation, is also used to treat such patients.

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Gynecology & Obstetrics

What is Healthy Nutrition in Pregnancy?

Every mother-to-be should have a regular diet containing foods rich in vitamins and minerals in order to maintain healthy growth of the baby and her own vitamin and mineral levels. Folic acid is not stored in the body; its deficiency may cause serious neural tube defects in the baby. Iron deficiency causes anemia of the mother, which may cause the risk of low birth weight. If iodine deficiency causes hypothyroidism in the mother, the baby can be born with certain abnormalities and mental retardation or learning difficulties can occur in the coming years.

Ginger is an effective remedy to relieve nausea and vomiting of pregnancy. Ginger has no known adverse effects on the fetus or the pregnant women.

Probiotics are microorganisms that have favorable effects on health and well-being of the recipient when consumed in sufficient amounts. Probiotics are thought to be safe in pregnancy, and there are scientific publications that suggest that they strengthen the immune systems of both the mother-to-be and the developing baby.

Probiotic consumption was shown to prevent allergic diseases such as atopic dermatitis, asthma, hay fever in children and significantly reduce the rates of gestational diabetes.

What is Iron Deficiency Anemia?

Iron is located in the hemoglobin of the red blood cells. Iron deficiency anemia is defined as hemoglobin levels in the blood below the normal range according to the age and gender due to reduced iron levels in the body.

Iron deficiency anemia occurs in cases of insufficient dietary intake of iron or malabsorption of iron despite sufficient dietary intake, in cases where the need to iron is increased such as pregnancy or childhood, or in cases of blood loss in the gastrointestinal system or other systems.

Symptoms such as weakness, loss of appetite, persistent headache, numbness in the limbs, shortness of breath, palpitations, burning sensation in the mouth and tongue, cracking at the edges of the mouth or dysphagia can be seen in iron deficiency anemia. Severe iron deficiency anemia can lead to cardiac problems, infections, growth or development problems in children and other complications. It can cause conditions such as preterm or low-weight delivery or blood transfusion need after delivery.

Iron deficiency anemia is mainly treated by applying a proper diet and iron replacement therapy with iron-containing pills.

What is Overactive Bladder?                         

Overactive bladder is sudden and involuntary contracting of the bladder as the bladder is filled with urine from the kidneys. It is characterized by frequent voiding and nighttime voiding (with or without leakage).

Incontinence (urine leakage) does not necessarily occur in every patient with overactive bladder. Incontinence is a condition seen in 25% of all women over 30 years.

Treatment options are behavioral, medical and surgical therapies. The primary element of behavioral therapy is Kegel exercises aimed to relax the bladder. Medical therapy includes anticholinergic drugs that provide relaxation of the bladder. Certain antidepressants can also be used to treat OAB. In resistant cases, Botox can be used for bladder relaxation. Surgical treatment is considered only for seriously affected patients who do not respond to medical treatments.

What is Osteoporosis?

Osteoporosis, also known as bone thinning, is the most common bone metabolism disease characterized by reduced bone mass. As a result of reduced mass and quality, bones can easily break.

The bone mass begins to gradually decrease after approximately 40 years of age. This loss is accelerated in women after menopause due to reduced estrogen levels. Therefore, women are at higher risk for osteoporosis compared to men.

The most common method to diagnose osteoporosis is measurement of bone density. Treatment can be planned according to measurement results.

A healthy diet, sufficient exposure to sunlight and regular exercise are essential to prevent osteoporosis. Additionally, calcium and vitamin D supplementations and drugs that prevent osteoporosis are often used as recommended by a doctor.

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Orthopedics – PMR

What is Osteoarthritis?

Osteoarthritis is a joint disease that affects the majority of middle-aged and elderly population. It is commonly known as “tear and wear arthritis” or “degenerative arthritis”. Although it is more common in the elderly, osteoarthritis may develop in younger ages due to wearing of the joints as a result of sports or occupational injuries. Frequency of the disease generally increases with age starting at middle age.

Osteoarthritis causes complaints such as joint pain, stiffness, hard swelling over the joint (due to bone enlargement), cracking or locking of joints or reduced range of motion.

What is Osteoporosis?

Osteoporosis, also known as bone thinning, is the most common bone metabolism disease characterized by reduced bone mass. As a result of reduced mass and quality, bones can easily break.

The bone mass begins to gradually decrease after approximately 40 years of age. This loss is accelerated in women after menopause due to reduced estrogen levels. Therefore, women are at higher risk for osteoporosis compared to men.

The most common method to diagnose osteoporosis is measurement of bone density. Treatment can be planned according to measurement results.

A healthy diet, sufficient exposure to sunlight and regular exercise are essential to prevent osteoporosis. Additionally, calcium and vitamin D supplementations and drugs that prevent osteoporosis are often used as recommended by a doctor.

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Gastroenterology

What is Chronic Hepatitis B Disease?

Hepatitis B disease is a liver disease caused by the Hepatitis B virus (HBV). Hepatitis B is a communicable disease, which is a critical health problem in our country and around the world.

Hepatitis B virus is spread from person to person by contact with blood, semen, vaginal fluid, saliva and other body fluids. Vaccination is very effective in preventing Hepatitis B disease. Hepatitis B virus affects the liver and causes weakness, fatigue, yellow coloring of skin and eyes, dark urine and light colored stools.

Hepatitis B infection can be acute or chronic. Hepatitis B infection lasting more than six months is defined as chronic Hepatitis B disease. Chronic infection generally persists a lifetime and may cause liver failure, cirrhosis or liver cancer.

What is Ulcerative Colitis?

Ulcerative colitis is a disease of the large intestine (colon). Ulcerative colitis is the disease of the inner layer (mucosa) of the colon. Inflammation and bleeding wounds (ulcers) occur in the mucosa.

Lower section of the colon (rectum) is affected in almost all of the patients. Some patients may have the disease in a larger portion of the large intestine while colon may be totally involved in some patients. In other words, the extent of the disease differs from person to person.

The cause of ulcerative colitis is unknown. Various food contents, bacteria, bacterial toxins, viruses may have a role in its development. However, there are no food or microbes found responsible. In response to a harmful factor, inflammatory cells in the intestinal mucosa increase, inflammation and ulcers develop.

Patient history including large intestine bleeding accompanied by diarrhea (or constipation) and abdominal pain suggests ulcerative colitis. Once intestinal infection is ruled out by stool and blood tests, the diagnosis should be confirmed by colonoscopy (or initially rectoscopy).

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Infectious Diseases

What is Chronic Hepatitis B Disease?

Hepatitis B disease is a liver disease caused by the Hepatitis B virus (HBV). Hepatitis B is a communicable disease which is a critical health problem in our country and around the world.

Hepatitis B virus is spread from person to person by contact with blood, semen, vaginal fluid, saliva and other body fluids. Vaccination is very effective in preventing Hepatitis B disease. Hepatitis B virus affects the liver and causes weakness, fatigue, yellow coloring of skin and eyes, dark urine and light colored stools.

Hepatitis B infection can be acute or chronic. Hepatitis B infection lasting more than six months is defined as chronic Hepatitis B disease. Chronic infection generally persists a lifetime and may cause liver failure, cirrhosis or liver cancer.

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Transplantation

What is Chronic Hepatitis B Disease?

Hepatitis B disease is a liver disease caused by the Hepatitis B virus (HBV). Hepatitis B is a communicable disease that is a critical health problem in our country and around the world.

Hepatitis B virus is spread from person to person by contact with blood, semen, vaginal fluid, saliva and other body fluids. Vaccination is very effective in preventing Hepatitis B disease. Hepatitis B virus affects the liver and causes weakness, fatigue, yellow coloring of skin and eyes, dark urine and light colored stools.

Hepatitis B infection can be acute or chronic. Hepatitis B infection lasting more than six months is defined as chronic Hepatitis B disease. Chronic infection generally persists a lifetime and may cause liver failure, cirrhosis or liver cancer.

What is Liver Transplantation?

Liver transplantation is required when liver damage seriously affects the well-being and life-quality of a patient. Currently, liver transplantation is theoretically the most effective mode of treatment for all diseases that lead to liver failure.

Liver transplantation is replacing the damaged liver in selected cases with chronic liver disease or acute fulminant failure, with normally functioning liver parts obtained from healthy individuals or people who had brain death. Liver failure is a life-threatening condition. Individuals whose life expectancy is less than 10% without a liver transplant get a 90% probability of survival after liver transplantation.

In our country, hepatitis B virus is the most common cause of liver failure. Liver failure may recur if hepatitis B infection relapses after liver transplantation. Therefore, it is essential to monitor the transplanted liver for hepatitis B virus infection with appropriate treatment and follow-up.

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Dermatology

What is Leprosy (Hansen’s) Disease?

Leprosy bacillus was discovered by Armauer Hansen, a Norwegian scientist, in 1876. It is a chronic infectious disease primarily affecting the skin and nervous system. According to World Health Organization data, there are approximately 4 million leprosy patients worldwide; 2589 patients are present in Turkey. It is most common in populations with insufficient access to healthcare services.

The disease is most common in multi-child families; infection spreads easily in families who live in a single room, eat from the same can, and have poor diet and low immunity. The disease affects both genders.

The bacillus is closely related to tuberculosis bacillus and the disease can develop in case of long-term close contact with an infected individual in the absence of natural immunity against the germ. The human being is the only known reservoir of infection. Cure is possible with early diagnosis and treatment. Leprosy is a reportable disease.

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Endocrinology

What is Central Diabetes Insipidus?

The production or action of antidiuretic hormone that ensures absorption of water in the kidneys and controls the amount of urine is reduced in patients with diabetes insipidus. Antidiuretic hormone (ADH) is also called arginine vasopressin (vasopressin). In the deficiency of antidiuretic hormone, which is responsible for concentrating the urine in the kidneys; patients present with excessive amounts of urine and extreme thirst. Patients with diabetes insipidus can have approximately 4 to 20 liters of urine and can drink the same amount of water.

Antidiuretic hormone secretion from the pituitary gland is not sufficient in the majority of patients with diabetes insipidus. This condition is called “central diabetes insipidus”. Pituitary and hypothalamic diseases cause central diabetes insipidus.

Replacement therapy with “desmopressin”, a vasopressin analogue, is administered to treat central diabetes insipidus.

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Ophtalmology

What is Birdshot Retinochoroidopathy?

Birdshot retinochoroidopathy (BRK) is a chronic disease of the posterior pole of the eye. It cause is unknown. However, an autoimmune reaction to retinal antigens is though to have a major role.

BRK is an inflammatory disease that involves both eyes symmetrically and is characterized by multiple, diffusely scattered, cream-colored depigmentation foci in the fundus. The general condition of patients, of which two-thirds are females, are good. The disease is seen between the ages of 40 to 65.

BRK is a chronic disease with exacerbations and remissions and can cause severe vision loss. Patients see floaters associated with more or less change in their vision. Photophobia, change in color vision and nyclalopia are also seen.

The most common complication is cystoid macular edema which is seen more than half of patients.

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Intensive Care

What is Albumin Deficiency?

Albumin is the most common protein found in the human blood plasma. It accounts for 60% of all proteins found in the blood. It is also found in tissue fluids, mainly in muscle and skin, and, in small amounts, in tears, sweat, gastric juice and bile. 30 to 40% of the total albumin in the body is found in the blood. In addition to transporting fatty acids and various other substances in the blood, the most important function of albumin is to maintain a proper water balance between the blood and tissue fluids.

Large proteins balance the leakage trend of the fluids in the blood since they cannot cross the capillaries. Albumin is therefore the main protein to regulate the colloid osmotic pressure, or oncotic pressure, that causes water and water-soluble substances to cross tissues from the capillaries. 70% of the oncotic pressure is exerted by albumin, therefore albumin is required for fluid balance between inside of the blood vessels and the external tissues. If the blood protein levels decrease, for example in the case of loss of protein to the urine (proteinuria), insufficient albumin production by the liver, malnutrition, or albumin loss from the body due to severe burns, “edema” (i.e water accumulation in the tissues) occurs.

Albumin binds the fatty acids, drug molecules, free oxygen radicals and various metal ions that can be toxic at high concentrations in the blood, thereby maintaining the consentrations of these substances in the blood at low and harmful levels as well as ensuring them to reach the locations where they are needed. Another feature of albumin is that it is able to partially buffer the blood acidity (pH).

Despite being a life-saving treatment tool, blood plasma is a hard-to-obtain and perishable product. Edwin J. Cohn invented a method for albumin purification from blood plasma in 1940s as a result of the research to find plasma segments that have the useful features of the plasma with additional convenience. It was been that albumin is an excellent material to substitute for blood plasma in certain cases. It is mainly used to increase or keep constant the blood volumes in the cases of severe trauma, surgery, blood loss and burn treatment. It is also used in cases of malnutrition, dehydration, chronic infection, hepatic impairment or renal impairment.

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Algology

What is Breakthrough Pain in Cancer Patients?

While the incidence of pain among cancer patients is 38% in early phases of the disease, this ratio increases up to 85% as the disease progresses and the quality of life is diminished. Although the chronic cancer pain can be controlled successfully with opioid analgesics in patients with medium or severe cancer pain, a great number of patients may experience a sudden onset of transient breakthrough pain associated with movement, which may be repeated several times a day.

Studies have shown that breakthrough pain may occur frequently in cancer patients and has an impact on the quality of life. A study has demonstrated the incidence of breakthrough pain as 64% among cancer patients. Breakthrough pain is the transient pain attack that flares up although the patient is on regular pain treatment. Usually the pain has a sudden onset and subsides within a few minutes to a few hours. Many patients experience multiple instances of breakthrough pain within the day.

Breakthrough pain may result from the cancer or the cancer therapy or may occur during a certain activity (like walking, dressing or coughing). However, it may also occur unexpectedly and without a reason. Breakthrough pain usually requires stronger painkillers with a more rapid effect than the chronic pain management medication.
Although this pain is directly linked with the invasion and compression of the tumour (85%), it is also associated with the tumour treatment in 17%, with the tumour in 9% and non-tumour causes in 9%.

In conclusion, cancer pain occurs in the form of continuous or intermittent pain or flares (sudden increase in pain intensity – breakthrough pain). Breakthrough pain observed in 2/3 of the cancer patients occurs especially during swallowing, coughing, defecation or micturition and it is severe, short-lived and difficult to control. Pain medication with short-term effect in addition to the basic medical therapy of the patient may help the pain relief.

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