Journal of Traditional Medical Complementary Therapies

.: REVIEW
Palyatif Bakım Gören Kanser Hastalarında Müziğin Ağrı ve Anksiyete Üzerine Etkisi: Geleneksel Derleme
The Effect of Music on Pain and Anxiety in Palliative Care Cancer Patients: Traditional Review
Gülsüm KEHRİBARa , Mehmet SELÇUKb
aKaramanoğlu Mehmetbey Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu, Evde Hasta Bakımı Programı, Karaman, Türkiye
bKaramanoğlu Mehmetbey Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu, Yaşlı Bakım Programı, Karaman, Türkiye
J Tradit Complem Med. 2024;7(1):113-21
doi: 10.5336/jtracom.2023-97722
Article Language: TR
Full Text
ÖZET
 Kontrolsüz hücre çoğalması ile bulunduğu dokuyu istila ederek çevre dokulara yayılan, kronik bir hastalık olan kanser günümüzde en çok korkulan, sakatlıklara ve ölüme yol açan hastalıklardan biridir. Kanser hastaları başta ağrı ve anksiyete olmak üzere pek çok problem yaşayabilmektedir. Ağrı ve anksiyete palyatif bakım kanser hastasında en yaygın görülen ve yaşam kalitesini düşüren semptomlardandır. Palyatif bakımın temel amacı semptom kontrolünü sağlayarak, hastanın konforunu artırmak ve yaşam kalitesini yükseltmektir. Semptom kontrolü için küratif tedavilere paralel olarak tamamlayıcı bütünleşik uygulamalarda kullanılmaktadır. Bunlardan biri de müziktir. Müziğin, nöroendokrin uyaran oluşturarak, dopamine ve serotonin hormonu salınımını, limbik sistemi aktive ederek endorfin salınımını, sempatik sinir sistemi aktivitesini baskılayarak stres hormon adrenalin salınımını azalttığı bunun da ağrı ve anksiyete düzeyinin azalmasında anlamlı düzeyde katkıda bulunduğu düşünülmektedir. Bu bağlamda, müziğin palyatif bakım gören kanser hastalarında ağrı ve anksiyete üzerindeki etkileri son derece önemlidir. Müziğin terapötik gücü, sakinleştirici ve duygusal rahatlama sağlayabilen özellikleri sayesinde, kanser hastalarının semptomları yönetmelerine ve tedavi sürecine daha olumlu bir bakış açısıyla yaklaşmalarına yardımcı olduğu vurgulanmaktadır. Bu mini derleme, müziğin palyatif bakım gören kanser hastalarında ağrı ve anksiyete üzerindeki etkisini araştırarak bilimsel araştırmalara dayalı olumlu etkilerini açıklamayı hedeflemiştir. Hastaların yaşam kalitesini artırmak ve tedavi süreçlerini desteklemek için müzik uygulamalarının geliştirilmesini ve uygulanmasını vurgulamayı ve palyatif bakım kanser hastalarında müziğin olumlu etkilerine ilişkin farkındalığı yükseltmeyi amaçlamaktadır.

Anahtar Kelimeler: Palyatif bakım; kanser; müzik; ağrı; anksiyete
ABSTRACT
 Cancer, a chronic disease characterized by uncontrolled cell proliferation invading the surrounding tissues and spreading to neighboring areas, is currently one of the most dreaded illnesses causing disabilities and fatalities. Cancer patients may experience many problems, especially pain and anxiety. Pain and anxiety are among the most common symptoms in palliative care cancer patients and reduce quality of life. The main aim of palliative care is to improve the patient's comfort and quality of life by providing symptom control. For symptom control, complementary integrated practices are used in parallel with curative treatments. One of these is music. It is thought that music reduces the release of dopamine and serotonin hormones by creating neuroendocrine stimuli, the release of endorphins by activating the limbic system, and the release of the stress hormone adrenaline by suppressing sympathetic nervous system activity, which contributes significantly to the reduction of pain and anxiety levels. In this context, the effects of music on pain and anxiety in cancer patients receiving palliative care are extremely important. It is emphasized that the therapeutic power of music, with its calming and emotional relaxation properties, helps cancer patients manage their symptoms and approach the treatment process with a more positive perspective. This mini-review aims to explore the positive effects of music on pain and anxiety in cancer patients receiving palliative care, based on scientific research. It highlights the need to develop and implement music interventions to enhance patients' quality of life and support their treatment processes. Additionally, it aims to raise awareness about the positive effects of music in palliative care for cancer patients.

Keywords: Palliative care; cancer; music; pain; anxiety
REFERENCES:
  1. Enç N. İç hastalıkları hemşireliği. Can G, editör. Onkolojik Hastalıklar ve Hemşirelik Bakımı. 1. Baskı. İstanbul: 50. Yıl Yayınları; 2014. p.365-411.
  2. Dalay N, Buyru N. Kanser biyolojisi. Can G, editör. Onkoloji Hemşireliği. 1. Baskı. İstanbul: Nobel Tıp Kitapevleri; 2015. p.7-18.
  3. World Health Organization [Internet]. © 2023 WHO [Cited: December 29, 2022]. Cancer. Available from: [Link] 
  4. Brafford P, Herlyn M. Gene expression profiling of melanoma cells - searching the haystack. J Transl Med. 2005;3(1):2. [Crossref]  [PubMed]  [PMC] 
  5. Baykara O. Kanser tedavisinde güncel yaklaşımlar [Current modalities in treatment of cancer]. Balikesir Saglik Bil. Derg. 2016;5(3):153-65. [Link] 
  6. Sağlık Bakanlığı. Ulusal Kanser Kontrol Planı 2013-2018. Erişim tarihi: 03.03.2024 [Link] 
  7. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü [İnternet]. [Erişim tarihi: 29 Kasım 2022]. Kanser Taramaları. Erişim linki: [Link] 
  8. Union for International Cancer Control [Internet]. [Cited: January 12, 2023]. Globocan 2020: New Global Cancer Data Available from: [Link] 
  9. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, Kanser Dairesi Başkanlığı [İnternet]. [Erişim tarihi: 29 Ocak 2023]. Kanser İstatistikleri. Erişim linki: [Link] 
  10. Sağlık Bakanlığı [İnternet] Türkiye Bulaşıcı Olmayan Hastalıklar Çok Paydaşlı Eylem Planı. Erişim tarihi: 03.03.2024 [Link] 
  11. Kabalak AA, Öztürk H, Çağıl H. Yaşam sonu bakım organizasyonu; palyatif bakım [End of life care organization; palliative care]. Yoğun Bakım Dergisi. 2013;11(2):56-70. [Link] 
  12. Mercadante S, Lazzari M, Reale C, Cuomo A, Fusco F, Marchetti P, et al; IOPS Study Group. Italian Oncological Pain Survey (IOPS): a multicentre Italian study of breakthrough pain performed in different settings. Clin J Pain. 2015;31(3):214-21. [Crossref]  [PubMed] 
  13. Nayak MG, George A, Vidyasagar MS, Mathew S, Nayak S, Nayak BS, et al. Quality of life among cancer patients. Indian J Palliat Care. 2017;23(4):445-50. [Crossref]  [PubMed]  [PMC] 
  14. Singh H, Kaur K, Banipal RP, Singh S, Bala R. Quality of life in cancer patients undergoing chemotherapy in a tertiary care center in malwa region of punjab. Indian J Palliat Care. 2014;20(2):116-22. [Crossref]  [PubMed]  [PMC] 
  15. Kitirci B. Palyatif bakim ünitelerinde uygulanan müzik terapi çalışmalari üzerine bir araştırma [A research on music therapy studies implemented in palliative care units]. Afyon Kocatepe Üniversitesi Akademik Müzik Araştırmaları Dergisi. 2018;4(8):64-89. [Crossref] 
  16. Koelsch S, Siebel WA. Towards a neural basis of music perception. Trends Cogn Sci. 2005;9(12):578-84. [Crossref]  [PubMed] 
  17. Öztürk L, Erseven H, Atik MF. Makamdan Şifaya. 3. Baskı. İstanbul: Türkiye İş Bankası Kültür Yayınları; 2017.
  18. Torun Ş. Kanıta dayalı müzik terapisi uygulamalarında müziğin rolü [The role of music in evidence based music therapy practices]. Anadolu Tıbbı Dergisi. 2022;1(2):1-13. [Link] 
  19. Genç F, Köçkar Ç, Mutlu F, Buğdaycı M. Kanser hastalarının ağrı için kullandıkları nonfarmakolojik yöntemler [Non-pharmacological methods for the pain management of cancer patients]. Koç Üniversitesi Hemşirelikte Eğitim ve Araştırma Dergisi. 2018;15(2):88-93. [Link] 
  20. Kollar J. Applying music as a supplemental treatment in cancer care. Mentálhigiéné es Pszichoszomatika. 2016;17(1):37-59. [Crossref] 
  21. Li Y, Xing X, Shi X, Yan P, Chen Y, Li M, et al. The effectiveness of music therapy for patients with cancer: a systematic review and meta-analysis. J Adv Nurs. 2020;76(5):1111-23. [Crossref]  [PubMed] 
  22. Helena M, Konstantinos-Foivos S, Georgia L, Georgia T, Eleni S, Panagiotis S. The healing effect of music in cancer patients: an Invocation to Apollo. Biomedical and Translational Science. 2021;1(3):1-8. [Crossref] 
  23. Fallon MT. Neuropathic pain in cancer. Br J Anaesth. 2013;111(1):105-11. [Crossref]  [PubMed] 
  24. Haroun R, Wood JN, Sikandar S. Mechanisms of cancer pain. Front Pain Res (Lausanne). 2023;3:1030899. [Crossref]  [PubMed]  [PMC] 
  25. Ripamonti CI, Santini D, Maranzano E, Berti M, Roila F; ESMO Guidelines Working Group. Management of cancer pain: ESMO Clinical Practice Guidelines. Ann Oncol. 2012;23 Suppl 7:vii139-54. [Crossref]  [PubMed] 
  26. Usta Yeşilbalkan Ö, Durmaz Akyol A, Çetinkaya Y, Altın T, Ünlü D. Kemoterapi tedavisi alan hastaların tedaviye bağlı yaşadıkları semptomlar ve yaşam kalitesine olan etkisinin incelenmesi [Studying the symptoms that are being experienced due to treatment by the patients who receive chemotheraphy and their effects on the quality of life]. Ege Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2005;21(1):13-23. [Link] 
  27. Running A, Seright T. Integrative oncology: managing cancer pain with complementary and alternative therapies. Curr Pain Headache Rep. 2012;16(4):325-31. [Crossref]  [PubMed] 
  28. Ankay Yılbaş A, Çelebi N. Palyatif bakımda ağrı tedavisi ve sorunlar [Pain management and difficulties in palliative care]. Journal of Anesthesia. 2014;22(3):124-34. [Link] 
  29. Blake A, Wan BA, Malek L, DeAngelis C, Diaz P, Lao N, et al. A selective review of medical cannabis in cancer pain management. Ann Palliat Med. 2017;6(Suppl 2):S215-S222. [Crossref]  [PubMed] 
  30. Jahn P, Kuss O, Schmidt H, Bauer A, Kitzmantel M, Jordan K, et al. Improvement of pain-related self-management for cancer patients through a modular transitional nursing intervention: a cluster-randomized multicenter trial. Pain. 2014;155(4):746-54. [Crossref]  [PubMed] 
  31. Gutgsell KJ, Schluchter M, Margevicius S, DeGolia PA, McLaughlin B, Harris M, et al. Music therapy reduces pain in palliative care patients: a randomized controlled trial. J Pain Symptom Manage. 2013;45(5):822-31. Erratum in: J Pain Symptom Manage. 2014;48(6):1279. [Crossref]  [PubMed] 
  32. Jost L, Roila F; ESMO Guidelines Working Group. Management of cancer pain: ESMO Clinical Practice Guidelines. Ann Oncol. 2010;21 Suppl 5:v257-60. [Crossref]  [PubMed] 
  33. Yang T, Wang S, Wang R, Wei Y, Kang Y, Liu Y, et al. Effectiveness of five-element music therapy in cancer patients: a systematic review and meta-analysis. Complement Ther Clin Pract. 2021;44:101416. [Crossref]  [PubMed] 
  34. Payne DK, Massie MJ. Anxiety in pallative care. In: Chochinov HM, Breitbart W, eds. Handbook of Psyhiatry in Pallative Medicine. 1st ed. New York: Oxford University Press; 2000. p.435.
  35. Rafian Z, Azarbarzin M, Safarifard S. Determine the effect of music therapy on anxiety, pain, nausea and vital signs of patients undergoing cesarean section at Shariati Hospital. Azad Univ J. 2009;19(1):25-30. Erişim tarihi: 03.03.2024 [Link] 
  36. Kadan-Lottick NS, Vanderwerker LC, Block SD, Zhang B, Prigerson HG. Psychiatric disorders and mental health service use in patients with advanced cancer: a report from the coping with cancer study. Cancer. 2005;104(12):2872-81. [Crossref]  [PubMed]  [PMC] 
  37. Tsigaroppoulos T, Mazaris E, Chatzidarellis E, Skolarikos A, Varkarakis I, Deliveliotis C. Problems faced by relatives caring for cancer patients at home. Int J Nurs Pract. 2009;15(1):1-6. [Crossref]  [PubMed] 
  38. Aydoğan F, Uygun K. Kanser hastalarında palyatif tedaviler [In cancer patients palliative treatments]. Klinik Gelişim Dergisi. 2011;24:4-9. [Link] 
  39. Krishnaswamy P, Nair S. Effect of music therapy on pain and anxiety levels of cancer patients: a pilot study. Indian J Palliat Care. 2016;22(3):307-11. [Crossref]  [PubMed]  [PMC] 
  40. Singh VP, Rao V, V P, R C S, K KP. Comparison of the effectiveness of music and progressive muscle relaxation for anxiety in COPD--A randomized controlled pilot study. Chron Respir Dis. 2009;6(4):209-16. [Crossref]  [PubMed] 
  41. Marletta G, Antoniazza B, Pinto MP, Ferraraccio M, Damini M, Sollami, et al. Effects of music therapy on vital signs and anxiety: a study with terminally ill patients. J Hosp Palliat Med Care. 2018;1:002. [Link] 
  42. de Andrade ÉV, Haas VJ, de Faria MF, Dos Santos Felix MM, Ferreira MBG, Barichello E, et al. Effect of listening to music on anxiety, pain, and cardiorespiratory parameters in cardiac surgery: study protocol for a randomized clinical trial. Trials. 2022;23(1):278. [Crossref]  [PubMed]  [PMC] 
  43. Pauwels EK, Volterrani D, Mariani G, Kostkiewics M. Mozart, music and medicine. Med Princ Pract. 2014;23(5):403-12. [Crossref]  [PubMed]  [PMC] 
  44. Warth M, Kessler J, Koenig J, Wormit AF, Hillecke TK, Bardenheuer HJ. Music therapy to promote psychological and physiological relaxation in palliative care patients: protocol of a randomized controlled trial. BMC Palliat Care. 2014;13(1):60. [Crossref]  [PubMed]  [PMC] 
  45. Waldon EG. The effects of group music therapy on mood states and cohesiveness in adult oncology patients. J Music Ther. 2001;38(3):212-38. [Crossref]  [PubMed] 
  46. Huang ST, Good M, Zauszniewski JA. The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Int J Nurs Stud. 2010;47(11):1354-62. [Crossref]  [PubMed] 
  47. Karamızrak N. Ses ve müziğin organları iyileştirici etkisi [Healing effects of sound and music on the organs]. Koşuyolu Herat J. 2014;17(1):54-7. [Crossref] 
  48. Tekinsoy K. Müzik terapi. Başer M, Taşçı S, editörler. Kanıta Dayalı Rehberleriyle Tamamlayıcı ve Destekleyici Uygulamalar. 1. Baskı. Ankara: Akademisyen Tıp Kitabevi; 2015. p.9-14.
  49. Clark NI, Tamplin J. How music can influence the body: perspectives from current research. ResearchGate. Voices A World Forum for Music Therapy. 2018;16(2). [Crossref] 
  50. Gao Y, Wei Y, Yang W, Jiang L, Li X, Ding J, et al. The effectiveness of music therapy for terminally Ill patients: a meta-analysis and systematic review. J Pain Symptom Manage. 2019;57(2):319-29. [Crossref]  [PubMed] 
  51. Bradt J, Dileo C, Magill L, Teague A. Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev. 2016;(8):CD006911. Update in: Cochrane Database Syst Rev. 2021;10:CD006911. [Crossref]  [PubMed] 
  52. Die Trill M. Anxiety and sleep disorders in cancer patients. EJC Suppl. 2013;11(2):216-24. [Crossref]  [PubMed]  [PMC] 
  53. Jasemi M, Aazami S, Zabihi RE. The effects of music therapy on anxiety and depression of cancer patients. Indian J Palliat Care. 2016;22(4):455-8. [Crossref]  [PubMed]  [PMC] 
  54. Sun C, Sang S, Tang Y, Niu X, Yoo HS, Zhou P, et al. Effects of music therapy on anxiety in patients with cancer: study protocol of a randomised controlled trial. BMJ Open. 2023;13(5):e067360. [Crossref]  [PubMed]  [PMC] 
  55. Hodges DA. Psychophysiological measures. In: Juslin PN, Sloboda J, eds. Handbook of Music and Emotion. 1st ed. Oxford: Oxford University Press; 2011. p.279-11.
  56. Koelsch S, Boehlig A, Hohenadel M, Nitsche I, Bauer K, Sack U. The impact of acute stress on hormones and cytokines, and how their recovery is affected by music-evoked positive mood. Sci Rep. 2016;6:23008. [Crossref]  [PubMed]  [PMC] 
  57. Kreutz G, Murcia CQ, Bongard S. Psychoneuroendocrine research on music and health: an overview. In: MacDonald R, Kreutz G, Mitchell L, eds. Music, Health, and Wellbeing. Oxford: Oxford University Press; 2021. p.457-76.
  58. Leardi S, Pietroletti R, Angeloni G, Necozione S, Ranalletta G, Del Gusto B. Randomized clinical trial examining the effect of music therapy in stress response to day surgery. Br J Surg. 2007;94(8):943-7. [Crossref]  [PubMed] 
  59. Linnemann A, Ditzen B, Strahler J, Doerr JM, Nater UM. Music listening as a means of stress reduction in daily life. Psychoneuroendocrinology. 2015;60:82-90. [Crossref]  [PubMed] 
  60. Nilsson U. The effect of music intervention in stress response to cardiac surgery in a randomized clinical trial. Heart Lung. 2009;38(3):201-7. [Crossref]  [PubMed] 
  61. Köhler F, Martin ZS, Hertrampf RS, Gäbel C, Kessler J, Ditzen B, et al. Music therapy in the psychosocial treatment of adult cancer patients: a systematic review and meta-analysis. Front Psychol. 2020;11:651. Erratum in: Front Psychol. 2020;11:2095. [Crossref]  [PubMed]  [PMC] 
  62. Warth M, Keßler J, Hillecke TK, Bardenheuer HJ. Music therapy in palliative care. Dtsch Arztebl Int. 2015;112(46):788-94. [Crossref]  [PubMed]  [PMC] 

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4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com