The adolescent and young adult gap in cancer care and outcome

Presented in part at the American Society of Pediatric Hematology/Oncology and Pediatric Academic Societies’ 2003 Annual Meeting.
https://doi.org/10.1016/j.cppeds.2005.02.001Get rights and content

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Cancer in older adolescents and young adults —Jeffrey C. Murray, MD

Dramatic progress has been made in the care and outcomes of children with malignancy during the last four decades. In fact, the progress in childhood cancer therapy has perhaps been the most dramatic success story in all of modern medicine. Remarkably, improvements in cancer therapy for all age groups have been witnessed, attributable to novel cancer drugs, improved understanding of tumor molecular biology and genetics, as well as patient participation in national cooperative group-sponsored

Adolescents with cancer and clinical trials: lack of participation and progress —Archie Bleyer, MD, Troy Budd, Michael Montello, PharmD

Clinical trials designed specifically to reduce late adverse sequelae of cancer therapy in children and adolescents have become commonplace since the cure rate of most of their cancers has become so high. Yet, adolescents have a much lower rater of clinical trial participation than do children, and hence, may not be benefiting from the high rate of clinical trial entries among younger patients.18 An adolescent with newly diagnosed cancer is more likely to be thrust into a state of limbo—both

Psychosocial issues in adolescent cancer patients and survivors —Brad J. Zebrack, PhD, MSW, MPH, Mark A. Chesler, PhD, Anthony Penn, MBBCh, MRCPCH, Ernest Katz

The literature focused on the long-term psychosocial impact of cancer diagnosed and treated in childhood is rapidly expanding. As one might expect, cancer can have a major impact on several dimensions of young people’s current and later lives. The shock of diagnosis, the threat of death, disablement, or disfigurement, the severity of treatment and its side effects, the potentially alienating responses of peers, and social discrimination all take a heavy toll.

In 1998, the American Cancer Society

The survivor transition challenge from childhood to adult life —Kevin Oeffinger, MD

The preceding sections have described the issues germane to adolescents and young adults with cancer. With the tremendous advancements in cancer care over recent decades, the population of long-term survivors has grown exponentially. Within the near future, about 1:450 young adults in the United States will be a pediatric cancer survivor.109 Following cure, the next challenge for survivors is maintaining their health, for the cure is not without a cost. Virtually all organ systems can be

North American survey of needs and best practice models

The world of pediatric oncology has a good problem on its hands. There is an “Epidemic of Survivors.”129 Epidemic may be an overstatement, but this issue has recently received the attention of health care professionals and organizations such as the National Cancer Institute, the Institute of Medicine, and COG. One in every 640 adults aged 20 to 39 years in the United States is now a survivor of childhood cancer.130 As the overall cure rate of childhood cancer approaches 85% by 2010, the ratio

Models of care for childhood cancer survivors including an overview of transition of care for young adults with special health care needs —Beverly Ryan, MD, Karen Kinahan, MS, RN, BC

Meeting the challenges born of our successes requires recognition, investigation, and problem-solving by teams of individuals with varying talents but one commitment. There is an expansive body of literature addressing awareness of, support for, and barriers to transitioning adolescents and young adults with special health care needs to adult-oriented health services.144, 145, 146, 147, 148, 149, 150 This population has been defined by the Maternal and Child Health Bureau as “… those who have

Preparation of the childhood cancer survivor for transition of care: role of the pediatrician —David R. Freyer, DO

Transition of medical care has been defined by the Society of Adolescent Medicine as “the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented health care systems.”164 Originally developed in relation to adolescents with special health care needs, transition of care represents a formal process involving considerable planning and coordination of care between their pediatric and adult care providers.165, 166

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      The age range of adolescents and young adults encompasses their formative years in life and spans the time from completing education, to possibly starting a career and raising children, and potentially contributing to society more broadly. A cancer diagnosis during these years can have a considerable impact on individuals' future life trajectory through major stressors, including feelings of isolation, anxiety and depression, concerns about infertility, discontinuing schooling or work, and financial hardship.1,12,26–28 Efforts to mitigate the issues distinct to this age group have resulted in the formation of organisations to help support adolescent and young adult patients with cancer.

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