Bridging the gap for young adult cancer patients

Bridging the gap for young adult cancer patients

Any time a child is diagnosed with cancer, it’s difficult on a family.

Many people think it must be more difficult the younger the patient. However, one segment of patients is often overlooked. Adolescent and young adult cancer patients, ages 16-29, are stuck at a crossroads between pediatric and adult treatments.

In many cases, adolescent and young adult patients are in the process of finishing high school, beginning college, entering the workforce or starting a family. They face enormous challenges that come from the abrupt change in the trajectory of their life after a cancer diagnosis.

Often, patients who were becoming independent of their parents become dependent once again.

Feelings of invincibility are replaced by a new and frightening awareness of their own mortality. They often experience profound loss of self-image, self-esteem, self-confidence and self-worth. The comprehensive care of these patients requires being able to address and respond to all of these issues.

Adolescent and young adult patients have not enjoyed the same improvements in survival over the last 20-30 years as other cancer patients, for a variety of reasons. These include:

• Lack of access to clinical trials. Cancer in this age group, in some cases, biologically different than similar cancers in older or younger individuals. Medicine, in general, has not advanced care of adolescent and young adult cancers because they simply haven’t been studied as much.

• Location of care. Several studies have shown that, at least for some types of cancer, survival rates are significantly better when patients in this age group are treated by pediatric oncologists rather than medical oncologists. This probably relates to the increased comfort level that pediatric oncologists have in delivering intensive chemotherapy to otherwise healthy patients. Despite the evidence supporting this, the majority of patients in the U.S. ages 16-21 with cancer are still treated by medical oncologists at adult oncology centers.

• Delays in diagnosis. Studies have consistently demonstrated the time from onset of symptoms due to cancer and the ultimate diagnosis and initiation of treatment for that cancer are significantly longer (by several months) in adolescent and young adult patients compared to younger children and older adults. This is partly due to a lack of recognition or consideration of a serious diagnosis in patients in this age range. It’s also the result of delay by the patient in seeking medical care, which can be due to denial of the potential for a serious illness, a lack of health insurance or the lack of a primary health care provider.

• Lack of compliance with therapy. For many reasons, adolescent and young adult patients are less likely to be compliant with cancer treatments. While unproven, it’s our hope that care specifically for this age group will improve compliance and therefore increase survival.

Recognizing that these patients have a variety of emotional, psychological, educational, vocational and financial needs that are truly unique, a variety of support services needs to be available as well. These include social networking groups, therapists, counselors, social workers, educational specialists and a treatment staff that is committed to bringing hope to every cancer patient.

By Dr. Robin Hanson
Article Source: http://www.stltoday.com/

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In Their Own Words: After a Diagnosis, Adolescents and Young Adults with Cancer