Teens and young adults with cancer face unique challenges and require targeted care

Adolescents and young adults are neither children nor adults and those affected by cancer require targeted care that crosses the boundaries between pediatric and adult oncology, according to several pioneers in this still-developing field of adolescent and young adult oncology. An illuminating roundtable discussion by these experts will be published in the premier issue of Journal of Adolescent and Young Adult Oncology, a multidisciplinary peer-reviewed publication of Mary Ann Liebert, Inc.

"AYA cancer presents the medical community with several unique problems. First, it requires true collaboration between pediatric and medical oncologists as the age range crosses both disciplines. Next, our AYA cancer patients not only have cancer but are also often dealing with ongoing developmental and psychosocial issues at the same time; as such, we must be aware of how a cancer diagnosis interferes with their normal development. The Roundtable discussion helps put AYA cancer in perspective for those who have not yet considered the 15-39 year old cancer patient as a distinct and relevant patient group," according to Editor-in-Chief Leonard S. Sender, MD, of the University of California, Irvine and CHOC Children's Hospital.

The roundtable discussion, "Trailblazers in Adolescent and Young Adult Oncology," was moderated by Archie Bleyer, MD, Medical Director of Clinical Research for the St. Charles Health System in Bend, Oregon. Participants were leading physicians of pediatric, adolescent, and young adult oncology who have helped mold and advance this area of specialization trace the history and driving forces behind programs and disease management strategies now in place that target this patient population. Representing the experiences and revolutionary changes that have taken place in the United States, England, and Canada, Dr. Bleyer was joined by Karen Albritton, MD, Director of the Adolescent and Young Adult Oncology Program at Cook Children's Medical Center and University of North Texas Health Science Center in Fort Worth; Ronald Barr, MB ChB, MD, Professor of Pediatrics, Pathology and Medicine at McMaster University in Canada; Ian Lewis, MB ChB, Professor of Cancer Research in Children and Young People at Leeds Teaching Hospital in the United Kingdom; and Editor-in-Chief Leonard Sender, MD, Medical Director of the Cancer Institute at CHOC Children's Hospital and Director of the Young Adult Cancer Program at the University of California, Irvine's Chao Family Comprehensive Cancer Center in Orange, CA.

Several factors contributed to the growing recognition that adolescents and young adults—defined by the National Cancer Institute as patients aged 15 to 39 at diagnosis— are a distinct group of cancer patients that have not enjoyed the same improvements in overall survival compared with their younger and older peers. The reasons for the differences have not been fully elucidated but many suspect multiple factors working independently or together, including biological differences, treatment protocol or medical care facility variances, lack of relevant clinical trials, and access to care due to un- or under-insured status. In addition to those newly diagnosed as an AYA, there is a growing community of AYAs who are survivors of pediatric cancer. Research has demonstrated that cancer is a chronic disease and that survivorship is often fraught with unintended consequences of cancer treatment, including infertility, heart and lung damage, and metabolic problems. Survivorship issues, both of the pediatric cancer survivor and the AYA cancer survivor, will be addressed in the new journal from Liebert.