(Wall Street Journal Online) – April 28, 2014: New treatments and earlier detection have led to steady gains in cancer survival for children and adults. But survival rates for teens and young adults with some types of cancer have barely budged in 30 years.
A push is on for better care and better outcomes for patients in what the National Cancer Institute calls a “no man’s land” between pediatric and adult oncology. At present, adolescents and young adults may be treated in adult units or in children’s wards – which both are places they are likely to feel isolated and distressed.
More hospitals are adding dedicated teen and young adult cancer units based on a model developed by the Teenage Cancer Trust in the U.K. It teams medical oncologists, pediatric specialists, therapists and social workers to offer an integrative approach to medical treatment, emotional issues, fertility counseling and clinical trials.
Patients out of childhood but not yet fully mature have physical, developmental and social needs that often go unrecognized by doctors, studies show. The adolescent-young adult group, dubbed “AYA,” ranges in age from about 13 to about 26, although some researchers include adults up to 39.
These patients, the least-frequent users of primary medical care, can experience delays in diagnosis, with symptoms often assumed to be something else. They may receive treatments that aren’t most effective for tumors that can have different mutations and behave differently in teens and young adults than in other patients. Few academic medical centers have offered clinical trials to adolescents, which is one reason only about 10% of 15- to 19-year-olds take part in research. And many young patients don’t learn enough about aspects of preserving fertility, such as sperm banking.