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Ehrhardt MJ, Friedman DN, Hudson MM. Health Care Transitions Among Adolescents and Young Adults With Cancer. J Clin Oncol 2024; 42:743-754. [PMID: 38194608 DOI: 10.1200/jco.23.01504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/06/2023] [Accepted: 11/01/2023] [Indexed: 01/11/2024] Open
Abstract
Survivors of adolescent and young adult (AYA) cancers, defined as individuals diagnosed with a primary malignancy between age 15 and 39 years, are a growing population with unique developmental, psychosocial, and health-related needs. These individuals are at excess risk of developing a wide range of chronic comorbidities compared with the general population and, therefore, require lifelong, risk-based, survivorship care to optimize long-term health outcomes. The health care needs of survivors of AYA cancers are particularly complicated given the often heterogeneous and sometimes fragmented care they receive throughout the cancer care continuum. For example, AYA survivors are often treated in disparate settings (pediatric v adult) on dissimilar protocols that include different recommendations for longitudinal follow-up. Specialized tools and techniques are needed to ensure that AYA survivors move seamlessly from acute cancer care to survivorship care and, in many cases, from pediatric to adult clinics while still remaining engaged in long-term follow-up. Systematic, age-appropriate transitional practices involving well-established clinical models of care, survivorship care plans, and survivorship guidelines are needed to facilitate effective transitions between providers. Future studies are necessary to enhance and optimize the clinical effectiveness of transition processes in AYA cancer survivors.
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Affiliation(s)
- Matthew J Ehrhardt
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Danielle Novetsky Friedman
- Department of Pediatrics, Division of General Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Melissa M Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
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Zucchetti G, Ciappina S, Dionisi-Vici M, Giordano M, Varetto A, Biasin E, Felicetti F, Fagioli F. Emotional Distress, Self-Management Skills, and Expectations Among Adolescents and Young Adult Childhood Cancer Survivors in Transition from Pediatric to Adult Care: A Brief Report. J Adolesc Young Adult Oncol 2023; 12:906-911. [PMID: 36867153 DOI: 10.1089/jayao.2022.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
The transition from pediatric to adult care poses several emotional and personal challenges to adolescents and young adult (AYA) childhood cancer survivors (CCSs), which need attention to avoid the risk of nonadherence and medical dropout. This brief report describes the condition of AYA-CCSs at the moment of transition in terms of emotional state, personal autonomy, and expectations regarding future care. The results provide insights for clinicians dealing with survivorship care, to enhance AYA-CCSs emotional resilience and to support them in being in charge of their health, thus facilitating their transition to adulthood.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Sabrina Ciappina
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Margherita Dionisi-Vici
- Transition Unit for Childhood Cancer Survivors, AOU Città Della Salute e Della Scienza, Turin, Italy
| | - Mario Giordano
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Antonella Varetto
- Transition Unit for Childhood Cancer Survivors, AOU Città Della Salute e Della Scienza, Turin, Italy
| | - Eleonora Biasin
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Francesco Felicetti
- Transition Unit for Childhood Cancer Survivors, AOU Città Della Salute e Della Scienza, Turin, Italy
| | - Franca Fagioli
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
- Department of Public Health and Paediatric Sciences, University of Torino, Turin, Italy
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Michael S, Borgmann-Staudt A, Sommerhäuser G, Kepakova K, Klco-Brosius S, Kruseova J, Nagele E, Panasiuk A, Vetsch J, Balcerek M. Educational pathways of childhood cancer survivors-a parental cohort. J Cancer Surviv 2023; 17:518-525. [PMID: 36459379 PMCID: PMC10036444 DOI: 10.1007/s11764-022-01303-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE Using the International Standard Classification of Education (ISCED), we examined the educational and vocational pathways of two comparable, parental cohorts: childhood cancer survivors (CCS) and their siblings. Both cohorts had previously entered parenthood. The aim of the study was to elucidate whether childhood cancer and treatment affect the educational pathways chosen by parents who are former patients. METHODS We analysed data that was collected from childhood cancer survivors and their siblings regarding their offspring's health within the FeCt Multicentre Offspring Study (conducted 2013-2016). We evaluated and compared the professional pathways of (i) all participating survivors and all participating siblings and those of (ii) survivors and their biological siblings. RESULTS Overall information on parental gender, age, and education were available from 1077 survivors and 246 siblings (group (i)). The majority of participants were female with a mean age of 35.2 (survivor) and 37.9 (sibling) years at time of survey. For subgroup (ii), analysis information was available on 191 survivors and 210 siblings. Fathers achieved university degrees significantly more often than mothers (p = 0.003 (i), p < 0.001 (ii)). The distribution of professional education was not significantly different between cancer survivors and siblings in either cohort (i) or (ii). CONCLUSIONS Regarding our research on the educational and vocational trajectory of CCS, patients can be reassured that family planning and vocational education are well compatible. Inequalities regarding gender-specific educational pathways remain to be addressed. IMPLICATIONS FOR CANCER SURVIVORS CCS should monitor their fertility status regularly and, if necessary, cryopreserve germ cells or tissue in order to optimize their family planning. Educational opportunities should be pursued as desired and with confidence. Local as well as European aftercare programs can assist with family planning and education.
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Affiliation(s)
- S Michael
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Borgmann-Staudt
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - G Sommerhäuser
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Hematology, Oncology, and Cancer Immunology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Berlin, Germany
| | - K Kepakova
- University Hospital Brno, Brno, Czech Republic
| | - S Klco-Brosius
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Kruseova
- University Hospital Motol, Prague, Czech Republic
| | - E Nagele
- Medical University Graz, Graz, Austria
| | - A Panasiuk
- Medical University Wroclaw, Wroclaw, Poland
| | - J Vetsch
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - M Balcerek
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
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