Adolescents and Young Adults with Cancer

Despite substantial improvement in the treatment of childhood cancer, adolescents and young adults (AYA) diagnosed with cancer between the ages of 15 and 39 years have not experienced the same improvements in survival. Across all cancer diagnoses, survival in AYA continues to lag behind younger (<14 years) and older (>40 years) patients. The National Cancer Institute has designated AYA with cancer as a vulnerable population.

AYA with a new cancer diagnosis face unique psychosocial challenges associated with both the cancer and treatment. Their development is often stalled while their peers finish high school, begin careers, or even start families. Further, the financial burden of cancer is prominent in AYA, many of whom experience unmet mental health and physical needs that affect their health-related quality of life.

Guidelines: To address the special needs of this distinct group and the factors that affect outcomes (ranging from diagnosis and treatment to biological factors), the National Comprehensive Cancer Network (NCCN) has developed AYA-specific oncology guidelines. These guidelines recommend that pediatric or adult providers manage AYA cancer patients based on experience with the particular malignancy.

AYA patients with some malignancies experience better survival outcomes when treated with pediatric regimens or by pediatric oncology services (e.g., acute lymphoblastic leukemia, Ewing sarcoma), while others benefit from management by adult oncologists (e.g., breast cancer). Clinicians should consider the unique developmental and psychosocial challenges that patients in this distinctive age group face as well as the potential benefit for older pediatric patients to remain on the pediatric oncology service.