Adolescents and Young Adults (AYAs) Living with Cancer: Why Palliative Care Fits Best (FR453)

Abstract

•Recognize the symptom burden in adolescents and young Adults (AYAs).•Recognize the unique psychosocial concerns of the adolescent and young adult patient.•Identify ways of integrating palliative care into the care of the adolescent and young adult with cancer. An estimated 70,000 AYAs receive a cancer diagnosis each year in the US. The AYA is defined as patients aged 15-39 years at cancer diagnosis. The AYA age spans the gap between pediatric and adult healthcare providers. Cancer occurring during this age range affects patients’ developmental trajectory with its impact on emotional growth (both positive and negative), physical development, and behavior. This population is at risk for a diverse array of cancers that exhibit unique behavior. Cancers in this age group include malignant epithelial neoplasms (eg, thyroid carcinoma, malignant melanoma), sarcomas, and malignancies involving reproductive organs. Leukemia exhibits less favorable cytogenics and has a less favorable outcome. Patients experience a wide array of emotional complications from their cancer diagnoses, such as learned decisional passivity or social anxiety because of extended social isolation or shrinkage in social network. These patients may have fertility concerns and/or young children needing special attention. AYA patients may existentially mature faster than anticipated. Teams managing these patients may experience problems with noncompliance, risky behavior, or patient isolation. Current cancer care models relegate these patients to either the pediatric or adult oncologic realm. Younger patients receive aggressive treatment at the end-of-life. Palliative care physicians become involved with these patients by their ability to manage symptoms and improve quality of life in all domains. This session will present, by way of research, didactic, and case presentations, an argument for the use of palliative care in the care of adolescents and young adults. The session will cover five main areas: 1) common symptoms experienced by the AYA; 2) common psychosocial issues associated with the AYA patient; 3) examples of palliative care intervention in AYA care; 4) practical recommendations regarding the emotional and behavioral issues associated with AYAs; and 5) approaches to the management of the young AYA survivor.