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Adolescents and Young Adults with Cancer: A Biopsychosocial Approach

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Pediatric Psychosocial Oncology: Textbook for Multidisciplinary Care

Abstract

Adolescence and young adulthood are phases of life when human growth and development can be derailed by significant challenges to physical, psychological, and social well-being. These challenges are experienced quite differently by older adolescents and young adults (AYAs) in their 20s and 30s when compared to both younger pediatric and older adult cancer patients and have distinct behavioral implications for clinical care. Understanding the biological, psychological, and social contexts of AYAs’ lives and the interface between adolescent and young adult development and cancer is critical for the delivery of optimal care for this age-defined population. Cancer-related issues such as premature confrontation with mortality, changes in physical appearance, increased dependence on parents, disruptions of social life and school/employment because of treatment, and loss of reproductive capacity become particularly distressing. They have the potential to exacerbate or complicate self-management of cancer-related symptoms, treatment side effects, and adherence to medical recommendations including medications, health-care appointments, and lifestyle modifications. This chapter reviews the supportive care interventions for AYAs that target body image, emotional and socioeconomic independence, social integration, identity formation, and educational and career directions which can enhance quality of life for this age-defined population.

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References

  • Bhatia S, Sklar C (2002) Second cancers in survivors of childhood cancer. Nat Rev Cancer 2(2):124–132

    Article  PubMed  Google Scholar 

  • Bhatia S, Landier W, Shangguan M, Hageman L, Schaible A, Carter A et al (2012) Nonadherence to oral mercaptopurine and risk of relapse in Hispanic and non-Hispanic white children with acute lymphoblastic leukemia: a report from the Children’s Oncology Group. J Clin Oncol 30:2094–2101

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Bleyer A (2011) Latest estimates of survival rates of the 24 most common cancers in adolescent and young adult Americans. J Adolesc Young Adult Oncol 1(1):37–42. doi:10.1089/jayao.2010.0005

    Article  Google Scholar 

  • Bleyer A, O’Leary M, Barr R, Ries L (eds) (2006) Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975–2000. National Cancer Institute, Bethesda, NIH Pub. no. 06–5767

    Google Scholar 

  • Bolte S, Zebrack B (2008) Sexual issues in special populations: adolescents and young adults. Semin Oncol Nurs 24(2):115–119

    Article  PubMed  Google Scholar 

  • Buchanan N, Block R, Smith A, Tai E (2014) Psychosocial barriers and facilitators to clinical trial enrollments and adherence for adolescents with cancer. Pediatrics 133:S123–S130

    Article  PubMed Central  PubMed  Google Scholar 

  • Butow P, Palmer S, Pai A, Goodenough B, Luckett T, King M (2010) Review of adherence-related issues in adolescents and young adults with cancer. J Clin Oncol 28(32):4800–4809. doi:10.1200/jco.2009.22.2802

    Article  PubMed  Google Scholar 

  • Canada AL, Shover LR, Li Y (2006) A pilot intervention to enhance psychosexual development in adolescents and young adults with cancer. Pediatr Blood Cancer 49(6):824–828

    Article  Google Scholar 

  • CanTeen Australia (2011a) Adolescent and young adult oncology psychosocial care manual. CanTeen, Sydney

    Google Scholar 

  • CanTeen Australia (2011b) Supporting adolescent and young adult siblings of cancer patients: the family context. Research to practice paper. CanTeen Australia, Sydney. https://www.canteen.org.au/health-professionals/research-and-evaluation/best-practice-projects/research-to-practice-paper-issue-1/. Accessed 28 July 2014

  • Centers for Disease Control and Prevention (2011) 2010 STD treatment guidelines, clinical prevention guidance, sexually transmitted diseases, treatment guidelines, 2010 retrieved 15 Jan 2015, from http://www.cdc.gov/std/treatment/2010/clinical.htm

  • Centers for Disease Control and Prevention (2012) Vital signs: binge drinking prevalence, frequency, and intensity among adults – United States, 2010. Morb Mortal Wkly Rep 61(1):14–19

    Google Scholar 

  • Crawshaw M (2013) Psychosocial oncofertility issues faced by adolescents and young adults over their lifetime: a review of the research. Hum Fertil 16:59–63

    Article  Google Scholar 

  • Dayer L, Heldenbrand S, Anderson PJ, Gubbins P, Martin B (2013) Smartphone medication adherence apps: potential benefits to patients and providers. J Am Pharm Assoc 53:172–18

    Article  Google Scholar 

  • Ehrentraut J, Kern K, Long S, An A, Faughnan L, Anghelescu D (2013) Opioid misuse behaviors in adolescents and young adults in a hematology/oncology setting. J Pediatr Psychol 39:1149–1160

    Article  Google Scholar 

  • Engel G (1977) The need for a new medical model: a challenge for biomedicine. Science 196:129–136

    Article  CAS  PubMed  Google Scholar 

  • Evan E, Zeltzer LK (2006) Psychosocial dimensions of cancer in adolescents and young adults. Cancer 107(7):1663–1671

    Article  PubMed  Google Scholar 

  • Evan E, Kaufman M, Cook A, Zeltzer LK (2006) Sexual health and self-esteem in adolescents and young adults with cancer. Cancer 107(7 Suppl):1672–1679

    Article  PubMed  Google Scholar 

  • Felner RD, DeVries ML (2013) Poverty in childhood and adolescence: a transactional-ecological approach to understanding and enhancing resilience in contexts of disadvantage and developmental risk. In: Goldstein S, Brooks RB (eds) Handbook of resilience in children. Springer, New York, pp 105–126

    Chapter  Google Scholar 

  • Fern LA, Whelan JS (2010) Recruitment of adolescents and young adults to cancer clinical trials – international comparisons, barriers, and implications. [Research Support, Non-U.S. Gov’t]. Semin Oncol 37(2):e1–e8

    Article  PubMed  Google Scholar 

  • Fernandez C, Fraser GAM, Freeman C, Grunfeld E, Gupta A, Mery LS, De Pauw S, Schacter B, Young Adults with Cancer, B (2011) Principles and recommendations for the provision of healthcare in Canada to adolescent and young adult–aged cancer patients and survivors. J Adolesc Young Adult Oncol 1(1):53–59

    Article  PubMed Central  PubMed  Google Scholar 

  • Ferrari A, Montello M, Budd T, Bleyer A (2008) The challenges of clinical trials for adolescents and young adults with cancer. [Review]. Pediatr Blood Cancer 50(5 Suppl):1101–1104

    Article  PubMed  Google Scholar 

  • Ferrari A, Thomas D, Franklin ARK, Hayes-Lattin BM, Mascarin M, van der Graaf W, Albritton KH (2010) Starting an adolescent and young adult program: some success stories and some obstacles to overcome. J Clin Oncol 28(32):4850–4857. doi:10.1200/jco.2009.23.8097

    Article  PubMed  Google Scholar 

  • Grinyer A (2003) Young adults with cancer: parent interactions with health care providers. Eur J Cancer 13:88–95

    Article  Google Scholar 

  • Grinyer A (2009) Contrasting parental perspectives with those of teenagers and young adults with cancer: comparing the findings from two qualitative studies. Eur J Oncol Nurs 13:200–206

    Article  PubMed  Google Scholar 

  • Hedstrom M, Kreuger A, Ljungman G, Nygren P, vonEssen L (2006) Accuracy of assessment of distress, anxiety, and depression by physicians and nurses in adolescents recently diagnosed with cancer. Pediatr Blood Cancer 46:773–779

    Article  PubMed  Google Scholar 

  • Hullman S, Brumley L, Schwartz L (2015) Medical and psychosocial associates of nonadherence in adolescents with cancer. J Pediatr Oncol Nurs 32:103–113

    Article  Google Scholar 

  • Institute for Patient- and Family-Centered Care (2010) Frequently asked questions: what is patient- and family-centered care? Retrieved 16 Dec 2014, from http://www.ipfcc.org/faq.html

  • Johnson RH, Chien FL, Bleyer A (2013) Incidence of breast cancer with distant involvement among women in the United States, 1976 to 2009. JAMA 309(8):800–805

    Article  CAS  PubMed  Google Scholar 

  • Jones B (2008) Promoting healthy development among survivors of adolescent cancer. Fam Community Health Adv Adolesc Health 31(1):S61–S70

    Article  Google Scholar 

  • Kato PM, Cole SW, Bradlyn AS, Pollock BH (2008) A video game improves behavioral outcomes in adolescents and young adults with cancer: a randomized trial. [Multicenter Study. Randomized Controlled Trial. Research Support, N.I.H., Extramural. Research Support, Non-U.S. Gov’t]. Pediatrics 122(2):e305–e317

    Article  PubMed  Google Scholar 

  • Katz A (2005) The sounds of silence: sexuality information for cancer patients. J Clin Oncol 1:238–241

    Article  Google Scholar 

  • Keim-Malpass J, Baernholdt M, Erickson J, Ropka M, Schroen A, Steeves R (2013) Blogging through cancer: young women’s persistent problems shared online. Cancer Nurs 36:163–172. doi:10.1097/NCC.0b013e31824eb879

    Article  PubMed  Google Scholar 

  • Kelvin JF, Steed R, Jarrett J (2014) Discussing safe sexual practices during cancer treatment. Clin J Oncol Nurs 18(4):449–453

    Article  PubMed  Google Scholar 

  • Kessler RC, Wang PS (2008) The descriptive epidemiology of commonly occurring mental disorders in the United States. Annu Rev Public Health 29:115–129

    Article  PubMed  Google Scholar 

  • Kondryn HJ, Edmondson CL, Hill J, Eden TO (2011) Treatment non-adherence in teenage and young adult patients with cancer. Lancet Oncol 12:100–108

    Article  PubMed  Google Scholar 

  • Lalor K, McElvaney R (2010) Child sexual abuse, links to later sexual exploitation/high-risk sexual behavior, and prevention/treatment programs. Trauma Violence Abuse 11(4):159–177

    Article  PubMed  Google Scholar 

  • Lauer AL (2015) Treatment of anxiety and depression in adolescents and young adults with cancer. J Pediatr Oncol Nursing 1–6

    Google Scholar 

  • Lehmann V, Grongvist H, Engvall G, Ander M, Tuinman M, Hagedoorn M, Sanderman R, Mattsson E, von Essen L (2014) Negative and positive consequences of adolescent cancer 10 years after diagnosis: an interview-based longitudinal study in Sweden. Psychooncology 23:1229–1235

    Article  PubMed Central  PubMed  Google Scholar 

  • Lizardi D, Thompson RG, Keyes K, Hasin D (2010) The role of depression in the differential effect of childhood parental divorce on male and female adult offspring suicide attempt risk. J Nerv Mental Dis 198(9):687–690

    Article  Google Scholar 

  • Loren A, Mangu P, Beck L, Brennan L, Magadalinski A, Partridge A, Quinn G, Wallace WH, Oktay K (2013) Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 19:2500–2510

    Article  Google Scholar 

  • Lyon ME, Jacobs S, Briggs L et al (2013) Family-centered advance care planning for teens with cancer. JAMA Pediatr 167(5):460–467

    Article  PubMed  Google Scholar 

  • Malbasa T, Kodish ED, Santacroce SJ (2007) Adolescent adherence to oral therapy for leukemia: a focus group study. J Pediatr Oncol Nurs 24:139–151

    Article  PubMed  Google Scholar 

  • Maynard A, Patterson P, McDonald FEJ, Stevens G (2013) What is helpful to adolescents who have a parent diagnosed with cancer? J Psychosoc Oncol 31(6):675–697

    Article  PubMed  Google Scholar 

  • McGrady ME, Williams SN, Davies SM, Pai AL (2014) Adherence to outpatient oral medication regimens in adolescent hematopoietic stem cell transplant recipients. Eur J Oncol Nurs 18(2):140–144

    Article  PubMed Central  PubMed  Google Scholar 

  • Miller V, Baker J, Leek A, Hizlan S, Rheingold S, Yamokoski A, Drotar D, Kodish ED (2013) Adolescent perspectives on phase I cancer research. Pediatr Blood Cancer 60:873–878

    Article  PubMed Central  PubMed  Google Scholar 

  • Murphy D, Klosky JL, Termuhlen A, Sawczyn KK, Quinn GP (2013) The need for reproductive and sexual health discussions with adolescent and young adult cancer patients. Contraception 88(2):215–220

    Article  PubMed  Google Scholar 

  • National Cancer Institute (2015) A snapshot of adolescent and young adult cancers. Retrieved 17 Feb 2015, from http://www.cancer.gov/researchandfunding/snapshots/adolescent-young-adult

  • National Institute of Mental Health (2005) Mental illness exacts heavy toll, beginning in youth. Retrieved 15 Jan 2015, from http://www.nimh.nih.gov/news/science-news/2005/mental-illness-exacts-heavy-toll-beginning-in-youth.shtml

  • Palmer S, Mitchell A, Thompson K, Sexton M (2007) Unmet needs among adolescent cancer patients: a pilot study. Palliat Support Care 5(2):127–134

    Article  PubMed  Google Scholar 

  • Palmer S, Patterson P, Thompson K (2014) A national approach to improving adolescent and young adult (AYA) oncology psychosocial care: the development of AYA-specific psychosocial assessment and care tools. Palliat Support Care 12(3):183–188

    Article  PubMed  Google Scholar 

  • Patterson P, McDonald FEJ, Orchard P (2014) A new Australian online and phone mental health support service for young people living with cancer. [Article]. Australas Psychiatry 22(2):165–169. doi:10.1177/1039856213519144

    Article  PubMed  Google Scholar 

  • Patton GC, Coffey C, Cappa C, Currie D, Riley L, Gore F, Degenhardt L, Richardson D, Astone N, Sangowawa AO, Mokdad A, Ferguson J (2012) Health of the world’s adolescents: a synthesis of internationally comparable data. Lancet 379:1665–1675

    Article  PubMed  Google Scholar 

  • Pereda N, Guilera G, Forns M, Gomez-Benito J (2009) The prevalence of child sexual abuse in community and student samples: a meta-analysis. Clin Psychol Rev 29:328–338

    Article  PubMed  Google Scholar 

  • Pergolizzi J, Gharibo C, Passki S, Labhsetwar S, Taylor R, Pergolizzi J, Muller-Schwefe G (2012) Dynamic risk factors in the misuse of opioid analgesics. J Psychosom Res 72:443–451

    Article  PubMed  Google Scholar 

  • Phillips F, Jones B (2014) Understanding the lived experience of Latino adolescent and young adult cancer survivors. J Cancer Surviv 8:39–48

    Article  PubMed  Google Scholar 

  • Pritchard S, Cuvelier G, Harlos M, Barr R (2011) Palliative care in adolescents and young adults with cancer. Cancer 117(S10):2323–2328. doi:10.1002/cncr.26044

    Article  PubMed  Google Scholar 

  • Roberts C, Piper L, Denny J, Cuddeback G (1997) A support group intervention to facilitate young adults’ adjustment to cancer. Health Social Work 22(2):133–141

    Article  CAS  PubMed  Google Scholar 

  • Rohan J, Drotar D, Alderfer M, Donewar C, Ewing L, Katz E, Muriel A (2015) Electronic monitoring of medication adherence in early maintenance phase treatment for pediatric leukemia and lymphoma: Identifying patters of non-adherence. J Pediatr Psychol 40:75–84

    Article  PubMed  Google Scholar 

  • Rourke MT, Hobbie WL, Schwartz L, Kazak AE (2007) Posttraumatic stress disorder (PTSD) in young adult survivors of childhood cancer. Pediatr Blood Cancer 49(2):177–182

    Article  PubMed  Google Scholar 

  • Santacroce SJ, Crandell J (2013) Feasibility and preliminary findings from a pilot study of allostatic load in adolescent-young adult (AYA) childhood cancer survivors and their siblings. J Pediatr Oncol Nurs 31:122–134

    Article  Google Scholar 

  • Trevino KM, Maciejewski PK, Fasciano K, Greer J, Partridge A, Kacel EL, Block S, Prigerson HG (2012) Coping and psychological distress in young adults with advanced cancer. J Support Oncol 10(3):124–130

    Article  PubMed Central  PubMed  Google Scholar 

  • Trevino KM, Fasciano K, Prigerson HG (2013) Patient-oncologist alliance, psychosocial well-being, and treatment adherence among young adults with advanced cancer. J Clin Oncol 31(13):1683–1689

    Article  PubMed  Google Scholar 

  • United States Department of Health and Human Services (2013) Child maltreatment. National Institutes of Health: Bethesda, MD. 2012

    Google Scholar 

  • Wakefield CE, Patterson P, McDonald FEJ, Wilson HL, Davis E, Sansom-Daly US (2013) Assessment of psychosocial outcomes in adolescents and young adults with cancer: a systematic review of available instruments. Clin Oncol Adolesc Young Adults 13:13–27

    Google Scholar 

  • Wiener L, Zadeh S, Battles H, Baird K, Ballard E, Osherow J, Pao M (2012) Allowing adolescents and young adults to plan their end-of-life care. Pediatrics 130:1–9. doi:10.1542/peds.2012-0663

    Article  Google Scholar 

  • Williams AB (2001) Adherence to HIV regimens: 10 vital lessons. Am J Nursing 101:37–44

    Article  CAS  Google Scholar 

  • Zadeh S, Pao M, Wiener L (2015) Opening end-of-life discussions: how to introduce Voicing My CHOiCES, an advance care planning guide for adolescents and young adults. Palliat Support Care 13:591–599, Published online, 13 March, 2014

    Google Scholar 

  • Zebrack BJ (2008) Information and service needs for young adult cancer patients. Support Care Cancer 16:1353–1360

    Article  PubMed  Google Scholar 

  • Zebrack BJ (2011) Psychological, social, and behavioral issues for young adults with cancer. Cancer 117(S10):2289–2294. doi:10.1002/cncr.26056

    Article  PubMed  Google Scholar 

  • Zebrack B, Isaacson S (2012) Psychosocial care of adolescent and young adult patients with cancer and survivors. J Clin Oncol 30(11):1221–1226. doi: 10.1200/jco.2011.39.5467

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Michigan School of Social Work, 1080 S. University, Room 2778, Ann Arbor, MI, 48109-1106, USA

    Brad Zebrack PhD, MSW, MPH

  2. School of Nursing, The University of North Carolina at Chapel Hill, Carrington Hall CB#7460, Chapel Hill, NC, 27599-7460, USA

    Sheila Judge Santacroce PhD, RN, CPNP, FAANP

  3. CanTeen Australia and Cancer Nursing Research Unit, Sydney University, CanTeen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia

    Pandora Patterson PhD

  4. Department of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA

    Alexandra Gubin MSW, LCSW-C

  5. Ulman Cancer Fund for Young Adults, Johns Hopkins Bloomberg Children’s Center, 1800 Orleans Street, Room 11365, Baltimore, MD, 21287, USA

    Alexandra Gubin MSW, LCSW-C

Authors
  1. Brad Zebrack PhD, MSW, MPH
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  2. Sheila Judge Santacroce PhD, RN, CPNP, FAANP
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  3. Pandora Patterson PhD
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  4. Alexandra Gubin MSW, LCSW-C
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Correspondence to Brad Zebrack PhD, MSW, MPH .

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Editors and Affiliations

  1. Hemat. Oncol. Massachusetts General Hosp, Div. of Child & Adol. Psychiatry & Pedia, Boston, Massachusetts, USA

    Annah N. Abrams

  2. Dana-Farber Cancer Institute, Depart. of Psychosocial Oncol. & Palliat, Boston, Massachusetts, USA

    Anna C. Muriel

  3. National Cancer Instit. Center for Cance, Pediatric Oncology Branch , Bethesda, Maryland, USA

    Lori Wiener

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Zebrack, B., Santacroce, S.J., Patterson, P., Gubin, A. (2016). Adolescents and Young Adults with Cancer: A Biopsychosocial Approach. In: Abrams, A., Muriel, A., Wiener, L. (eds) Pediatric Psychosocial Oncology: Textbook for Multidisciplinary Care. Springer, Cham. https://doi.org/10.1007/978-3-319-21374-3_12

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  • DOI: https://doi.org/10.1007/978-3-319-21374-3_12

  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-21374-3

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