Journal of adolescent and young adult oncology最新文献

Purpose: To investigate the actual status of fertility preservation techniques in oncofertility in Japan and to clarify the involvement of embryologists in this field. Methods: This survey was conducted online, targeting embryologists working at 622 facilities registered with the Japan Society of Obstetrics and Gynecology for assisted reproductive technology. Results: The response rate was 56.6%. In total, 56.8% of facilities used some form of cryopreservation as fertility preservation therapy for patients with cancer; patients' age range was widely defined at each facility. The most common renewal frequency of cryopreserved specimens for patients with cancer was at 1-year intervals. The most common renewal methods were during patient visits to the hospital and contact by letter. Knowledge levels regarding fertility preservation therapy were not high among many embryologists, but respondents recognized the important role of embryologists in oncofertility. Conclusions: This study is the first to clarify the importance of embryologists in oncofertility. Many embryologists felt that their knowledge of fertility preservation was limited and considered it necessary to improve their education, including public certification. Guidelines for long-term storage systems, including methods for renewal of cryopreservation, need to be established.

Purpose: Childhood acute lymphoblastic leukemia (ALL) is associated with executive dysfunction in long-term survivorship. This is evidenced by subjective and objective measures of executive functions (EFs). However, the two measures do not always align, and the EF discrepancy in this population is understudied. This cross-sectional study aimed to examine the association between global measures of subjective and objective EF in young adult (YA) survivors of childhood ALL. Second, we aimed to explore how psychological distress, fatigue, self-efficacy, and estimated IQ relate to the discrepancy between these measures. Methods: A total of 53 subjects (age 18-34) participated in a clinical trial baseline assessment (clinicaltrials.gov NCT04541056). The Behavior Rating Inventory of Executive Function for Adults assessed subjective EFs. Results from six neurocognitive tests were combined to represent objective EFs. Discrepancy scores were calculated by subtracting the objective EF composite score from the subjective EF score. Spearman's correlations and simple and multiple linear regression analyses were performed to explore associations and predictors for the global EF discrepancy. Results: Subjective and objective measures of EF were moderately correlated (r_s = 0.407). The regression analyses showed that psychological distress (R² = 0.44), fatigue (R² = 0.29), and self-efficacy (R² = 0.24) significantly predicted the global EF discrepancy (p < .001). Only psychological distress explained unique variation (B = -0.46). Conclusion: Neurocognitive tests and self-reports offer valuable insights into EF assessment for YA survivors. Psychological distress emerged as the most central contributor to the overall EF discrepancy. Consequently, screening for anxiety and depression alongside subjective EF complaints will be of significance.

Guidelines regarding the optimal use and timing of anti-Mullerian hormone (AMH) screening in childhood cancer survivors to evaluate for the risk of premature ovarian insufficiency or reduced fertility potential are lacking. We conducted a systematic review of the current evidence supporting AMH screening of female childhood cancer survivors with the overall objective to identify gaps in the literature needing further study, to allow for future data-driven recommendations. Search terms included "cancer, fertility, and anti-Mullerian hormone." We included original research articles that had ≥20 female childhood cancer survivors and excluded studies not including pediatric oncology survivors (≤18 years of age), did not include raw AMH values, were a mixed pediatric/young adult population which were minority pediatric, or did not separate pediatric from adult AMH data. In total, 17 studies (8 case-control, 5 cross-sectional, and 4 longitudinal prospective cohorts), encompassing 1106 total survivors met inclusion criteria and were further evaluated. Three studies evaluated the relationship of AMH to antral follicle count with generally good concordance. Four studies analyzed longitudinal changes in AMH with chemotherapy demonstrating that most patients will have an acute drop in AMH during therapy, and recovery of AMH over time is dependent on treatment intensity. No studies evaluated the optimal timing or interval of AMH testing. AMH correlates well with other markers of ovarian reserve, but there is insufficient data regarding the utility of AMH to predict the ability to conceive or timing of menopause. Optimal AMH screening initiation, duration, and intervals also require further study.

Objective: The aim of this study was to determine the incidence of the self-use of plants in cancer patients and its impact on overall survival (OS). Methods: This was a prospective study including young adult patients collected between January 15, 2018 and January 15, 2019 in the department of medical oncology at the Habib Bourguiba University Hospital. All patients were questioned about the concept of taking herbs. We compared OS among those who received plants versus the nonusers. Results: A total of 223 patients were included. The average age was 35 ± 4 years. Ninety-seven patients had taken plants. Sixty patients had consumed alenda (61.8%), and 36 patients had received graviola (37.1%). Ten patients have had diarrhea (10.3%), 10 cytolysis (10.3%), 11 cholestasis (11.3%), 15 thrombocytosis (15.4%), 17 leukocytosis (17.5%), and 13 anemia (13.4%). OS at 5 years was 67.1%. It was lower in patients consuming the plants (54% vs. 83%, p = 0.023). Conclusion: Factors associated with a decrease in the 5-year OS were metastatic stage and plant consumption.

Purpose: A cancer diagnosis in adolescence and young adulthood significantly impacts a person's quality of life, particularly concerning identity, self-esteem, and subsequently, body image. This study aims to develop a psychometrically-sound patient-reported outcome measure of body image for adolescent and young adult (AYA) oncology patients that was guided by the National Institutes of Health's Patient-Reported Outcomes Measurement Information System® (PROMIS) Scientific Standards and our past concept elicitation interviews with AYAs. Methods: We conducted a multi-step approach involving item identification, refinement, generation; translatability and reading level review; and cognitive interviews. A purposive sample of 25 AYA patients participated, ensuring representation across educational levels, gender, treatment status, and cancer type. Results: Translatability and reading level reviews facilitated language adjustments. Cognitive interviews revealed that 76% of AYAs found the 50 candidate items assessing body image concerns to be easy to answer. AYAs reported that the body image items captured their lived experiences. Three items were excluded due to comprehension difficulties. Conclusion: This study addresses the critical gap in validated measures for assessing body image in AYA oncology patients. Interview findings provided evidence for the content validity and comprehensibility for 47 items assessing body image. The next steps involve large-scale psychometric testing to evaluate the reliability and validity of the body image items to form an item bank allowing the design of short forms or use of computerized-adaptive testing. Ultimately, this work lays the foundation for developing interventions to mitigate the impact of cancer on AYAs' body image during diagnosis, treatment, and recovery.

Eating disorders are prevalent in the adolescent and young adult (AYA) population, with 2.7% of adolescents effected. AYAs with cancer possess several risk factors for eating disorders that may place them at an even higher risk. Since these patients see their oncology team frequently, oncology clinics are opportune settings for eating disorder screening. Here, we describe a study to implement screening for eating disorders in AYA patients in an oncology clinic. During regularly scheduled oncology visits, eligible patients were given the SCOFF questionnaire. A total of 163 eligible patients filled out the SCOFF questionnaire with 11 positive results (6.75%). Eating disorder screening was successfully implemented in our pediatric oncology clinic. With a rate more than double than the general population, we observed that AYA patients with a history of cancer are at a higher risk for eating disorders and should undergo routine screening in oncology clinics.

Purpose: The aim of this study is to reveal the impact of skin cancer and sun knowledge on sun protection behavior in young people. In addition, identifying predictors influencing sun protection behaviors in young people is also aimed. Methods: A cross-sectional study was conducted with 424 young people in Turkey. Data were collected using Skin Cancer and Sun Knowledge Scale, Self-Efficacy Scale for Sun Protection, and Sun Protection Behavior Scale. The independent samples t-test was used to determine differences between the mean scores of sociodemographic characteristics, Bonferroni-corrected one-way ANOVA was used to determine differences among three or more groups, and the relationship between scale score means was analyzed using Pearson correlation analysis. Factors influencing sun protection behavior were identified using multiple linear regression. Results: Of the young people, 43.4% use sunscreen continuously throughout the year, 10.10% go to solarium, and 25.7% perform self-examinations of their skin. In youth, high sun protection self-efficacy (β = 0.486), being female (β = 0.077), regular use of sunscreen throughout the year (β = 0.464), and avoiding tanning beds (β = 0.075) positively influence sun protection behavior scores. Spending more than 6 hours in the sun during the summer months (β= -0.118) negatively affects sun protection behavior. Conclusion: The level of skin cancer sun knowledge, sun protection self-efficacy, and sun protection behaviors of young people are moderate and there is a positive correlation among them. The study's findings indicate the necessity to increase awareness of skin cancer risk factors among young people and initiate effective interventions to promote sun protection behaviors.

Purpose: Chimeric antigen receptor T cell therapy (CAR-T) is a breakthrough treatment for hematological malignancies, but sexual health, crucial for quality of life among young adults (YAs) ages 18-39, remains unexplored among YA CAR-T recipients. This study explored sexual health and patient-provider sexual health communication among YAs post-CAR-T. Methods: This cross-sectional mixed-methods study recruited YAs ≤5 years post-CAR-T. Participants completed Patient-Reported Outcomes Measurement Information System measures assessing sexual health and study-specific items assessing patient-provider sexual health communication. A subset completed a semistructured interview exploring the impact of CAR-T on sexual health and patient-provider sexual health communication. Descriptive statistics compared quantitative data to evidence-based thresholds. Qualitative data were thematically analyzed. Results: Fourteen YAs participated; 11 completed interviews. Median age was 33 years (range: 22-39), 64.3% were male, 92.9% were heterosexual, and median time post-CAR-T was 22 months. Interest in sexual activity was low among females (mean [M] = 35.1, standard deviation [SD] = 10.0), and orgasm ability was low among males (M = 39.3, SD = 19.5). Females reported less interest in sexual activity than males. Most YAs had not (50.0%) or did not recall (35.7%) discussing sexual health with a provider pre-CAR-T. Most (78.6%) had not discussed sexual health with a provider post-CAR-T. Three higher level qualitative themes emerged as follows: (1) treatment negatively affected libido, sexual activity, and romantic relationships, (2) YAs face challenges communicating with health care providers about sexual health, and (3) there is limited sexual health education and support for YAs. Conclusion: Findings highlight a need for improved patient-provider communication about sexual health and educational resources for YA CAR-T recipients.

Acute lymphoblastic leukemia requires around 18 months of daily oral chemotherapy called 6-mercaptopurine (6-MP) for treatment. Previous research has included a broad age range and shows adolescent/young adult (AYA) age and minoritized race/ethnicity are associated with lower adherence. Few studies have evaluated how these intersecting identities impact adherence. In a retrospective analysis of an AYA sample, we evaluated the relationships between race/ethnicity, area deprivation index (ADI), and insurance with electronically monitored 6-MP adherence. Results showed minoritized race/ethnicity and ADI correlated with adherence. Findings highlight the need for equitable interventions that enhance adherence and improve outcomes among AYAs.

In this focus group study of 11 women younger than 45 years of age treated at Memorial Sloan Kettering Cancer Center (New York, NY, USA) between March 2020 and April 2021, patients were asked about their preferences for types of resources, and timing and method of information delivery. Patients expressed interest in personalized medicine, access to integrative health and a holistic approach to treatment, and early consultation for fertility preservation. Their narratives elaborated on how age at diagnosis influences interpersonal relationships and quality of life, and provides direction for interventions to better counsel and support this population.