Journal of adolescent and young adult oncology最新文献

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.

Childhood cancer survivors' (CCS) knowledge about late effects can promote positive health behaviors and autonomy. Cardiotoxicity is a major source of morbidity, which can be mitigated through exercise. Descriptive and Fisher's exact statistics were used to characterize health knowledge and physical activity in CCS ≥13 years at high risk for cardiotoxicity. Of 16 CCS (mean age 17.0 ± 2.1 years), 3 (18.8%) identified previous anthracycline exposure, and 5 (31.2%) had adequate physical activity. Of survivors <18 years, 82% had poor late effects knowledge (p = 0.005). Knowledge was not associated with physical activity (p = 0.60). Interventions are needed to improve late effects knowledge in adolescent CCS.

The adolescent and young adult (AYA) ages are a time when individuals are susceptible to risky behaviors, including binge drinking, tobacco, marijuana, and illicit drug use. AYAs are at an increased risk for developing chronic health problems compared with their healthy peers, and substance use can pose additional risks. The purpose of this review is to compare substance use in AYAs with their healthy peers and identify contributing factors. A literature search was conducted of PubMed, Scopus, and OVID databases using keywords substance*, adolescent*, adolescence*, teens*, teenager*, young adult*, pediatric*, childhood*, cancer*, and oncology*. The initial search yielded 148 articles. Inclusion criteria specified English language and articles from January 1, 2013, to December 31, 2023. Studies were excluded if they did not include participants aged <18 years and without a noncancer comparison group. Five relevant articles were included after review and appraisal. Substance use was examined by substance use type and contributing factors, including caregiver-AYA relations, age, and depression/coping. Findings were mixed for substance use, including tobacco and alcohol use. Findings indicate no consistent pattern-substance use was both more and less common in AYAs than in their noncancer peers, or substance use did not differ between AYAs and their noncancer peers. With mixed results, each study identified some level of substance use in AYAs. Given this knowledge, when treating AYAs, providers should be diligent about screening for substance use during each visit. AYAs should be educated about the risk of substance use, especially as a vulnerable, at-risk population.

Purpose: The population of childhood cancer survivors in low- and middle-income countries is set to increase due to diagnosis and treatment advancements. However, cancer is still associated with stigma that may hinder societal re-entry. This study explores the social reintegration and stigmatization of Kenyan childhood cancer survivors to develop targeted interventions for follow-up care. Methods: Adult survivors of childhood cancers who completed treatment at the largest referral hospital in Western Kenya were interviewed using semi-structured questionnaires between 2021 and 2022. Stigma was assessed using the Social Impact Scale. Results: Twenty-six survivors (median age 20 years) were interviewed, with 16 (62%) being males. All survivors missed classes during treatment, and 16 (62%) had to repeat school grades after treatment completion. Many (13; 50%) reported negative feelings about the situation at school. Six (23%) were excluded from school activities and four were bullied (15%). Most 25 (96%) could not openly speak about cancer to all community members. Reasons for lacking social support, avoidance, and discrimination were cancer is a curse, contagious, or inheritable. Nine (35%) felt that their marital prospects were negatively affected by their cancer history. Stigma was higher for survivors who received a negative response after cancer disclosure (p = 0.001) and survivors with negative perspectives on their marital prospects (p = 0.002). Survivors recommended community and school education, peer support groups, and counseling. Conclusion: Childhood cancer survivors in Kenya face difficulties with social reintegration and stigmatization. Outreach campaigns focusing on education at schools and communities should be implemented. Counseling and support groups may facilitate re-entry into society.