Journal of adolescent and young adult oncology最新文献

Purpose: Adolescent and young adult (AYA) cancer survivors have unique psychological needs and require tailored support, as they transition from hospital settings following cancer treatment. This study aimed to evaluate the safety and clinical effectiveness of the online "Recapture Life" program to improve AYA aged survivors' psychological adjustment in early cancer survivorship. Methods: The intervention was delivered in community settings, by trained psychosocial staff at partnering cancer-support organizations. The participants received seven cognitive behavioral therapy-based online sessions six weekly 90-minute group sessions and a booster session. A pre-post design was used, where participants completed patient-reported outcome measures at intake, and 6 months after intervention completion. Measures assessed psychological distress, cancer-related problems, peer support, and program benefit/burden. Results: Thirty 13-39-year-olds with mixed cancer diagnoses (mean time since diagnosis 2.9 years) completed both assessments. We did not find evidence that the intervention reduced psychological distress. However, 6 months after completing Recapture Life, AYAs reported fewer cancer-related problems (t(29) = 2.63, p = 0.003) and improved peer support (t(29) = 8.04, p = 0.015), with medium effect sizes. Most participants reported no program burden (72%) and found Recapture Life at least somewhat beneficial (79%). Most (73%) reported staying in contact with AYAs from their group post-intervention. Conclusion: Six months after completing Recapture Life, AYAs reported having more peer support and fewer cancer-related problems. This study addresses a well-documented gap in psychological services tailored to AYA survivors' needs. Recapture Life delivered in the community addressed areas of concern for the AYAs and may teach adaptive skills for survivors adjusting to life after cancer treatment.

An increasing number of cancer predisposition syndromes (CPSs) have been associated with childhood cancer in light of advent advances in genomic medicine. While children and adolescents with CPSs present with compounded medical and psychosocial sequalae across the developmental trajectory, little is known about how adaptive psychosocial outcomes are conceptualized and promoted. Exploring adaptive and modifiable targets in psychological care may potentially promote coping among patients with CPSs and their families. The study undertakes a scoping review to describe, synthesize, characterize, and identify gaps in the literature on adaptive psychosocial outcomes among young people with CPSs and their caregivers. Adhering to PRISMA Extension guidelines and checklist, a systematic search in four databases was most recently conducted in February 2024: (PubMed, EMBASE, CINAHL, and PsycINFO). A total of 642 titles were screened and 36 articles were reviewed at the full-text level. Of those, five met the study inclusion criteria. The majority of articles were descriptive and centered around caregivers of at-risk patients with CPSs. The scoping review describes what is known about adaptive psychosocial outcomes associated with pediatric CPS and underscores the substantial gap in existing literature. Several important findings were identified across studies: significance of undergoing genetic testing, perceived surveillance benefits, positive psychological outcomes, intra-family communication, young people and caregiver psychosocial support. Future research is needed to investigate adaptive psychosocial outcomes associated with CPSs and delineate potential coping mechanisms. Findings may inform the development and dissemination of evidence-based psychological approaches designed to promote coping with pediatric CPSs.

Adolescent and young adult (AYA) cancer survivors face increased risks of long-term health complications, compounded by engagement in risky health behaviors such as smoking or vaping nicotine or cannabis products (e.g., inhaled substance use). This scoping review explores the existing literature on inhaled substance use among AYA cancer survivors to better understand the prevalence, methods, and contributing factors driving these behaviors. While combustible cigarette smoking is decreasing, vaping remains prevalent, and both are associated with inhaled cannabis co-use. Mental health challenges experienced by AYA survivors, such as depression and anxiety, may drive increased substance use as a maladaptive coping mechanism. Despite the well-documented risks of continued substance use post-cancer diagnosis, evidence for substance use interventions tailored specifically to this population is limited. Our review identifies significant knowledge gaps, including the need for targeted research on substance use patterns, effective cessation interventions, and health care provider engagement. Further research is essential to develop evidence-based interventions to reduce inhaled substance use in AYA cancer survivors, improving their long-term health outcomes.

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.

Germ cell tumors (GCTs) are chemosensitive neoplasms with high cure rates; however, a small group of patients present tumors with refractory chemotherapy, with a dismal prognosis and few effective management options. Although immune checkpoint inhibitors (ICIs) are approved for use in chemotherapy refractory GCT, the evidence supporting this indication remains scarce. Original research studies were included on patients with GCTs refractory to chemotherapy treated with ICI up to December 2023. Comprehensive search strategies databases and MeSH keywords were used to locate eligible literature. Study characteristics, participant demographics, and oncological outcomes were recorded. A total of 13 studies (n = 106) were included, five single-patient case reports, one retrospective cohort, six-phase II randomized controlled trials (RCTs), and an abstract from the preliminary results of a phase II RCT. Most of the studies evaluated did not request biomarkers as inclusion criteria. Median overall response rate across studies was 3.4% (range, 0-57) and 0% (range, 0-6) in retrospective cohort and phase II studies. Progressive disease as the best response was present in most patients, with 75% (range, 0-82.9) in the overall population and 82% (range, 75 -83) in the retrospective cohort and phase II trials. Some of the most durable clinical responses documented in this systematic review corresponded to high tumor mutational burden (TMB-H) or high microsatellite instability (MSI-H)/dMMR tumors. Retrospective cohorts and clinical trials evaluating ICIs for the treatment of chemo-refractory GCTs documented limited activity of these drugs as a single intervention in patients not selected by biomarkers, with a tendency to better results described in those with TMB-H or MSI-H/dMMR tumors.

Over a half million children are living with cancer in the United States. Social media platforms offer unique opportunities for cancer communication by public health organizations as well as health care providers, scientists, patients, and caregivers. Given the dearth of research on childhood cancer communication, the present study aimed to examine the nature of tweets on the social media platform X (formerly Twitter) that used the hashtag #childhoodcancer, the types of these tweets that attracted the most retweets, the types of users tweeting about childhood cancer (e.g., individuals, health care professionals), and the nature of tweets made by the different types of users. We performed a content analysis of tweets we captured on X via NCapture in October and December 2022. Of the 3217 tweets captured, we randomly sampled 1000 eligible tweets and manually double-coded them. Interrater agreement was 83% (κ = 0.75). Results revealed six themes in the tweets, including fundraising (21.2%), advocacy (20.2%), motivational (17.5%), educational (15.3%), science (12.8%), and shout-outs (12.1%). Motivational, advocacy, and science tweets attracted more retweets than fundraising tweets and shout-outs (p < 0.001). Individuals (i.e., patients, caregivers, and advocates tweeting on their own behalf) and nonprofit organizations made a majority of the tweets at 41.5% and 38.6%, respectively, followed by health care professionals (8.7%), academic and/or medical centers (4.2%), and for-profit companies (3.5%). Childhood cancer communication on X is dominated by individuals doing advocacy and fundraising. X may provide important opportunities for public health messaging and science communication about childhood cancer.

Background: Young adult (YA) LGBTQ+ cancer survivors face inequities and unmet needs that impact their well-being. However, the impact of age and cancer among LGBTQ+ individuals have not been adequately assessed. Methods: The North Carolina LGBTQ+ Health Needs Assessment survey, conducted at local Pride events, aimed to collect data to describe the well-being of LGBTQ+ people in NC. Chi-squared tests and multivariable logistic regression models controlling for demographic factors were used to assess age and cancer-related differences in discrimination, violence, mental health, and substance use outcomes among LGBTQ+ individuals. Results: A total of N = 3170 LGBTQ+ individuals took part in the survey, n = 89 of which were YA (aged 18-39) cancer survivors and n = 111 of which were middle to older adult (M/OA, age 40+) cancer survivors. In bivariate analyses, YA LGBTQ+ cancer survivors reported significantly more LGBTQ+ violence (43.8%), sexual assault (61.4%), experiencing homelessness (33.7%), post-traumatic stress disorder (32.6%), cocaine use (16.9%), opioid use (15.7%), and having ever accidental overdose (43.8%) in comparison with YAs without a cancer history as well as M/OA with and without a cancer history. In multivariable models, YA LGBTQ+ survivors remained at elevated odds of all outcomes in comparison with M/OA survivors without a cancer history. Outcomes varied by intersecting identities among YA survivors. Conclusions: The overlap of anti-LGBTQ+ stigma and discrimination, being young, and having been diagnosed with cancer positions YA LGBTQ+ cancer survivors to experience a higher burden of serious and life-threatening outcomes.

We investigated insurance coverage among adolescents and young adults (AYA) with cancer before and during the COVID-19 pandemic. AYAs diagnosed with cancer 15-39 years of age were identified using Utah Cancer Registry records and linked with University of Utah electronic health records. Poisson models calculated incidence rate ratios (IRRs) of health insurance coverage during pre-pandemic (11/4/2017-3/5/2020; n = 2,140) and pandemic (3/6/2020-7/6/2022; n = 1,894) periods. Prior to the pandemic, insurance gaps were higher (pre-pandemic = 16.40%, pandemic = 13.73%; IRR = 0.84, 95%CI = 0.71-0.98); more AYAs had continuous public insurance during the pandemic (pre-pandemic = 8.60%, pandemic = 10.98%; IRR = 1.28, 95%CI = 1.05-1.56). Research is needed on the durability of pandemic relief programs on insurance coverage among AYA cancer survivors.

Purpose: Individuals below the age of 40 make up only 3%-11% of colorectal cancer (CRC) cases. In this study, we aimed to review clinicopathological characteristics of rectal cancer in young adults. Methods: Rectal adenocancer patients aged ≤40 were included in this study from Antalya Training and Research Hospital. A single-arm descriptive study was designed. Results: There were 85 patients in the final analyses (n = 85). The median age was 37 (19-40). Mucinous adenocarcinoma and signet-cell carcinoma rates were 11.8% for each. Twenty patients (24.4%) had high-grade cancer. Fourteen patients (16.5%) had CRC history in a first-degree relative. None of the patients were diagnosed through a screening test. Of the 85 patients, 41 (48.2%) were stage 3 and 23 (27.1%) were stage 4 at the time of diagnosis. Thirty-four (54.8%) of the 62 nonmetastatic patients had neoadjuvant and 27 (43.5%) had adjuvant treatment because of having an upfront surgery before presentation. In the nonmetastatic population, the 5-year disease-free survival rate was 69.7 ± 6.5%. De-novo metastatic underwent chemotherapy, and biological agents were administered when feasible. KRAS mutation rate was 56.5% among metastatic patients. The median progression-free survival for the first-line treatment was 11.2 months (5.7-16.6), and the median overall survival was 22.3 months (15.4-29.1). Conclusion: We demonstrated that rectal cancer is usually diagnosed at late stages in young individuals which is compatible with the previous reports. Low cancer awareness in young patients and their caregivers and adverse histological features were advocated as the reason for the diagnostic delay. However, future studies may elucidate the reason behind the common diagnosis at advanced stages.

Purpose: Many young adult (YA) breast cancer survivors (BCS) experience psychosocial distress during and after treatment, but do not utilize supportive care resources to maximize their health outcomes. The purpose of this pilot study was to test the feasibility and acceptability of a brief, internet-based expressive writing (EW) intervention intended to improve psychosocial health among YA BCS. Methods: Thirty YA BCS were remotely recruited via a hospital patient database and randomly assigned to the EW (n = 20) or neutral writing (n = 10) group. The EW intervention included delivery of positive messages and a weekly 30-minute EW activity for 3 weeks. Feasibility, acceptability, patient-reported satisfaction, and health outcomes were evaluated at baseline and 1-month follow-up. Results: The database-focused recruitment strategies (40% response) appeared to be feasible. Almost all (93%) participants adhered to at least one writing task and 67% to at least two writing tasks. Participants perceived the study as enjoyable and helpful for reducing stress. The difference in QOL of the intervention versus control group was medium to large (d = 0.73). Conclusion: This is the first study to test the feasibility of an internet-based EW for YA BCS. The online EW pilot intervention demonstrated evidence of feasibility and acceptability to YA BCS; its potential to improve health outcomes should be evaluated in an adequately powered prospective randomized controlled trial (RCT). Online EW may be offered to YA BCS in low-resource settings to address their unique physical and psychological challenges.