NCCN Cancer Guidelines Focus on Adolescent, Young Adult Needs
The guidelines advise the following for AYA patients:
– Undergo a comprehensive assessment following the cancer diagnosis, including psychosocial assessment, discussion of infertility risks, options for fertility preservation, and genetic and familial risk assessment within 2 months of treatment initiation.
– Be managed by a multidisciplinary team comprising experts in cancer treatment and in specific developmental issues such as fertility, education, career development, employment, family planning, pregnancy, sexually transmitted diseases, and substance use.
– Be treated with aggressive therapy in the absence of contraindications, accompanied by appropriate management of symptoms and side effects to minimize treatment severity and toxicity.
– Be apprised at the time of diagnosis of the risk of infertility due to cancer treatment and be referred to a fertility preservation clinic within 24 hours when appropriate and desired.
– Be apprised of and evaluated for treatment-associated risks in the case of pregnancy and be referred to a gynecologic oncologist and perinatologist with expertise and knowledge of the physiological changes that occur during pregnancy.
– Undergo assessment for developmentally appropriate psychosocial and supportive care across multiple domains, including individual function (developmental, emotional, and behavioral issues); relationships (family, peer, and health care provider); socioeconomic issues; and supportive care interventions.
– Be offered interdisciplinary palliative and end-of-life care as needed to control symptoms, relieve suffering, and improve patient and family quality of life.
To address the increased risk of late effects related to cancer treatment and the risk for long-term effects among AYA cancer survivors, the guidelines recommend cardiovascular, pulmonary, neuroendocrine, renal, gonadal, and neuropsychological screening interventions adapted from the Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers, which are based on treatment exposure.
Of critical importance, according to Dr. Zebrack, “every member of the [management] team must be trained in how to communicate with teens and young adults to make sure all of their needs are understood and are being met.”
Some members of the NCCN AYA Oncology Panel disclosed financial and research relationships with multiple companies.
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By: DIANA MAHONEY, Oncology Report Digital Network