Adolescent and Young Adult Oncology—Ongoing Challenges and Developments in the Future

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Childhood, Adolescent and Young Adult Oncology".

Deadline for manuscript submissions: closed (30 July 2023) | Viewed by 26443

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Special Issue Editors


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Guest Editor
Division of Pediatric Oncology - Hematology, Kantonsspital Aarau, Aarau, Switzerland
Interests: pediatric neurooncology; survivorship and long-term follow-up; AYA oncology
Special Issues, Collections and Topics in MDPI journals

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Co-Guest Editor
Division of Pediatric Oncology - Hematology, Kantonsspital Aarau, Aarau, Switzerland
Interests: survivorship and long-term follow-up; oncopolicy; AYA oncology
Special Issues, Collections and Topics in MDPI journals

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Co-Guest Editor
Pediatrics III, West German Cancer Centre, University Hospital Essen, 45147 Essen, Germany
Interests: translational research in bone sarcoma of young people; academia initiated clinical trials in bone sarcoma of young people; late effects and prevention
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

The care of adolescents and young adult cancer patients remains a challenge for all healthcare providers as they neither fit into the pediatric nor the adult oncology world.

For this Special Issue on "Adolescent and young adult oncology—ongoing challenges and developments in the future", the aim is to present the full range of issues and topics within the AYA cancer world, including its current status but also future developments.

This Special Issue aims to look at the following main topics: tumor spectrum; treatment and treatment protocols; models of care; and survivorship and long-term follow-up, especially the psychosocial and economic impact.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: treatment for AYA cancer including special entities; outcomes; long-term sequelae including psychosocial, etc.; models of care for AYA oncology; and fertility.

I/We look forward to receiving your contributions.

Prof. Dr. Katrin Scheinemann
Dr. Maria Otth
Prof. Dr. Uta Dirksen
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • AYA oncology
  • treatment
  • models of care
  • long-term follow-up
  • survivorship
  • fertility

Published Papers (12 papers)

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Research

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13 pages, 528 KiB  
Article
Exploring the Relationship between Self-Rated Health and Unmet Cancer Needs among Sexual and Gender Minority Adolescents and Young Adults with Cancer
by Nina Francis-Levin, Lauren V. Ghazal, Jess Francis-Levin, Bradley Zebrack, Meiyan Chen and Anao Zhang
Curr. Oncol. 2023, 30(10), 9291-9303; https://doi.org/10.3390/curroncol30100671 - 20 Oct 2023
Viewed by 1553
Abstract
This study evaluates the unmet needs of sexual and gender minority (SGM) adolescent and young adult (AYA) cancer survivors by comparing SGM AYA self-rated health (SRH) scores to their non-SGM (i.e., cisgender/heterosexual) counterparts. The Cancer Needs Questionnaire—Young People (CNQ-YP) and self-rated health measures [...] Read more.
This study evaluates the unmet needs of sexual and gender minority (SGM) adolescent and young adult (AYA) cancer survivors by comparing SGM AYA self-rated health (SRH) scores to their non-SGM (i.e., cisgender/heterosexual) counterparts. The Cancer Needs Questionnaire—Young People (CNQ-YP) and self-rated health measures were used to assess unmet needs in AYAs aged 15–39 who had been diagnosed with cancer in the previous ten years (n = 342). Participants were recruited from a National Cancer Institute (NCI) Comprehensive Cancer Center registry using the modified Dillman’s method. Self-reported sexual orientation and gender identity (SO/GI) data were collected. Independent t-tests were used to test between-group differences in unmet needs and Pearson’s chi-square test was used to determine the difference in SRH scores between SGM and non-SGM AYA cancer survivors. SGM AYA cancer survivors reported greater mean needs than their non-SGM counterparts across all six domains and reported significantly greater needs in the domains of Feelings and Relationships, t(314) = −2.111, p = 0.036, Information and Activities, t(314) = −2.594, p = 0.009, and Education, t(207) = −3.289, p < 0.001. SGM versus non-SGM SRH scores were significantly different, indicating that a higher percentage of SGM AYAs reported poor/fair health compared to those who were non-SGM. Unmet life and activities needs were negatively associated with AYA cancer survivors’ SRH, whereas unmet work needs were positively associated with AYA cancer survivors’ SRH. An AYA’s gender identity (SGM versus non-SGM) was not a moderator. SGM AYAs are an understudied group within an already vulnerable patient population. Unmet psychosocial needs related to one’s feelings and relationships, and information and activity needs merit further research to develop tailored interventions that reflect the experiences of SGM AYAs. Full article
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11 pages, 272 KiB  
Article
Utilization, Delivery, and Outcomes of Dance/Movement Therapy for Pediatric Oncology Patients and their Caregivers: A Retrospective Chart Review
by Karolina Bryl, Suzi Tortora, Jennifer Whitley, Soo-Dam Kim, Nirupa J. Raghunathan, Jun J. Mao and Susan Chimonas
Curr. Oncol. 2023, 30(7), 6497-6507; https://doi.org/10.3390/curroncol30070477 - 6 Jul 2023
Viewed by 2872
Abstract
Children with cancer and their caregivers face physical and psychosocial challenges during and after treatment. Dance/movement therapy (DMT) has been used to improve well-being, promote healthy coping, and mitigate the impact of illness, but limited knowledge exists regarding DMT utilization, delivery, and outcomes [...] Read more.
Children with cancer and their caregivers face physical and psychosocial challenges during and after treatment. Dance/movement therapy (DMT) has been used to improve well-being, promote healthy coping, and mitigate the impact of illness, but limited knowledge exists regarding DMT utilization, delivery, and outcomes in pediatric oncology. This retrospective study aimed to identify reasons for referral to DMT, DMT visit characteristics, key DMT techniques and processes, and clinician-reported outcomes. We examined the electronic medical records of 100 randomly selected pediatric patients (resulting in 1160 visits) who received DMT services between 2011 and 2021. Sociodemographic, clinical, and visit characteristics, referral reasons, and clinician-reported outcomes were reported as frequency and proportions. Qualitative thematic analysis was used to identify key DMT techniques and processes. Among 100 patients (63% female, aged 0–27 years), 77.9% were referred for psychological distress and 19.6% for pain. Two distinct DMT approaches were used during visits: a traditional DMT approach (77%) and a multisensory DMT approach (23%). The most common visit length was 15–25 min (41.6%), followed by sessions of 30–45 min (22.5%) and ≤10 min (18.1%). A total of 61.9% of DMT visits were inpatient and 38.1% outpatient. Of all visits, 8.8% were new and 91.2% were follow-ups. Caregivers were engaged in treatment in 43.7% of visits, and 5.5% of visits focused entirely on the work with the caregiver. DMT intervention focused on self-expression, emotional self-regulation, coping strategies, socialization, and caregiver–child interaction. Clinician-reported outcomes included enhanced coping with hospital experience (58%), improved pain management (27%), improved self-regulation (21%), and increased physical activation (13.2%). The results suggest DMT as a supportive intervention for psychological distress and pain management in pediatric oncology patients and provide insights into DMT practices and outcomes to guide intervention development and future research. Full article
22 pages, 956 KiB  
Article
Young Adults’ Lived Experiences with Cancer-Related Cognitive Impairment: An Exploratory Qualitative Study
by Sitara Sharma and Jennifer Brunet
Curr. Oncol. 2023, 30(6), 5593-5614; https://doi.org/10.3390/curroncol30060422 - 9 Jun 2023
Cited by 2 | Viewed by 2233
Abstract
Cancer-related cognitive impairment (CRCI; e.g., disrupted memory, executive functioning, and information processing) affects many young adults, causing significant distress, reducing quality of life (QoL), and thwarting their ability to engage in professional, recreational, and social experiences. The purpose of this exploratory qualitative study [...] Read more.
Cancer-related cognitive impairment (CRCI; e.g., disrupted memory, executive functioning, and information processing) affects many young adults, causing significant distress, reducing quality of life (QoL), and thwarting their ability to engage in professional, recreational, and social experiences. The purpose of this exploratory qualitative study was to investigate young adults’ lived experiences with CRCI, and any strategies (including physical activity) they use to self-manage this burdensome side effect. Sixteen young adults (Mage = 30.8 ± 6.0 years; 87.5% female; Myears since diagnosis = 3.2 ± 3) who reported clinically meaningful CRCI whilst completing an online survey were interviewed virtually. Four themes comprising 13 sub-themes were identified through an inductive thematic analysis: (1) descriptions and interpretations of the CRCI phenomenon, (2) effects of CRCI on day-to-day and QoL, (3) cognitive–behavioural self-management strategies, and (4) recommendations for improving care. Findings suggest CRCI is detrimental to young adults’ QoL and must be addressed more systematically in practice. Results also illuminate the promise of PA in coping with CRCI, but research is needed to confirm this association, test how and why this may occur, and determine optimal PA prescriptions for young adults to self-manage their CRCI. Full article
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15 pages, 763 KiB  
Article
Exercise Preferences in Young Adults with Cancer—The YOUEX Study
by Annelie Voland, Verena Krell, Miriam Götte, Timo Niels, Maximilian Köppel and Joachim Wiskemann
Curr. Oncol. 2023, 30(2), 1473-1487; https://doi.org/10.3390/curroncol30020113 - 21 Jan 2023
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Abstract
(1) Background: Strong evidence supports the persuasive positive effects of exercise for cancer patients and survivors. Different approaches of exercise programs have been established; however, the special interests of young adults (YAs) with cancer have rarely been considered in exercise interventions. Therefore, the [...] Read more.
(1) Background: Strong evidence supports the persuasive positive effects of exercise for cancer patients and survivors. Different approaches of exercise programs have been established; however, the special interests of young adults (YAs) with cancer have rarely been considered in exercise interventions. Therefore, the study YOUng EXercisers (YOUEX) aimed to investigate exercise preferences in YAs. (2) Methods: YOUEX was a three-arm, patient preference-based non-randomized, longitudinal, pre–post exercise intervention, offering three different exercise modules to YAs during or after acute therapy (Module 1: online supervised group-based (M1); Module 2: online unsupervised (M2); Module 3: in-person supervised (M3)). The intervention period was 12 weeks with another 12-week follow-up period, the modules could be changed or amended after 6 and 12 weeks. (3) Results: 92 YAs were allocated to the study. At baseline, 50 YAs (54%) chose M2, 32 YAs (35%) M1 and 10 YAs (11%) M3. The analysis revealed high acceptability and feasibility of the online exercise programs (M1, M2). There was a high impact of the COVID-19 pandemic on the execution of M3. YAs showed diverse preferences in module selection due to differences in, e.g., cancer therapy status or favored level of supervision. (4) Conclusions: YAs need personalized exercise programs that consider their individual interests and needs. Online exercise programs can be a promising addition to existing exercise opportunities. They are an effective way to increase physical activity levels in YAs. Full article
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9 pages, 736 KiB  
Article
Reproductive Outcomes in Young Breast Cancer Survivors Treated (15–39) in Ontario, Canada
by Moira Rushton, Jessica Pudwell, Xuejiao Wei, Madeleine Powell, Harriet Richardson and Maria P. Velez
Curr. Oncol. 2022, 29(11), 8591-8599; https://doi.org/10.3390/curroncol29110677 - 12 Nov 2022
Cited by 1 | Viewed by 1989
Abstract
We conducted a population-based, retrospective, matched-cohort study to examine the impact of breast cancer diagnosis and treatment on fertility outcomes. Relative risks of infertility, childbirth, premature ovarian insufficiency (POI; age < 40) and early menopause (age < 45) were calculated using modified Poisson [...] Read more.
We conducted a population-based, retrospective, matched-cohort study to examine the impact of breast cancer diagnosis and treatment on fertility outcomes. Relative risks of infertility, childbirth, premature ovarian insufficiency (POI; age < 40) and early menopause (age < 45) were calculated using modified Poisson regression. Our primary cohort included young women (15–39) with early stage BC diagnosed 1995–2014. Five cancer-free patients were matched to each BC patient by birth year and census subdivision. The BC cohort was further divided by treatment with chemotherapy vs. no chemotherapy treatment. 3903 BC patients and 19,515 cancer-free women. BC patients treated with chemotherapy were at increased risk of infertility (RR 1.81; 95% CI 1.60–2.04), and POI (RR 6.25; 95% CI 5.15–7.58) and decreased childbirth (RR 0.85; 95% CI 0.75–0.96), compared to women without cancer. BC patients who did not receive chemotherapy were also at increased risk of infertility (RR 1.80 95% CI 1.48–2.18) and POI (RR 2.12 95% CI 1.37–3.28). All young BC survivors face an increased risk of diagnosed infertility and POI relative to women without cancer, independent of chemotherapy. These results emphasize the importance of pre-treatment fertility counselling for young women diagnosed with BC. Full article
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14 pages, 1711 KiB  
Article
Effects of an Exercise Intervention on Gait Function in Young Survivors of Osteosarcoma with Megaendoprosthesis of the Lower Extremity—Results from the Pilot Randomized Controlled Trial proGAIT
by Simon Basteck, Wiebke K. Guder, Uta Dirksen, Arno Krombholz, Arne Streitbürger, Dirk Reinhardt and Miriam Götte
Curr. Oncol. 2022, 29(10), 7754-7767; https://doi.org/10.3390/curroncol29100613 - 14 Oct 2022
Cited by 1 | Viewed by 2249
Abstract
Limb preservation with megaendoprosthesis in adolescents and young adults (AYA) with bone tumors is associated with functional limitations and gait abnormalities. The proGAIT trial evaluated the effectiveness of an exercise program on gait function and quality of life, functional scales (MSTS, TESS), functional [...] Read more.
Limb preservation with megaendoprosthesis in adolescents and young adults (AYA) with bone tumors is associated with functional limitations and gait abnormalities. The proGAIT trial evaluated the effectiveness of an exercise program on gait function and quality of life, functional scales (MSTS, TESS), functional mobility, and fatigue as secondary outcomes. Eleven AYA survivors of malignant osteosarcoma with a tumor endoprosthesis around the knee (mean age: 26.6 (±8.4) years) were randomized into an intervention group receiving an 8-week exercise program or into a control group. Gait function was assessed via 3D motion capture and analyzed using the Gait Profile Score (GPS) and the Gait Deviation Index (GDI). GDI and GPS scores of participants suggest deviations from a healthy reference group. The exercise intervention had small-to-medium positive effects on gait score GDI |d| = 0.50 (unaffected leg), |d| = 0.24 (affected leg), subjective functional scores TESS |d| = 0.74 and MSTS |d| = 0.49, and functional tests TUG and TUDS |d| = 0.61 and |d| = 0.52. None of these changes showed statistical significance. Promising intervention effects suggest that regular exercise could improve lower limb function and follow-up care for survivors; however, a powered RCT as a follow-up project needs to confirm the pilot findings. Full article
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19 pages, 664 KiB  
Article
Recruiting Adolescent and Young Adult Cancer Survivors for Patient-Reported Outcome Research: Experiences and Sample Characteristics of the SURVAYA Study
by Carla Vlooswijk, Lonneke V. van de Poll-Franse, Silvie H. M. Janssen, Esther Derksen, Milou J. P. Reuvers, Rhodé Bijlsma, Suzanne E. J. Kaal, Jan Martijn Kerst, Jacqueline M. Tromp, Monique E. M. M. Bos, Tom van der Hulle, Roy I. Lalisang, Janine Nuver, Mathilde C. M. Kouwenhoven, Winette T. A. van der Graaf and Olga Husson
Curr. Oncol. 2022, 29(8), 5407-5425; https://doi.org/10.3390/curroncol29080428 - 29 Jul 2022
Cited by 14 | Viewed by 2595
Abstract
Background: Participation of Adolescents and Young Adults with cancer (AYAs: 18–39 years at time of diagnosis) in patient-reported outcome studies is warranted given the limited knowledge of (long-term) physical and psychosocial health outcomes. We examined the representativeness of AYAs participating in the study, [...] Read more.
Background: Participation of Adolescents and Young Adults with cancer (AYAs: 18–39 years at time of diagnosis) in patient-reported outcome studies is warranted given the limited knowledge of (long-term) physical and psychosocial health outcomes. We examined the representativeness of AYAs participating in the study, to observe the impact of various invitation methods on response rates and reasons for non-participation. Methods: A population-based, cross-sectional cohort study was performed among long-term (5–20 years) AYA cancer survivors. All participants were invited using various methods to fill in a questionnaire on their health outcomes, including enclosing a paper version of the questionnaire, and sending a reminder. Those who did not respond received a postcard in which they were asked to provide a reason for non-participation. Results: In total, 4.010 AYAs (response 36%) participated. Females, AYAs with a higher socio-economic status (SES), diagnosed more than 10 years ago, diagnosed with a central nervous system tumor, sarcoma, a lymphoid malignancy, stage III, or treated with systemic chemotherapy were more likely to participate. Including a paper questionnaire increased the response rate by 5% and sending a reminder by 13%. AYAs who did not participate were either not interested (47%) or did want to be reminded of their cancer (31%). Conclusions: Study participation was significantly lower among specific subgroups of AYA cancer survivors. Higher response rates were achieved when a paper questionnaire was included, and reminders were sent. To increase representativeness of future AYA study samples, recruitment strategies could focus on integrating patient-reported outcomes in clinical practice and involving AYA patients to promote participation in research. Full article
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20 pages, 644 KiB  
Article
Setting Priorities for a Provincial Adolescent and Young Adult Oncology Program
by Julian Surujballi, Grace Chan, Caron Strahlendorf and Amirrtha Srikanthan
Curr. Oncol. 2022, 29(6), 4034-4053; https://doi.org/10.3390/curroncol29060322 - 1 Jun 2022
Cited by 2 | Viewed by 2103
Abstract
Adolescent and young adult (AYA, ages 15–39 years) oncology patients are an underserved population with specialized needs. AYA programs are absent from most Canadian centers. We identified a priority list and sequence for new programs to address. Program goals, priorities, and activities were [...] Read more.
Adolescent and young adult (AYA, ages 15–39 years) oncology patients are an underserved population with specialized needs. AYA programs are absent from most Canadian centers. We identified a priority list and sequence for new programs to address. Program goals, priorities, and activities were developed through literature review, national consensus documents, and expert opinion. Health care providers (HCPs) involved in AYA cancer care, administrators, and patient and family representatives were engaged to co-develop program goals and activities. A modified Delphi technique was used through two iterations followed by an in-person meeting to prioritize program implementation. Consensus was defined as a mean score of less than 2.0 (not important) or 4.0 or greater (important). Items without consensus (scored between 2.0 and 3.99) were discussed at the in-person meeting. Sixty provincial stakeholders completed the Delphi survey across multiple disciplines. Twenty-seven stakeholders attended the in-person meeting. All goals were deemed important, except development of a research program. Patient implementation tasks ranked highest. Priority sequence of implementation was: patient care first, followed by HCP education; patient and family education; program sustainability plan; evaluation; research; then a model for multidisciplinary tumor board review. These represent key goals for new AYA oncology programs and a priority sequence of implementation. Full article
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Review

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14 pages, 1030 KiB  
Review
The Impact of Exercise on Cardiotoxicity in Pediatric and Adolescent Cancer Survivors: A Scoping Review
by Stephanie J. Kendall, Jodi E. Langley, Mohsen Aghdam, Bruce N. Crooks, Nicholas Giacomantonio, Stefan Heinze-Milne, Will J. Johnston, Melanie R. Keats, Sharon L. Mulvagh and Scott A. Grandy
Curr. Oncol. 2022, 29(9), 6350-6363; https://doi.org/10.3390/curroncol29090500 - 3 Sep 2022
Cited by 4 | Viewed by 2790
Abstract
Childhood and adolescent cancer survivors are disproportionately more likely to develop cardiovascular diseases from the late effects of cardiotoxic therapies (e.g., anthracycline-based chemotherapy and chest-directed radiotherapy). Currently, dexrazoxane is the only approved drug for preventing cancer treatment-related cardiac damage. While animal models highlight [...] Read more.
Childhood and adolescent cancer survivors are disproportionately more likely to develop cardiovascular diseases from the late effects of cardiotoxic therapies (e.g., anthracycline-based chemotherapy and chest-directed radiotherapy). Currently, dexrazoxane is the only approved drug for preventing cancer treatment-related cardiac damage. While animal models highlight the beneficial effects of exercise cancer treatment-related cardiac dysfunction, few clinical studies have been conducted. Thus, the objective of this scoping review was to explore the designs and impact of exercise-based interventions for managing cancer treatment-related cardiac dysfunction in childhood and adolescent cancer survivors. Reviewers used Joanna Briggs Institute’s methodology to identify relevant literature. Then, 4616 studies were screened, and three reviewers extracted relevant data from six reports. Reviewers found that exercise interventions to prevent cancer treatment-related cardiac dysfunction in childhood and adolescent cancer survivors vary regarding frequency, intensity, time, and type of exercise intervention. Further, the review suggests that exercise promotes positive effects on managing cancer treatment-related cardiac dysfunction across numerous indices of heart health. However, the few clinical studies employing exercise interventions for childhood and adolescent cancer survivors highlight the necessity for more research in this area. Full article
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Other

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10 pages, 448 KiB  
Commentary
Adolescents and Young Adults with Cancer and the Desire for Parenthood—A Legal View from a Swiss Perspective in Consideration of the Relevance of Cancer Support Organizations
by Isabel Baur, Sina Staudinger and Ariana Aebi
Curr. Oncol. 2023, 30(12), 10124-10133; https://doi.org/10.3390/curroncol30120736 - 27 Nov 2023
Viewed by 1074
Abstract
This commentary focuses on the challenges and possibilities that adolescents and young adults with cancer (AYA) desiring parenthood face under Swiss law. The regulation of reproductive medicine procedures is stricter in Switzerland than in some other countries. Health insurance is compulsory, but the [...] Read more.
This commentary focuses on the challenges and possibilities that adolescents and young adults with cancer (AYA) desiring parenthood face under Swiss law. The regulation of reproductive medicine procedures is stricter in Switzerland than in some other countries. Health insurance is compulsory, but the interventions that are covered are in constant flux. Recent changes pertain to the possibilities of future AYA parenthood and keeping up to date with practical and legal ramifications is taxing even for health professionals. AYA facing treatment decisions are uniquely vulnerable and dependent on comprehensive, clear, current, and country-specific information regarding risks and options pertaining to their fertility. This commentary provides a short overview of the Swiss legal framework related to reproductive medicine, highlighting its access restrictions and prohibitions, as well as recent changes. While the importance of patient, peer, caregiver, and interest groups supporting people affected by health conditions has long been recognized in many countries, an AYA organization was only recently established in Switzerland. Such organizations are vital for providing accurate, country-specific information and support, while individualized medical guidance, informed by the most current legal framework and its consequences, remains essential in addressing AYAs’ specific needs in connection with the desire to have children. Full article
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43 pages, 1234 KiB  
Systematic Review
Education, Employment, and Financial Outcomes in Adolescent and Young Adult Cancer Survivors—A Systematic Review
by Aurelia Altherr, Céline Bolliger, Michaela Kaufmann, Daniela Dyntar, Katrin Scheinemann, Gisela Michel, Luzius Mader and Katharina Roser
Curr. Oncol. 2023, 30(10), 8720-8762; https://doi.org/10.3390/curroncol30100631 - 25 Sep 2023
Viewed by 1515
Abstract
Adolescents and young adults (AYAs) with cancer face unique challenges. We aimed to describe (i) education, employment, and financial outcomes and (ii) determinants for adverse outcomes in AYA cancer survivors. We performed a systematic literature search. We included original research articles on AYA [...] Read more.
Adolescents and young adults (AYAs) with cancer face unique challenges. We aimed to describe (i) education, employment, and financial outcomes and (ii) determinants for adverse outcomes in AYA cancer survivors. We performed a systematic literature search. We included original research articles on AYA (15–39 years of age) cancer survivors (≥2 years after diagnosis) and our outcomes of interest. We narratively synthesized the results of the included articles. We included 35 articles (24 quantitative and 11 qualitative studies). Patients in education had to interrupt their education during cancer treatment, and re-entry after treatment was challenging. After treatment, most survivors were employed but started their employment at an older age than the general population. Overall, no disadvantages in income were found. Survivors reported more absent workdays than comparisons. We identified chemotherapy, radiotherapy, late effects or health problems, female sex, migration background, and lower education associated with adverse outcomes. Although most AYA cancer survivors were able to re-enter education and employment, they reported difficulties with re-entry and delays in their employment pathway. To facilitate successful re-entry, age-tailored support services should be developed and implemented. Full article
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21 pages, 745 KiB  
Systematic Review
Pediatric-Inspired Regimens in the Treatment of Acute Lymphoblastic Leukemia in Adolescents and Young Adults: A Systematic Review
by Aida Zeckanovic, Philipp Fuchs, Philip Heesen, Nicole Bodmer, Maria Otth and Katrin Scheinemann
Curr. Oncol. 2023, 30(9), 8612-8632; https://doi.org/10.3390/curroncol30090625 - 20 Sep 2023
Viewed by 1456
Abstract
Adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) have significantly worse outcomes than their younger counterparts. Current treatment guidelines rely mostly on non-randomized retrospective studies. We performed a systematic review of studies published within the last 15 years comparing pediatric-inspired regimens [...] Read more.
Adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) have significantly worse outcomes than their younger counterparts. Current treatment guidelines rely mostly on non-randomized retrospective studies. We performed a systematic review of studies published within the last 15 years comparing pediatric-inspired regimens (PIR) versus adult-type regimens or performing an age-stratified analysis of outcomes in the AYA population. Due to the heterogeneity of data, a meta-analysis was not possible. However, the gathered data show a trend toward improvement in outcomes and an acceptable toxicity profile in patients treated with PIRs compared to conventional adult-type regimens. There is still room for further improvement, as older patients within the AYA population tend to perform poorly with PIR or conventional adult-type chemotherapy. Further randomized studies are needed to develop an optimal treatment strategy for AYA with ALL. Full article
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