Management of medical and psychological problems of adolescent and young adult (AYA) patients: Analysis of 64 cases

Abstract

Although countermeasures against adolescent and young adult (AYA) cancers are currently being promoted in Japan, domestic reports of treatment and especially psychosocial problems encountered by patients are limited. We retrospectively reviewed AYA cases in our pediatric hematology/oncology department on the basis of medical records. The subjects were 64 patients aged 15 years or older at the time of admission to our department from January 2005 to December 2015. The median age was 17 years (15 to 41 years). The numbers of cases of hematopoietic tumors, brain tumors and solid tumors were 27, 21 and 16, respectively. Outcome data were available for 62 patients; 35 survived and 27 died. In 10% of patients, lack of prompt consultation with experts and delay of appropriate diagnosis were considered to lead to their poor prognosis. As for school attendance, 23.6% of the patients attending high school and all four patients attending college were forced to quit school or be on holdover status. Psychosocial problems considerably varied among AYA patients, including those arising from post-treatment chronic complications, difficulty in returning to daily life and friendship recovery in the premorbid state, and difficulty in finding employment; one patient committed suicide. There were patients, however, who showed a positive personal sense of growth with cancer experience. On the basis of their characteristics, AYA patients should each be carefully assessed, and it is important to find out what they really think. Knowledge gained from such assessments should be shared and reflected in medical practices in the future.