Survivors(of(Cancer(in( Adolescence(and(Young( - PowerPoint PPT Presentation

Survivors(of(Cancer(in( Adolescence(and(Young( Adulthood:(A(Canadian(Strategy( Dr.(Krista(Wilkins,(University(of(New(Brunswick( Fredericton,(New(Brunswick,(CANADA(

Adults((AYA)(with(Cancer?( Adults((AYA)(with(Cancer?( 15E29(year(olds(( � 2,075(new(cases(per(year( � 2%(of(all(invasive(cancers(( � 326(deaths(per(year( � 16,000(potential(years(of(life(lost(due(to(cancer( 16,000(potential(years(of(life(lost(due(to(cancer( ( ( Survivor,((March,(2010,(CPAC(AYA(workshop( ( Oeffinger,(Hudson,(&(Landier,(2009)(( ,(2009)(( (

Survival(Rates( � 1Eyear,(3Eyear(and(5Eyear(observed(survival(proportions( were(93%,(86%(and(83%,(respectively( � 5Eyear(survival(among(females(was(similar(to,(or(higher,( than(among(males( � 5Eyear(survival(similar(across(age(groups( � Slow(gains(in(5Eyear(survival(rates( ( (Canadian(Cancer(Society’s(Steering(Committee,(2009)(( (

Survivors(of(Cancer(in(AYA( � ~1/640(individuals(between(the(ages(of(20(and(39( years(is(a(survivor(of(childhood(cancer(( � ~(2/3(will(have(1(adverse(sequelae(from(the(treatment( for(their(disease( ( “It(totally(blindsided(me…It’s(the(last(thing(you(expect(when(you’re(25…I( felt(cheated…I(watched(friends(getting(married,(going(on(trips,(advancing( in(their(careers(–(and(I(was(in(a(stalemate.”(( Shawn(Sajkowski,(age(25,(nonEHodgkin(lymphoma( ( (Canadian(Cancer(Society’s(Steering(Committee,(2009;(Oeffinger,(Hudson,(&(Landier,(2009)(

What(are(the(Issues?( � Different(spectrum(of(cancers( � Biology(of(cancers(may(actually(be(different( � health(care(system((pediatric(vs.(adult(cancer(centres)( Not(well(served(by(the(traditional(dichotomy(of(the( � Lack(of(dedicated(resources(and(staff(( � � Lack(of(dedicated(resources(and(staff(( Very(few(collaborative(activities( � Very(few(collaborative(activities( Landier,(2009;(Ramphal(et(al.,(2011)( ,(2009;(Ramphal

Canadian(Task(Force(on(Adolescents( and(Young(Adults(with(Cancer( outcomes(and(quality(of(life(of(AYA(with(cancer( Eliminate(current(disparities(of(care(for(AYA(during( and(after(cancer(treatment(( 2. Ensure(AYA(with(cancer(have(prompt(and(equitable( access(to(best(care( 3. Establish(and(support(research(to(optimize(health( outcomes(and(quality(of(life(of(AYA(with(cancer( The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer, and then open the file again. If the red x still appears, you may

Task(Force’s(Recommendations(for( Provision(of(Survivorship(Care( � “Implementation(of(lifeElong(monitoring(and(followE up(of(survivors(of(cancer(in(childhood,(adolescence,( and(young(adulthood(will(provide(economic(and(other( societal(benefits(and(help(mitigate(lateE(or(longEterm( treatment(effects.”( ( (Fernandez,(et(al.(2011)(

Priority(Areas(for(Intervention( � Discussions(and(education(about(survivorship(during(active(treatment( � Transition(record(( � Tumor,(treatment,(medical(and(preventive(healthcare,(rehab(opportunities( � Easily(accessible( � Updated(( � Part(of(healthcare(delivery(responsibility(( � Quality,(evidenceEbased(longEterm(followEup(guidelines(( � RiskEstratified( � Patient(needs(and(preferences( � Integrated(into(local(healthcare(delivery(system( � Quality,(evidenceEbased(rehab(services( � For(range(of(rehab(needs((physical,(psychosocial,(occupational,(educational)( (Fernandez,(et(al.(2011)(

Going(Forward(with(Survivorship( Recommendations( (The(Canadian(Task(Force(on(Adolescents(and(Young(Adults(with(Cancer,(2012)(

Introduction(of(multiEdisciplinary(teams(who( would(be(responsible(for(delivering(active(and( followEup(AYA(care ( ( ( Year(1 ! Year(2 ! Year(3 ! Year(4 ! Year(5 ! Identify(leaders( Obtain(buy(in( Phased(roll(out( Evaluation(and( AgeEappropriate( and(champions( from(all( and(data( refinement( care(is(delivered( (( stakeholders,( gathering ! ( ! and/or(supported( Constitute(a( including( by(multiE Regional(Action( government(and( disciplinary(teams( Partnership( policy(makers( (( (RAP)( (may(include( ( ! (( funding( Develop(a(local( approval) ! action(plan(with( clear(objectives( and(priorities ! (The(Canadian(Task(Force(on(Adolescents(and(Young(Adults(with(Cancer,(2012)(

( ( Incorporate(AYAEspecific(tools(into( AYA(care( ( ( Year(1 ! Year(2 ! Year(3 ! Year(4 ! Year(5 ! Survey( Identify(gaps( Disseminate( Roll(out(tools( All(AYAs(have( existing(tools ! with(existing( and(evaluate( and( access(to( tools( tools ! integrate( validated(tools( (( into(practice ! that(improve( Develop(and( and(facilitate( test(new(/ management( improved( of(their(cancer( tools ! journey ! (The(Canadian(Task(Force(on(Adolescents(and(Young(Adults(with(Cancer,(2012)(

References( Adolescents(and(Young(Adults((Ages(15E29(Years)(.( and(young(adultEaged(cancer(patients(and(survivors.( Journal(of(Adolescent(and(Young(Adult(Oncology,(1 ,(53E59.( ,(W.((2009).( Clinics(in(Office(Practice ,( 36, (743E780.(doi:10.1016/j.pop. 2009.07.007( Ramphal ,(R.,(et(al.((2011).(Practices(and(resources(devoted( to(the(care(of(adolescents(and(young(adults(with(cancer( with(Cancer((2012).(( Framework(for(Action(on( treatment(centers.( Journal(of(Adolescent(and(Young( in(Canada:(A(survey(of(pediatric(and(adult(cancer( Recommendations(for(Care(of(AYA(with(Cancer. ( ( 2009.07.007( Ramphal,(R.,(et(al.((2011).(Practices(and(resources(devoted( to(the(care(of(adolescents(and(young(adults(with(cancer( in(Canada:(A(survey(of(pediatric(and(adult(cancer( treatment(centers.( Journal(of(Adolescent(and(Young( Adult(Oncology,(1,( 140E144.(doi:10.1089/jayao.2011.0023( The(Canadian(Task(Force(on(Adolescents(and(Young(Adults( with(Cancer((2012).(( Framework(for(Action(on( Recommendations(for(Care(of(AYA(with(Cancer. ( (