ISSUES ASSOCIATED WITH CANCER IN ADOLESCENTS AND YOUNG ADULTS

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Abstract

Background

The clinical aspects and problems in adolescents and young adults (AYA) with cancer in the western countries have been elucidated. These patients have benefited less from therapeutic advances partly because of less opportunity to participate in clinical trials. And AYA cancer patients have many social problems such as school, employment and expense. This situation is called as AYA gap and some programs have been started in the USA to improve the outcome of AYA cancer patients as an orphaned population. AYA cancer patients have not been studied in Japan and we do not have any available nation-wide data of this population. Here, we report AYA cancer patients who were treated at Osaka Medical Center and Research Institute for Maternal and Child Health (OMCRI).

Method

Sixteen AYA cancer patients aging from 15 to 29 years were treated at OMCRI during 2005–2009. These cases were analyzed in terms of diagnosis, age, treatment, and outcomes.

Result

Ten cases (62.5%) were diagnosed with hematological malignancies, four (25%) were soft tissue sarcomas. Fifteen of 16 patients were between 15 and 20 years old. A multimodal therapy consisting of chemotherapy, radiotherapy, and/or hematopoietic stem cell transplantation was applied for most of them. The overall survival rate with a median follow-up of 6.3 years is 62.5% (10/16).

Discussion

Although the number of patients in this series is small, it appears that incidence and characteristics of AYA cancer patients in Osaka is similar to that of USA. These results suggest the importance of a multimodal combination therapy for the treatment of AYA cancer patients. Approximately 250 young people aged 15–29 are annually diagnosed with cancer in Osaka prefecture, and cancer is the leading cause of death in this age population. Therefore, it is important to analyze the incidence, situation of medical-examination, treatment and outcome of AYA cancer patients in the large scale. We recently organized an AYA cancer information-sharing system (Osaka AYA Cancer Network) including specialists such as pediatric or adult hemato-oncologist, epidemiologist, and so on to understand and investigate AYA cancer patients in Osaka area in an attempt to improve the outcomes and quality of life for these patients.

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