New guidance to help adolescents and young adults living with and beyond cancer

Adolescents and young adults (AYA) living with and beyond cancer have unique needs and perspectives that clinicians should be aware of when providing health care. A practice article in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.260027 provides easy-reference guidance on how to support this demographic of people aged 15 to 39 years.

1. Disrupted milestones - As cancer disrupts milestones in life for adolescents and young adults, clinicians should try to address their unique needs and the effect of disruptions in various stages of development. This should include addressing topics such as fertility, sexual health, and advance care planning.
2. Mental health impacts - Cancer has a mental health impact on all patients. As adolescents and young adults are especially at risk of anxiety and depression, clinicians should regularly screen for mental health challenges and support patients with counselling, referrals, and appropriate medications if relevant.
3. Patient-centred language - Avoid language that might minimize the effect of being diagnosed with cancer and use terms preferred by the patient.
4. Post-treatment support - As most AYAs will live 50 to 60 years after initial treatment, ongoing guideline-aligned follow-up in collaboration with specialists is necessary. Patients may have long-term physical impacts, including potential cancer recurrence.
5. Intersectional identities - Adolescents and young adults have varied identities beyond age, and clinicians should ask about preferred names, pronouns, and other aspects of identity.

Adolescents and young adults diagnosed with cancer are navigating far more than a diagnosis; they are often managing facing significant life transitions at the same time. Clinicians can make a meaningful difference by delivering care that is responsive to each patient's unique needs, priorities, and identities, and tailored to their stage of development. In this article we explore practical ways that clinicians can do this based on our personal and professional lived experiences."

Dr. Perri Tutelman, coauthor, clinician psychologist and assistant professor, University of Calgary, Calgary, Alberta