Purpose: Palliative care for adolescents with poor-prognosis cancer raises distinct and unresolved psychological challenges that differ from the broader adolescent and young adult (AYA) oncology population. This article aims to clarify key psychological processes of adolescents in palliative care and to support multidisciplinary teams in navigating complex behaviors and clinical decision-making. Approach: The study was grounded in developmental and psychodynamic theory and employed a structured reflective methodology to examine emotional, behavioral, and relational dynamics emerging during clinical management. Clinical observations and practices were integrated with current literature on palliative AYA oncology care. Conceptual Framework: Anticipatory grief (AG) emerges as the primary psychological construct through which adolescents’ experiences in palliative oncology care can be understood. It is associated with fragmentation of future perspectives, identity development, and bodily experiences. These processes are illustrated through clinical manifestations, with clear implications for multidisciplinary team practice. Defense mechanisms, along with transference and countertransference dynamics, are also crucial aspects for professionals to recognize and manage. Understanding these elements allows the health care team to provide better emotional containment, navigate relational complexities, and support the adolescent’s evolving needs. Conclusions: Adolescents in palliative oncology require a distinct psychological framework that goes beyond standard AYA care models. Addressing AG as an organizing process of the adolescent experience calls for greater clinical attention to developmental disruption, relational dynamics, and meaning-making processes. Multidisciplinary teams should integrate reflective and psychologically informed approaches into routine care to improve care quality and clinical decision-making.
PURPOSE:Adolescent and young adult (AYA) cancer survivors treated in pediatric settings face long-term physical and psychosocial effects from cancer treatment, and lifelong specialized survivorship care is recommended. Prior research has focused on what survivors need to know about past cancer and future health, with less emphasis on how clinicians communicate with AYAs and families. This study evaluated effective communication strategies and challenges with survivorship-related communication according to experienced clinicians. METHODS:We conducted individual interviews with survivorship clinicians from diverse practice settings across the United States between November 2024 and February 2025. Interviews queried communication strategies, barriers, and recommendations for improving clinical interactions with AYA survivors. Qualitative analysis identified key themes and patterns. RESULTS:Clinicians (nine females and three males), in practice for 4-37 years, were physicians specializing in pediatric oncology (N = 7; two with med-peds training), primary care with a survivorship focus (N = 3), or nurse practitioners (N = 2). Barriers to effective communication included information complexity and volume, lack of time, and anxiety among AYA survivors and families. Effective communication strategies included building rapport, a mindset to "meet the patient where they're at," use of clear, accessible language with visual aids, and contextualizing information about health risks and associated uncertainty. Findings illustrated ways that clinician communication may promote or inhibit AYA engagement in survivorship care. CONCLUSION:Effective communication between clinicians and AYA cancer survivors may improve health outcomes by helping survivors understand health risks, managing associated uncertainty and anxiety, and promoting AYA engagement in survivorship care. This study will inform the development of communication interventions and training for clinicians.
PURPOSE:Survivors of childhood cancer have unique needs, requiring tailored psychosocial support. To ascertain the effectiveness of a community-based survivorship group's services on changes in emotional and social self-efficacy, perceived purpose and meaning in life, loneliness, and post-traumatic growth from pre- to postretreat among minority adolescent and young adult (AYA) survivors over a 2-year period. METHODS:Two annual residential retreats were attended by 15 and 13 AYA survivors, respectively. Experiential learning activities that fostered connection, self-reflection, and resilience were provided. Inventories assessing meaning/purpose (Patient-Reported Outcomes Measures Information Systems [PROMIS]), social (SSE) and emotional self-efficacy (ESE), loneliness, and Post-Traumatic Growth Inventory (PTGI) were administered at four timepoints (pre-/post-2024 and 2025 retreat). Quantitative data were analyzed with orthogonal polynomial contrasts and the MIXED procedure method. Qualitative survivor feedback was collected after the retreats. Counselor journals, participant quotes, and exit interviews were used to contextualize survivor-reported data. RESULTS:PROMIS, SSE, and ESE improved immediately following the retreats, with continual improvement after the second retreat. PTGI did not change. After each retreat, AYAs scored the improvement in loneliness (7.3 ± 1.3 and 7.5 ± 1.9, respectively, with 10 representing maximal benefit), indicating that each retreat impacted their loneliness to the same degree. Qualitative data indicate that AYAs appreciated the opportunity to face difficult topics in a safe space and could benefit from attending consecutive retreats. CONCLUSION:The intervention benefited participants who were in different stages of their cancer and life journey and reached an underserved minority population. Implementation of these types of support groups could reduce loneliness and improve self-efficacy, thereby having broader impacts on quality of life.
The Gustave Roussy Institute (IGR) is considered the leading cancer center in Europe. Since 2012, a multidisciplinary team dedicated to adolescents and young adults (AYAs)-known as SPIAJA-has been developing a comprehensive care model for patients in this age group treated at the IGR. This mobile unit, integrated into the pediatrics department, collaborates with several adult care departments and offers a wide range of specialized services. Based on both interviews and observations, this qualitative study highlights the role of leadership as a catalyst for overcoming barriers and improving interprofessional collaboration, which appears to have a positive impact on the quality of life of AYA patients. However, the identified barriers and challenges highlight certain performance limitations when this "managerial culture" is not implemented at all levels of the institution.
PURPOSE:While challenges faced by young adults (YAs) aged 18-39 years with breast cancer are well-documented, health care providers' experiences caring for YAs are underinvestigated. Given high burnout rates among oncologists, this study explores providers' perspectives about how complex care of YAs may impact emotional well-being. PARTICIPANTS AND METHODS:A multidisciplinary cohort of breast oncology practitioners from a single Comprehensive Cancer Center were recruited to complete (1) semistructured interviews, and (2) the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) between August and November 2025. Interview questions prompted participants' narratives about how complexities in clinical care for YAs might affect their emotional well-being. Transcribed interview audio-recordings were analyzed for recurring themes. Three MBI-HSS subscales were scored as follows: emotional exhaustion (low ≤ 16, moderate/high ≥ 17), depersonalization (low ≤ 5, moderate/high ≥ 6), and reduced personal accomplishment (low ≥ 40, moderate/high ≤ 39). RESULTS:Participants included a multidisciplinary cohort of breast oncology providers comprised of 14 (70%) physicians and 6 (30%) advanced practice providers. Thirteen completed the MBI-HSS; 5 (38%) scored as moderate/high risk for emotional exhaustion and depersonalization, and 8 (62%) scored as moderate/high risk for reduced sense of professional achievement. Participant narratives highlighted four themes: (1) age-related considerations complicate care and contribute to workplace stress; (2) systematic barriers to patient care impact burnout; (3) multidisciplinary collaborations promote optimal care and provider well-being; and (4) system-level initiatives could facilitate delivery of high-value care. CONCLUSION:In this mixed-methods study of breast oncology providers caring for YA patients, risks for emotional exhaustion, depersonalization, and reduced sense of accomplishment were common. Qualitative findings underscore the emotional complexity of caring for this population and suggest that multidisciplinary support may play a crucial role in mitigating risk for burnout.Context Summary:Health care providers' experiences caring for young adults (YAs) aged 18-39 years with breast cancer are underinvestigated. Given high burnout rates among oncologists, this mixed-methods study explores providers' perspectives about how complex care of YAs may impact emotional well-being through (1) semistructured interviews, and (2) the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Of the 20 multidisciplinary breast oncology specialists who participated, 13 completed the MBI-HSS; 5 (38%) scored as moderate/high risk for emotional exhaustion and depersonalization, and 8 (62%) scored as moderate/high risk for reduced sense of professional achievement. Participant narratives highlighted four themes: (1) age-related considerations complicate care and contribute to workplace stress; (2) systematic barriers to patient care impact burnout; (3) multidisciplinary collaborations promote optimal care and provider well-being; and (4) system-level initiatives could facilitate delivery of high-value care. Findings underscore the complexity of caring for YAs and suggest that multidisciplinary support plays a crucial role in mitigating burnout.
Adolescents and young adults (AYAs) with cancer experience substantial symptom burden. Integrative medicine (IM) offers evidence-based symptom management, yet real-world data in AYAs are limited. We retrospectively examined initial IM visits for AYAs (15-39 years) at a tertiary cancer center, abstracting demographics, clinical characteristics, symptoms, and discussions/recommendations. Among 272 AYAs (59.6% female), 42.7% had three concurrent symptoms, most commonly nausea, gastrointestinal issues, and pain. Discussions addressed diet (91.2%), supplements (87.5%), and stress management (77.2%). Nearly half (46.0%) received at least one IM referral, most commonly acupuncture and massage (24.6% each). IM interventions may support symptom management in AYA oncology care.
PURPOSE:To utilize the social-ecological model of adolescent and young adult readiness to transition to understand the interplay of social determinants of health with condition management ability (CMA) of caregivers of young adult survivors of childhood brain tumors (YAS). METHODS:Maternal caregivers (N = 53) of 18- to 29-year-old YAS ≥2 years off-treatment living at home were screened into a problem-solving intervention randomized trial based on their risk of poorer CMA. They completed the Transition Readiness Assessment Questionnaire (TRAQ) and rated YAS cognitive late effect severity prior to randomization. Medical experts scored cognitive medical sequelae and treatment intensity. Social vulnerability was rated using the CDC/ATSDR social vulnerability index. RESULTS:CMA was not related to transition readiness when accounting for cognitive late effects. Cognitive late effects were associated with transition readiness (p < 0.01). For families with less social vulnerability, higher cognitive late effects were associated with poorer CMA, which was in turn related to lower managing daily activities and tracking health issues subscales of transition readiness. There were no other significant relationships. CONCLUSION:For families with more resources, CMA may explain the relationship between cognitive late effects and transition readiness, although findings were inconsistent by the TRAQ subscale. Additional investigation of social vulnerability in CMA and transition readiness is needed. Findings highlight the saliency of mitigating cognitive late effects resulting from childhood brain tumors and their treatment. There is a significant need for ongoing resources to support both ongoing condition management and transition readiness in the period of young adulthood for YAS.
PURPOSE:Adolescents and young adults (AYAs) with cancer face care disparities, compounded by a lack of formal AYA oncology education in pediatric and medical oncology fellowship programs. This critical workforce training gap hinders optimal AYA outcomes. We developed a virtual program, "AYA POWER" (Adolescent and Young Adult Program for Oncology Workforce Education and Resources), to provide high-yield education to improve care delivery and outcomes. METHODS:AYA POWER is a virtual, longitudinal series addressing high-priority AYA topics. Content includes live lectures, on-demand recordings, and supplemental tools and materials. We evaluated the development, implementation, uptake, and impact via registration data, website analytics, and post-session feedback. RESULTS:The curriculum launched in August 2023, attracting 1243 engagements with 653 live participants (395 unique attendees) and 590 on-demand views from 12 countries. Attendees represented diverse AYA stakeholders, including nurses, advanced practice providers, and oncologists. Feedback was overwhelmingly positive, emphasizing the content's relevance, practicality, and importance in addressing under-discussed topics. CONCLUSION:AYA POWER demonstrates the feasibility and early impact of a global, virtual, longitudinal AYA oncology curriculum. It successfully bridges a crucial educational void. Future integration into formal training and expanded outreach will enhance access to specialized AYA cancer care knowledge.
BACKGROUND:Among young adults (20-39), cancer is the fifth leading cause of death. Delayed diagnoses in this population are frequent, contributing to reduced survival and higher morbidity. Delays may be driven by individuals attributing symptoms as nonserious and failing to seek timely medical care. Google search is commonly used for health information seeking, but we do not know the current online symptom content quality that young adults may encounter. PURPOSE:We aimed to answer 1. What is the content quality of top-ranked webpages for common young adult cancer symptom searches? 2. Does quality differ by website type (e.g., academic/health care vs. for profit)? METHODS:Using 18 young adult cancer symptoms as input into the SEMRush Keyword Magic Tool, we generated a list of the most common keyword searches and the top-ranked webpages (i.e., first three pages listed in Google output). We evaluated 162 pages on 9 quality metrics, including the JAMA benchmark criteria. RESULTS:Two-thirds of pages (66.7%, n = 108) were written at less than a 9th-grade reading level, and three-quarters (72.8%, n = 118) provided actionable content about when to seek medical care for symptoms. However, only 13.6% (n = 22) of pages included content framed for young adults. On average, pages met about half (2.33) of four JAMA criteria (authorship, disclosures, currency/up-to-date, and references). CONCLUSION:Academic/health and government organizations should devote resources to improving information about young adult cancer symptoms on their webpages and optimize these pages to appear higher in search result rankings.
Background: Neurofilament light chain (NfL)is a promising biomarker of axonal injury and may facilitate earlier detection of chemotherapy-induced peripheral neuropathy (CIPN). This study evaluated longitudinal changes in NfL and its association with patient-reported CIPN symptoms in adolescents and young adults receiving neurotoxic chemotherapy. Methods: In this prospective, single-center study, patients >10 years of age with cancer receiving atubulin toxin were enrolled. Serum NfL and the Functional Assessment of Cancer Therapy-Gynecologic Oncology Group-Neurotoxicity (FACT-GOG-NTx) questionnaire were collected at baseline, midchemotherapy, and at the follow-up visit closest to 90 days after therapy initiation.Results: Eleven participants (median age 17 years [range, 12-24]; 63.6% male) were included. NfL levels increased longitudinally in all participants, with a median maximum increase from baseline of 112.5% (range, -32.0% to 4896.2%). Mean NfL levels increased from 2.32 at baseline (median 2.16) to 3.28 at mid-chemotherapy (median 3.47) and remained elevated at the follow-up visit (mean 3.85; median 4.38). Higher NfL levels were associated with worse FACT-GOG-NTx scores during chemotherapy (r = -0.32, p ≤ 0.01) and after chemotherapy (r = -0.31, p < 0.01).Conclusions: NfL increased throughout treatment and was associated with patient reported CIPN symptoms, supporting its potential as an objective biomarker for early detection and monitoring of chemotherapy-induced peripheral neuropathy in adolescents and young adults receiving neurotoxic chemotherapy.
INTRODUCTION:The incidence of colorectal cancer (CRC) in adolescents and young adults is increasing, and affected individuals often face diagnostic delays, psychological distress, fertility-related concerns, and limited access to social support. Few studies have evaluated these multidimensional factors. This study aimed to clarify the clinical characteristics, psychosocial burden, fertility-related issues, and support needs of young adults with CRC. PATIENTS AND METHODS:Patients aged 15-39 years diagnosed with CRC between 2012 and 2025 were evaluated. Clinical characteristics, psychological distress, fertility-related concerns, and utilization of social support resources were assessed using medical records, nursing documentation, multidisciplinary reports, and institutional assessment tools. Documented psychological and fertility concerns were categorized, and survival outcomes were estimated using the Kaplan-Meier method. RESULTS:Symptom-driven diagnosis occurred in 59.2% overall and was significantly more common in patients in their 20 seconds (91.7% vs 52.5%, p = 0.011). Screening-based detection was lower in the 20 seconds (16.7%) than in the 30 seconds (49.2%, p = 0.039). Advanced disease (Stage II-IV) accounted for 56.3% of cases and was associated with poorer survival (p = 0.013). Psychological distress was documented in 77.5% of patients. Fertility-related anxiety occurred in 22.5% and was more frequent in women (35.5% vs 12.5%, p = 0.022). Fertility preservation was performed in 9.9%. Social worker involvement was noted in 66.2%, while use of public support systems remained low. CONCLUSION:Young adults with CRC face delayed diagnosis, substantial psychological distress, sex-specific fertility concerns, and limited engagement with public support programs. Improved symptom recognition, routine distress screening, gender-inclusive fertility counseling, and strengthened multidisciplinary support are needed for this population.
Adolescents and young adults (AYAs) aged 15-39 with cancer face distinct challenges during treatment, with eating consistently emerging as one of the most distressing and underrecognized concerns. At a critical life stage, AYAs must navigate illness-related consequences that profoundly affect well-being. Eating reflects these broader challenges and is identified as a key issue requiring health care attention. To address this, we synthesized evidence on AYAs' eating experiences and well-being during mealtime-related activities to inform health care practice. Qualitative and mixed-method studies were identified through searches across CINAHL, Embase, PubMed, Scopus, and Web of Science for studies published up to May 2025, supplemented by snowball searches. Of 3214 records, 74 full-text articles were reviewed, and 18 met the inclusion criteria. These represented 302 AYAs, 73 relatives, and 88 health care professionals. Studies were analyzed using Joanna Briggs Institute review methods and GRADE-CERQual to support clinical interpretability. The meta-synthesis identified one core theme: "Eating as an embodied struggle and act of agency," with three subthemes: (a) living through physical and sensory disruption, (b) carrying the weight of new emotions and shifting relations, and (c) finding ways through gaps in support. Eating emerged as a disrupted, emotionally charged, yet agentic act requiring sensitive, individualized approaches. Thirteen evidence-informed recommendations were developed to guide clinical application. These emphasize early nutritional screening, dietetic support, flexible meal options, respectful family involvement, and psychosocially attuned care. Future research should codevelop and evaluate tailored interventions that address AYAs' embodied, emotional, and social needs to improve eating-related quality of life during cancer treatment.
Early endometrial metastasis from triple-positive breast cancer is a rare phenomenon in young patients, especially when anti-human epidermal growth factor receptor 2 (HER2) target therapy is used as the primary treatment. We present a case of a 24-year-old patient with advanced triple positive breast cancer. The patient developed abnormal uterine bleeding during chemotherapy combined with anti-HER2 therapy (trastuzumab plus pyrotinib). Due to the transvaginal sonography are not characteristic and the low incidence rate of endometrial metastasis from breast cancer, this potential diagnosis was overlooked. The disease progressed rapidly thereafter, and the overall survival was only 13 months. The swift and devastating progression highlight the immense challenges in managing such complex cases. It remains a current challenge to identify such cases at an early stage and explore more effective therapeutic regimens. Based on this case review and previous studies, we speculate that disease progression might be attributed to the absence of endocrine therapy, chemotherapy resistance, or insufficient anti-HER2 therapeutic intensity. This case provides new insights into the metastatic pattern of HER2-positive breast cancer under targeted drug resistance. Clinicians should be alert to the possibility of reproductive system metastasis during anti-tumor treatment. Timely diagnosis and appropriate treatment are expected to improve patient prognosis.
BACKGROUND:Adolescents and young adults (AYAs; 15-39 years) with cancer face unique ethical challenges. Variations in ethics consultations (ECs) among different AYA age groups remain understudied, despite evolving developmental and psychosocial milestones. METHODS:A 10-year retrospective review at an academic medical center examined EC cases in AYA oncology patients. Ethicists categorized ethical issues using an institutional 5 domains, 23-category classification schema Decisional Processes, Medical/Surgical Treatments, Patient/Family Behavior, Professional Issues, and Information/Communication. Categories included surrogate decision-making, informed consent, pain management, and resuscitation status/do-not-resuscitate (DNR) order. Multiple categories could be documented per EC. Primary outcomes were (1) the distribution of categories across domains and (2) the prevalence of specific categories among patients, compared across age groups (15-21, 22-29, and 30-39 years) using χ2 or Fisher's exact tests (α = 0.05). RESULTS:Among 59 ECs (mean patient age 26.4 ± 7.1 years; 52.5% female), Decisional Processes accounted for 41% of category applications, followed by Medical/Surgical Treatments (25%), Patient/Family Behavior (12%), Professional Issues (12%), and Information/Communication (9%). A total of 153 categories were recorded. The most common were surrogate decision-making (45%), quality-of-life (QoL) considerations (37%, including QoL deliberations [20%] and treatment-related QoL concerns [17%]), informed consent (20%), and DNR (18%). The distribution was consistent across age groups, except for pain control, observed only in 22-29-year-olds (3/16; p = 0.014). CONCLUSION:Decision-making primarily drove EC with consistent patterns across the AYA spectrum, except for pain control in 22-29-year-olds. Findings emphasize the need for structured decision-making approaches and age-specific pain management in AYA oncology.
Relevance: Adolescents and young adults (AYAs) diagnosed with cancer represent a particularly vulnerable group with unique developmental, psychosocial, and functional challenges. Beyond survival, improving health-related quality of life (HRQoL) has become a major priority in cancer survivorship and public health. Purpose: This umbrella review aimed to critically synthesize evidence from existing systematic reviews and meta-analyses evaluating the effectiveness of physical, psychosocial, and mixed interventions for improving HRQoL and related health outcomes in AYA (e.g., cancer-related fatigue, anxiety, and physical functioning) cancer patients and survivors. Methods: A comprehensive search of PubMed/MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and ScienceDirect identified eligible systematic reviews and meta-analyses published between 2015 and 2025. Results: Fifteen reviews were included. Physical activity interventions showed the most consistent moderate benefits, particularly in reducing fatigue and improving physical functioning and domain-specific HRQoL. Psychosocial interventions demonstrated small-to-moderate improvements in anxiety, depression, and emotional well-being. Mixed interventions showed promising but less robust evidence, particularly due to limited long-term follow-up. Overall evidence certainty ranged from low to moderate. Primary study redundancy was minimal (the corrected covered area = 1.7%). Conclusions: Psychosocial interventions, especially exercise-based and psychosocial programs, can improve key HRQoL domains in AYAs with cancer. However, more rigorous long-term studies are required, particularly for combined and digital approaches.
PURPOSE:Adolescents and young adults (AYAs) with cancer are at risk for treatment-related infertility, yet gaps in fertility preservation (FP) counseling persist. While patient-level barriers are well described, provider-level factors remain understudied. We evaluated oncology providers' perceived versus demonstrated knowledge of FP guidelines and identified barriers to oncofertility care. METHODS:We conducted a cross-sectional survey of oncology providers at a single academic medical center caring for postpubertal AYA patients receiving gonadotoxic therapy. The survey assessed demographics, prior FP training, counseling and referral practices, and perceived barriers. Participants self-rated their FP knowledge and completed guideline-based clinical vignettes to assess demonstrated knowledge, enabling direct comparison of perceived versus demonstrated knowledge. RESULTS:Providers reported limited formal oncofertility training, with most rating prior education as fair or poor. Knowledge varied across FP strategies, with high familiarity for ovarian suppression and sperm cryopreservation and lower familiarity for ovarian transposition and male-directed surgical techniques. A trend toward discordance between perceived and demonstrated knowledge was observed but was not statistically significant. Awareness of institutional FP resources and referral pathways was limited. Providers most frequently cited patient-level barriers, including treatment urgency and cost, although provider- and system-level barriers were also reported. DISCUSSION:Oncology providers may overestimate oncofertility knowledge, contributing to inconsistent counseling and missed opportunities for FP. This pattern, combined with gaps in training and awareness of institutional protocols, highlights the need for competency-based education, clearer institutional communication, and improved referral systems. Objective assessments may better identify knowledge gaps and guide targeted interventions to support guideline-concordant FP care.
PURPOSE:Adolescents and young adults (AYAs) with cancer have unique physical, emotional, and social challenges. We aimed to identify key concerns among AYAs with cancer, evaluate pathways for connecting patients with resources, and inform the development of an AYA oncology program. METHODS:This study was conducted at Mayo Clinic in Arizona and included English-speaking patients aged 18-39 years with recently diagnosed cancer. Participants completed a modified Needs Assessment Service Bridge questionnaire, which assessed patient-perceived needs with 39 items spanning 7 domains. An AYA nurse navigator discussed each participant's results with them and connected them to the desired resources. RESULTS:Of 52 eligible patients, 32 (62%) completed the questionnaire. Among them, 30 (94%) reported unmet needs in at least 1 domain and 19 (59%) reported unmet needs in 5 or more domains. The domains with the most frequently reported needs were health behaviors and wellness (81%), emotional health (72%), finances and everyday needs (59%), and work- and education-related assistance (56%). Younger participants reported more needs related to school life and scholarships/loans than did older participants. No significant differences were observed between the responses of men and women. Of 133 total needs identified by all participants, 93 (70%) were addressed by connecting patients to relevant resources. CONCLUSION:Systematic assessment of AYA needs and targeted connection to resources are essential for individualized and developmentally appropriate care. The current study identified key service gaps at our institution and will guide the continued evolution of our comprehensive AYA oncology program.
PURPOSE:There is increasing recognition of the critical need to support informal caregivers of young adults with cancer, including parents. Given the unique developmental needs of young adults, cancer diagnosis and treatment have a profound impact on their parents. However, there is limited psychosocial support provided to parents of young adults with cancer to date. METHODS:Following a program improvement framework, a virtual six-session parent support group curriculum was developed and adapted to provide specialized psychosocial care to parents of young adults receiving cancer care in 2025. The participants provided feedback and completed an evaluation. RESULTS:Thirty-four parents (85% female) of young adults participated, with 19 (55%) completing the evaluation. The majority of participants evaluated the program as accessible (95%) and relevant (84%) to the parent's shared concerns and experiences. The program was highly rated as supportive (95%) engaging (100%) and was unanimously recommended to other parents (100%). Additionally, parents reported feeling more connected to others (79%), empowered with knowledge (90%), and an improved perceived capacity (79%) to navigate the unique concerns related to their young adult's cancer. CONCLUSION:This novel parent program has the potential to address the distinct psychosocial needs among parents, which are currently overlooked in existing models of young adult cancer care.
BACKGROUND:We analyzed the predictors of marriage and parenthood in our cohort of adult survivors of childhood cancer. METHODS:We conducted a retrospective cohort analysis of adult survivors of childhood cancer aged > 25 years at a tertiary cancer center in India, evaluating marital status, parenthood, and associated predictors using multivariable logistic regression. RESULTS:Among 844 survivors, 36.4% of males and 37.6% of females were ever married. On multivariable analysis, male sex (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.41-0.83, p = 0.003) and diagnosis of central nervous system (CNS) tumor/retinoblastoma (OR 0.42, 95% CI 0.22-0.81, p = 0.009) were associated with lower likelihood of marriage, while employment was strongly associated with higher likelihood (OR 3.75, 95% CI 2.62-5.37, p < 0.001).Among married survivors, treatment before 2000 was associated with a higher likelihood of parenthood (OR 3.94, 95% CI 2.20-7.06, p < 0.001), while other treatment-related factors were not significantly associated. Highly gonadotoxic treatment (OR 2.19, 95% CI 1.22-3.93, p = 0.01) was associated with use of assisted reproductive technology. CONCLUSIONS:Sociodemographic and temporal factors, particularly employment and treatment era, were the primary determinants of marriage and parenthood in this cohort.
