Meeting the Needs of Teens Who Have Cancer

Lamia P. Barakat, PhD


April 28, 2014

Editorial Collaboration

Medscape &

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Hello. I am Lamia Barakat, a pediatric psychologist and Director of Psychosocial Services at The Children's Hospital of Philadelphia (CHOP) Cancer Center. Today I will be talking about a vulnerable subpopulation of people with cancer: the more than 21,000 adolescents and young adults who are diagnosed with cancer each year in the United States, with similar rates worldwide.

Why vulnerable? We know that the 5-year survival rate and the morbidity reduction rate for adolescents and young adults have not improved over time. We also know that adolescents and young adults are less likely to enroll in clinical trials for treatment, they are less likely to be adherent to treatment, and they are more likely to be diagnosed later in the disease course. Moreover, adolescents and young adults face these life-threatening conditions and intensive treatments at a time of rapid physical, cognitive, social, and emotional change. What does that mean? Adolescents and young adults experience physical changes that can affect their fertility, their body image, and their ability to build relationships with peers, as well as romantic relationships.

Adolescents and young adults with cancer miss school, may have cognitive changes related to treatments, and may experience treatment-related late neurocognitive effects that can inhibit academic attainment and vocational options. Adolescents and young adults also experience anxiety and depression. This may lead to increased dependence on their families at a time when they should be striving for autonomy, limit their ability to set and achieve goals for themselves, and also lead to social isolation. Thus, all of these vulnerabilities can affect health-related quality of life across physical, cognitive, social, emotional, spiritual, physical, and sexual domains.

What can we do? We know that adolescents and young adults can be quite resilient. It is very important to support them at this time and to encourage their resiliencies. We can do that by thinking about how they are changing developmentally and how we can assist and encourage them as they approach and attain developmental milestones. The program at CHOP includes a number of activities related to supporting these potential resiliencies.

We provide education that targets adolescents and young adults specifically, including information about sexual health, survivorship, and engaging in healthy behaviors. We have dedicated adolescent and young adult spaces. We have adolescent and young adult activities, in addition to opportunities for adolescents and young adults to connect with each other either in person or virtually, through online discussion groups. We have a school reintegration program that helps adolescents and young adults identify their particular learning needs, what school accommodations they need to be successful, and how they can reset their academic and vocational goals and strive to achieve them. Finally, we have programs to ease the transition to adult services at an appropriate time.

For more information about meeting the unique psychosocial needs of adolescents and young adults with cancer, please feel free to visit our Website. Thank you.