Considerable controversy exists about whether to manage AYA with cancer at paediatric or adult facilities. AYA have unique needs that require tailored services which are currently inadequately met in adult and paediatric oncology settings.34
Evidence suggests that cancers most common in the AYA group are more like childhood cancers in terms of their biological reactions and responses to treatment.37 However, when considering the most appropriate treatment facility for an individual, consideration must be given to the ability of the unit to provide appropriate psychological and social support to the AYA.13, 34
It has been suggested that AYA oncology units offer an ideal environment for treatment, multidisciplinary interaction, skilled nursing care, individualised psychosocial support, and coordinated clinical research.34
Improved outcomes in AYA cancer have been associated with care provided in facilities with a high volume of similar caseloads annually.34
Improved survival rates have been demonstrated in health facilities with specialty caseloads in the AYA groups being treated for germ cell tumours, Hodgkin's lymphoma, sarcomas, and for bone marrow transplantation.41 The effect is particularly clear for surgical expertise where the impact of caseload on short-term outcomes is large.41 The reasons for this relationship are complex and multifactorial.
South Australian Adolescent and Young Adult Cancer Care Pathway(PDF, 2.14Mb). Department of Health, Government of South Australia (2009)42
National Service Delivery Framework for Adolescents and Young Adults with Cancer(PDF, 1.07MB). Cancer Australia & Canteen (2008)43
Access the following resources and discuss key features that have been identified in care delivery models to optimise outcomes for AYA.
- National Service Delivery Framework for Adolescents and Young Adults with Cancer(PDF, 1.07MB). Cancer Australia & Canteen (2008)43
- Steps forward: towards a service delivery improvement framework for adolescents and young adults with cancer. Cancer Forum (2009)44