A follow-up question to understanding the different causes of AYA cancer is to find appropriate regimens and to discover novel treatments specific for the AYA population. The five-year survival rates of AYAs diagnosed with cancer have not improved in the past two decades, and it is with the support of the TEDMED Great Challenges Program and the knowledge and expertise of health and medical professionals that we hope to see those rates improve.
Unique genetic and biological features of AYA tumors compared to their pediatric or older adult counterparts translate to different clinical behaviors for AYA cancers, thus requiring different cancer treatments. Even for cancers with little molecular differences among younger and older patients, such as with breast cancer, Dr. Donald Blair of National Cancer Institute’s Division of Cancer Biology shares that breast cancer diagnosed in younger women are more aggressive than those diagnosed in older women. The regimens required to treat breast cancer in younger as opposed to older women may therefore differ.
For AYA cancer patients, discussion about treatment with an oncologist should not be limited to chemotherapy, radiation or surgery, but should also include the effects of those treatments. Fertility preservation has long been overlooked for adolescents and young men and women, many of whom have not begun to think about their desire to have children or are concerned primarily with surviving their cancer. Choice and aggressiveness of treatments do affect fertility and must be considered. Other forms of psychosocial support need to be extended to AYA patients who may struggle with a variety of concerns. These challenges include continuing their education, adapting to the natural changes of their bodies as they progress from adolescence into young adulthood, seeking employment or maintaining their relationships.
Importantly, should an AYA cancer patient be given a pediatric or adult treatment regimen? At what point is an adolescent no longer a child? At what age should a young adult be considered an older adult? How do the answers to those questions affect the treatment that should be provided to the patient?