Can the Early Introduction of Palliative Care Alleviate the Disease Burden in Adolescents and Young Adults With Cancer?

摘要

As a result of oncology research and technology, great improvements in cancer treatment and survival have occurred in the past 2 decades. However, adolescents and young adults (AYAs) who received a diagnosis of cancer have not witnessed the same improvements in survival as children or older adults. Adolescent and young adult oncology is an emerging field that focuses on the physical and psychosocial treatment of patients between the ages of 15 and 39 years. Adolescent and young adult oncology patients experience high burden of psychological distress, in addition to physical symptoms, which affect their quality of life. Cancer is the leading disease-related cause of death in AYAs; it is imperative that healthcare professionals work to improve the high morbidity and mortality within this age group. Adolescent and young adult oncology patients would benefit from earlier implementation of palliative care. Incorporating palliative care alongside early cancer treatment regimens is beneficial in helping to relieve psychosocial and symptom burden, increase quality of life, and identify the patient's goals of care throughout the treatment process. Initiating palliative care at the beginning of treatment helps build therapeutic relationships between the patient and caregiver. When there are changes in goals of care, having an established relationship with palliative care eases the transition between active disease treatment and end-of-life care. Despite research indicating benefits to patients and increased growth of clinical and academic palliative care programs, many barriers still exist in incorporating palliative care alongside standard oncology care. Palliative care is not routinely incorporated into AYA oncology despite the high symptom burden and unique psychosocial needs of this population. This literature review discusses unique challenges that AYAs face throughout the diagnosis of cancer, identifies the unmet needs of this population, and advocates for an earlier introduction of palliative care throughout the treatment process.