Adolescent oncology services: catching up with the kids.

摘要

In the May issue of the Journal, there is a review by Thomas et al. of the special needs of adolescents and young adults (AYA) with cancer. The special needs include cancer-specific expertise and the need for a minimum caseload in uncommon cancers, outcomes, psychosocial support, communication, education and research. The article states that outcomes in AYA patients lag behind the advances in both childhood and adult cancer. It then proceeds to discuss the possible causes for this. Included are the possibilities of adult oncologists' therapeutic nihilism, a small number of concentrated paediatric services versus a more dispersed adult service, leading to a reduction in expertise, minimum caseloads and multidisciplinaryapproach to cancer and the poor relative of adult services in the availability of psychosocial support services, especially needed in the management of the difficult adolescent.Although wholeheartedly endorsing this group's special needs, one must not forget that for the general public, the diagnosis of cancer engenders a fear that markedly exceeds any other diagnosis. Indeed, to many adults, such a personal or family diagnosis is like a large black hole opening up in front of them. All adult hospitals fall short of the National Health and Medical Research Council of Australia guidelines for the psychosocial care of adults with cancer largely because of limited funding.