Psychosocial care of adolescent and young adult patients with cancer and survivors

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The delivery of quality health care for adolescent and young adults with cancer and survivors requires an in-depth and comprehensive approach that focuses on the unique psychosocial challenges faced by this group.

 

Young patients with cancer are forced to mature mentally and emotionally in order to overcome the stresses they face on a day-to-day basis. Counselling and clinical care can promote the ability of these patients to cope with a cancer diagnosis and treatment. 

The psychosocial care challenges for young adults with cancer and survivors

  • Challenges in communicating information 

Puberty is a challenging time as children approach mental maturity and learn impulse control skills and goal-oriented behaviors. However, the frontal cortex of the brain only develops fully at approximately 25 years of age. This means that although young adults are capable of making responsible choices, they are not equipped to deal with the emotional and mental stresses of a cancer diagnosis and treatment. Some young adults find in-depth information on their condition to be distressing while others consider it empowering. Discus how much information the patient wants and how they want it communicated to help provide them with some sense of autonomy and involve them in their own treatment. 

  • High risk of PTSD, anxiety and depression

Studies show that adolescents and young adolescents are the most vulnerable age group for PTSD, anxiety and depression. Furthermore, the quality of life for young adolescents with cancer or survivors is poorer compared to older cancer survivors which is why therapy and counselling are vital for patients in this subset. It is important to keep in mind that these young adults have the cognitive capacity to understand the severity of their condition which is likely to result in persistent fears including a fear of death, recurrence and treatment side-effects. Cancer treatments result in weight changes, hair loss and surgical scars which can make young patients feel self-conscious and awkward and different from their peers. 

  • Forced dependence and loss of autonomy

In most cases, a cancer diagnosis means that young adults need to move back home and once again become dependent on their parents. Deterioration of physical functioning and pain management can lead to feelings of frustration and loss of independence and autonomy. Adolescents and young adults with cancer do not have the life experience and coping skills to manage the stress, emotional responses and adverse effects of their treatments. Psychosocial interventions that promote self-efficacy and coping will help these patients remain active and independent and manage the disruptions to their lives. 

  • Identity development challenges 

A cancer diagnosis during adolescence or young adulthood can disrupt the social maturation process which is vital for the development of identity and social cognition. Several studies show that young people with cancer and survivors face greater social functioning challenges as compared to their peers. Adolescence is also the time when individuals develop their sexual identity. Cancer diagnosis and treatment during this time has an impact on this development and can also raise concerns about the short-term and long-term effects of cancer treatments on future sexual experiences. 

  • Sexual functioning and intimacy

A recent study found that 49% of adolescents and young adults reported negative effects on sexual function at 1 year post-cancer diagnosis. Cancer and subsequent treatments can cause premature ejaculation, problems with erection or vaginal dryness which result in discomfort and reduces the ability to enjoy sex. The long-term effects of some cancer treatments can also reduce interest in sex and hinder intimacy. Patients are likely to believe that damage caused by their cancer treatment cannot be treated which is why it is important for doctors to address these issues. 

  • Impact of cancer on employment and wage growth 

Adolescents and young adult cancer survivors have a greater risk of unemployment as compared to older cancer survivors. This is because two thirds of real lifetime wage growth typically occurs in the first 10 years of an individual’s career. Young adult survivors often miss out on employment opportunities which can threaten their long-term career goals and can also limit their access to appropriate follow-up care due to their lack of health insurance. The added stress of unemployment will also increase the patient’s risk of depression and anxiety. 

Psychosocial interventions for adolescents and young adults with cancer helps to develop their ability to cope with the stress of their diagnosis and treatment. These evidence-based interventions help to address the unique requirements of these young patients as well as improve oncology care. Psychosocial intervention programs should include social and emotional support via support groups, access to age-relevant resources for information and practical support such as programs for re-entry into school or the work force. Studies show that female cancer survivors have twice the relative risk of anxiety than males. This is why it is essential that they are provided with information on how diet, exercise and sleep can improve overall wellness

Author’s Bio: Anita Fernandes has been writing extensively on health and wellness for over a decade. She has expertise in nutrition, fitness, public health, and weight loss and has contributed content to a variety of leading digital health publishers. Anita has a unique perspective on healthy living and lifestyle, as she has battled and overcome stress and overall wellness. She shares experiences in an effort to help others overcome the physical and mental health problems that can sometimes seem insurmountable.

 

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