Palliative care for adolescents and young adults with cancer

Adolescents and young adults (AYAs) with cancer represent a unique and challenging group of patients with distinct developmental and psychosocial needs that may be unrecognized or unmet during their cancer experience. Palliative care refers to the total care of a patient, regardless of his or her disease status, and aims to improve quality of life by controlling symptoms and alleviating physical, social, psychological, and spiritual suffering. Integrating palliative care into standard oncology practice for AYAs is therefore valuable, if not imperative, in improving their overall cancer experience. In this review, we aimed to describe the scope, benefits, and challenges of palliative care for AYA oncology patients. We provide a broad impression of the existing literature describing or investigating palliative care in this population. Put together, the evidence suggests that palliative care is not only needed, but can also be critically beneficial to patients, families, and health care professionals alike. As we increase public and professional awareness of the needs and applications of palliative care for AYA patients with cancer, we will ultimately enable better psychosocial outcomes for the AYA patients and their larger communities.

Among the challenges of caring for AYA patients is the fact that they have unique developmental and psychosocial needs that are distinct from those of pediatric and adult patients and that may be unrecognized or unmet during their cancer experience. AYA development is characterized by the establishment of individual identity.

The scope of palliative care in AYAs

Because “palliative care” was viewed as being synonymous with “end-of-life care,” subspecialty palliative-care teams historically were involved only in challenging or “end-stage” cases. However, as the concept of concurrent palliative care has evolved, so too has its scope. While primary oncology teams may be adept at providing primary palliative care, and while patients continue to rely on them for guidance, current models of palliative care suggest that interdisciplinary approaches that include both the primary oncology team and specialized palliative-care staff enable optimal patient and family care, regardless of the outcome.