Adolescence and young adulthood is a dynamic and distinct developmental period and in recent years has emerged as a distinct field in oncology (Cancer Australia 2008; Canteen 2017). This focus has helped address the lack of progress in survival and quality-of-life outcomes for this group (Ferrari et al. 2010).

The needs of adolescents and young adults with cancer

(This section has been reproduced with permission from the Australian youth cancer framework,

Canteen 2017, pp. 4–5.)

Young people with cancer face an unexpected, life-changing and extraordinary challenge to accept, manage and overcome a critical illness during this transformative stage of life. In addition to facing

a potentially life-threatening illness at a time that is usually filled with life-affirming potential, young people with cancer face a range of challenges that have particularly significant impact at this stage of life (see diagram below).

In caring for young people with cancer, akin to the comorbidities that require specific care in the older cancer population, the treatment team needs to pay careful attention to promoting normal development (COSA 2014). This requires personalised assessments and management involving a multidisciplinary, disease-specific, developmentally targeted approach that adheres to the following principles:

• understanding the developmental stages of adolescence and supporting normal adolescent health and development alongside cancer management
• understanding and supporting the rights of young people
• communication skills and information delivery that are appropriate to the young person
• meeting the needs of all involved, including the young person, their carers and their family
• working with educational institutions and workplaces
• considering survivorship and palliative care

An oncology team caring for an adolescent or young adult with cancer should be able to demonstrate these specific areas of expertise:

• be able to ensure access to expert adolescent and young adult health providers who have knowledge specific to the biomedical and psychosocial needs of the population
• understand the biology and current management of the disease in the adolescent and young adult age group
• consider participating in research and clinical trials for each patient
• engage in proactive discussion and management of fertility preservation, late effects of treatment, ongoing need for contraception, and psychosocial and psychosexual needs
• provide treatment in an environment that is friendly to adolescents and young

If a young person is aged 15–25 years, contact with Youth Cancer Services  is recommended for advice or referral regarding developmentally appropriate treatment and support.

The comprehensive model of care offered by Youth Cancer Services is consistent with national optimal care pathways developed by the Australian Government’s National Cancer Expert Reference Group. Specialist, age-appropriate medical, nursing and allied health treatment and support is offered to young cancer patients via a national network of hospitals.

At the time of publication, a population based optimal care pathway for adolescents and young adults with cancer was under development. This resource provides a tool to help guide system safety and responsiveness to the unique needs of adolescents and young adults diagnosed with cancer and improve outcomes and experience. It can be used in conjunction with the optimal care pathway for each cancer type.