The definition of adolescents and young adults (AYAs) in oncology varies with upper limits up to age 39. Younger AYAs, ages 12-24 years, are often cared for within pediatrics. In caring for AYAs with cancer, there are unique considerations that become even more important to recognize, acknowledge, and address in AYAs with lifethreatening cancer receiving palliative care. This review highlights important factors such as psychosocial development, cultural considerations, and support structure, which should be considered when providing palliative care to AYAs with cancer during the various stages of care: introduction of palliative care; symptom management; advanced care planning (ACP); end-of-life (EOL) care; and bereavement. K E Y W O R D S adolescent and young adult, end-of-life care, palliative care, pediatric oncology, support care 1 INTRODUCTION While much medical advancements have occurred in pediatric oncology, challenges in functioning, quality of life, and living with a poor prognosis contribute to symptom burden and suffering within this population. 1 Interdisciplinary palliative care (PC) teams aim to provide specialized care to patients with serious illness, and help their families to improve symptom control, ease suffering, and attend to associated psychological challenges. 2-7 When caring for adolescents and young adults (AYAs) with cancer diagnoses, there are unique considerations given their stage of psychosocial development. In this study, AYA is defined as ages 12-24 years, 8 per the World Health Organization (WHO) definition. While the upper age range of AYAs can be defined as up to 39 years, 9 the intended audience of this study paper is pediatric

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