Health Promotion in Adolescent and Young Adult Cancer Survivors

Abstract

With rising cure rates of childhood cancer, nurse practitioners have an increased chance of encountering a large survivor cohort in practice. A variety of late effects programs exist; however, funding is limited for these programs and is not accessible for all patients. Primary providers may increasingly act as a medical home for childhood cancer survivors (CCS). Understanding the inherent risks of cytotoxic treatment and the progressive consequences of late effects is vital to limit morbidity and mortality. Adolescent and young adult survivors (AYA) are particularly apt to make health behavior decisions that create risks for comorbidities. Developmentally appropriate experimentation with drug, alcohol, or tobacco use and increased ultraviolet ray exposure intensifies the risk for secondary malignancies and novel diseases. The paucity of evidence-based surveillance guidelines and survivor-specific health promotion programs cumulatively widen the gap in noncompliance and misinformation. This article overviews the risk profile of CCS. It explores health practices, as well as emerging health promotion techniques, within the AYA survivor population and the role nurse practitioners have in enhancing health maintenance.

Promoting adherence in adolescents and young adults with cancer to optimize outcomes: A developmentally oriented narrative review

“…Similar interventions with potential promise include internet‐ and mobile phone–based engagement programs . These have been shown to facilitate individualized health promotion, peer support, and improved clinic attendance in AYA cancer survivors and AYAs with sickle cell disease, though have not been explicitly studied as an adherence‐enhancing strategy for AYAs with cancer . The acceptability of smartphone‐based applications to AYAs with cancer has been demonstrated …”

“…68 These have been shown to facilitate individualized health promotion, peer support, and improved clinic attendance in AYA cancer survivors and AYAs with sickle cell disease, though have not been explicitly studied as an adherence-enhancing strategy for AYAs with cancer. [69][70][71][72][73] The acceptability of smartphone-based applications to AYAs with cancer has been demonstrated. 74,75 AYAs with cancer identify developmentally targeted services as important to supporting disease self-management.…”

A randomized controlled pilot trial of a Web-based resource to improve cancer knowledge in adolescent and young adult survivors of childhood cancer

“…Poor cancer knowledge may also be a barrier to survivors taking important steps to mitigate health risks in their daily lives (e.g., sun protection, smoking cessation, physical activity, and diet). Additionally, survivors of childhood cancers face neurocognitive and psychosocial sequelae of their cancer and treatment (e.g., anxiety, problems in social/family relationships, and difficulties in attention or memory) , which may impact their engagement in medical care or make it challenging for them to understand their health history and risk profile . For some, ongoing follow‐up care and medical testing for late effects are associated with worry and distress .…”

Care Transitions in Childhood Cancer Survivorship: Providers' Perspectives

“…7,[15][16][17][18] At different centers, LTF is offered during oncology clinic, on designated survivors' days in oncology clinic space, and in free-standing programs with their own space and staff. 19 Regardless of how it is structured, providing LTF is resource-intensive.…”