Needs and Lifestyle Challenges of Adolescents and Young Adults With Cancer: Summary of an Institute of Medicine and Livestrong Foundation Workshop

Abstract

Background Among adolescents and young adults (AYAs) in the United States, cancer is the leading cause of disease-related death. AYA survivors face numerous short- and long-term health and psychosocial issues, as well as increased risk for behavioral and lifestyle challenges, including poor diet, low physical activity (PA), and substance abuse. Many of these behaviors are modifiable, but gaps in care serve as barriers for AYA survivors. Objectives The purpose of this article is to (a) raise awareness of AYAs’ increased risk for poor diet, low PA, and substance abuse; (b) examine previous interventions addressing these issues; and (c) provide recommendations for future directions. Methods This article summarizes a workshop coordinated by the Institute of Medicine and the Livestrong Foundation to address AYA survivors’ needs and ways to enhance their quality of care. Findings Oncology nurses can promote the inclusion of lifestyle behaviors in survivorship care plans of AYA patients and serve as a valuable resource in improving AYA care on a larger scale. In addition, oncology nurse researchers may offer greater understanding of AYA patients’ and survivors’ needs and best practices by conducting much-needed research with this understudied population.

The health behaviour status of teenage and young adult cancer patients and survivors in the United Kingdom

“…The primary aim of this study was to compare the health behaviours of young people with cancer to general population controls. Our results indicate that, despite the importance of health behaviour in cancer survivorship [27][28][29], young people with cancer in the UK have a similar health behaviour status to their peers in that they are largely inactive, consume diets low in fibre, lean meat and fruit and vegetables and regularly binge on alcohol. Nevertheless, reassuringly, a high proportion of TYA cancer patients and survivors held a desire to make positive lifestyle changes, specifically to be more active and have a healthier diet.…”

Lifestyle advice provision to teenage and young adult cancer patients: the perspective of health professionals in the UK

“…TYA health professionals may perceive low levels of patient enquiry about lifestyle as a lack of interest. However, a recent roundtable workshop addressing the needs and the lifestyle challenges of TYA cancer survivors concluded that health professionals working with TYA cancer patients can and should initiate discussions regarding lifestyle behaviour [8].…”

“…Given that lifestyle habits formed during adolescence and young adulthood often continue throughout the life-course, it is vital to provide young people who have had a cancer diagnosis are provided with the support necessary to make informed choices about their health behaviour. Health professionals who work with TYA cancer survivors and/or TYA aged childhood cancer survivors are well positioned to provide young people living with and beyond cancer with the right support and guidance to make healthy lifestyle choices [7,8].…”

“…Specifically, health professionals are advised to provide health behaviour counselling to young people within the context of late-effects management, especially when regarding the treatment of cardiac problems and metabolic syndrome. While there is currently no formal guidance for TYA cancer survivors receiving treatment, there is general consensus that health professionals caring for young people with cancer have a duty to advocate the importance of healthy lifestyle choices throughout the cancer care pathway [8]. Health behaviour change interventions delivered early within the care pathway have the potential to mitigate the onset of treatment-related comorbidities and prevent the development of unhealthy lifestyle habits, such as inactivity and poor dietary intake, often noted during cancer therapy [9].…”

Substance use behaviors in adolescent and young adult cancer patients: Associations with mental and physical health

“…Unique to AYAs is that cancer diagnosis occurs during a developmental stage characterized by the transition from adolescence to adulthood, coinciding with significant developmental milestones such as living independently, entering the workforce, and establishing committed relationships . This transition period often coincides with the initiation of risky health behaviors, such as substance use and a more sedentary lifestyle, and the emergence of affective disturbance …”