Primary care for young adult cancer survivors: an international perspective

Abstract

PurposeInternationally, family physicians (FP) are not routinely involved in young adult cancer (YAC) care. In this short report, we would like to make a compelling argument for primary care involvement.MethodsComparative descriptions and literature review.ResultsCancer among YAs is rare and usually not the first thing that comes into the FP’s mind. Youth is sometimes mistakenly regarded as a protective factor. Across the countries, almost all YACs are treated in tertiary health care facilities with specialists providing the majority of care. Health care services are covered by the universal health insurance in Denmark, The Netherlands, and Canada but not in the US. Once the YAC has completed acute treatment and follow-up care, they often return to the care of the FPs who may potentially be expected to deal with and take action upon any possible medical, mental health, and psychosocial issues the YA cancer patient may present with. The role of the FP in follow-up care seems to be very limited.ConclusionsYACs in the western world seem to have comparable medical and psychosocial problems. However, the nature of health insurance is such that it impacts differently on the care of this group of cancer patients. Primary care features such as patient-centered, integrated, and comprehensive care over extended periods of time bring the FP into the unique position to provide follow-up for YAC. However, this will require integrating patient’s perspectives on their care, professional continuing medical education (CME) initiatives, and an enhanced cooperative effort between those delivering and coordinating cancer care.

Under the same umbrella: A model for knowledge and practice development

“…The three programmes based on the Umbrella Model have led to publication of professional articles as well as research articles in international journals, [14][15][16][17][18] three books 7,13,19 and one PhD dissertation. 20 The majority of the professional articles published in national journals were written by nurses who had never published before.…”

Inquiries of discomfort: Cancer experiences in young adulthood

“…It is now recognized that young adults with cancer often have to deal with unique medical, mental health and psycho-social issues (Hølge-Hazelton et al, 2010a, Treadgold, Kuperberg, 2010. Having cancer in young adulthood, like other serious and chronic illnesses (Hølge-Hazelton, 2002a), has a distinct affect resulting from what has been called "a disrupted biography at a critical transitional moment in the life trajectory that can have a chronic effect after the acute stage of illness is passed" (Grinyer, 2007, p. 265).…”