The unique challenges of AYA cancer care in resource-limited settings

Abstract

IntroductionAdolescents and young adults (AYAs) diagnosed with cancer represent a distinct group with exceptional and unique characteristics. The survival rates for this age group are worse than in children or adults. Cancer care for this population is a challenge, not only for low-income countries but also for the developed world. This review addresses the unique challenges adolescents and young adults (AYAs) diagnosed with cancer in low-income countries face.MethodsTwo individual authors conducted the literature review to present the global burden of AYAs in resource-limited settings. The articles selected focused on AYA care from Latin America, Asia, and Africa.ResultsAmong the challenges of managing AYAs with cancer are the absence of national and/or hospital cancer registries, and a lack of adequate infrastructure, AYA-dedicated programs, appropriate psycho-social support, fertility preservation, and genetic counseling services. Furthermore, education and training activities specifically dedicated to the care of AYAs diagnosed with cancer are scarce in those countries.ConclusionImplementing a dedicated AYA program in resource-limited settings will be critical in providing patient-centered care bolstered by age-appropriate infrastructure and comprehensive clinical, psycho-social, and allied health support. It will significantly reduce the treatment abandonment rate, diminish the duration of diagnosis delay, and alleviate emotional detachment and disarray.

Adapting an Adolescent and Young Adult Program Housed in a Quaternary Cancer Centre to a Regional Cancer Centre: Creating Equitable Access to Developmentally Tailored Support

“…An interdisciplinary AYA advisory committee was also created to expand the perspectives and expertise informing the program [ 8 , 29 , 31 ]. The advisory committee consists of psychologists, a pediatric nurse, adult and pediatric medical oncologists, a physician’s assistant, a music therapist, a PM hospital foundation representative, researchers, AYA palliative care team providers, and a patient representative [ 29 ].…”

“…The PM Cancer Care Network developed a partnership with the Stronach Regional Cancer Centre (SRCC) at Southlake. In the form of a hub-and-spoke organization design, an opportunity arose to develop the first community based AYA program to address An interdisciplinary AYA advisory committee was also created to expand the perspectives and expertise informing the program [8,29,31]. The advisory committee consists of psychologists, a pediatric nurse, adult and pediatric medical oncologists, a physician's assistant, a music therapist, a PM hospital foundation representative, researchers, AYA palliative care team providers, and a patient representative [29].…”

“…For patients who live in rural communities or who identify with marginalized populations, the presence of and access to specialized AYA services within cancer care is further limited. Moreover, psychosocial care at large urban centers is often provided by hospital employees, whereas patients at community centres often rely on external psychosocial support in a fee for service model [ 8 , 9 ], further highlighting inequities.…”