AYA Patients Face Fertility, Cognitive Concerns Over Time

For young patients with cancer, the transition to adulthood takes on a unique dimension as they navigate the complexities of survivorship while grappling with long-term health consequences and psychosocial concerns, as Lillian Dugan, director of programs for the Dear Jack Foundation, explained to CURE® as part of the “Speaking Out” video series in a conversation about issues faced by adolescent and young adult (AYA) patients.

"They truly are in this weird group where they're not little kids, they're not in pediatrics, and they're not older adults," Dugan said. Such patients face challenges including psychosocial issues ranging from cognitive impairments to fertility concerns, which significantly impact the day-to-day lives of young survivors.

Cognitive impairments stemming from cancer treatments, pose a formidable obstacle for AYA patients academically and professionally as they work to balance college, careers and personal aspirations in the aftermath of cancer treatment. Additionally, fertility emerges as a poignant issue for many AYA patients contemplating family planning and parenthood.

“It's such a struggle, because they might not be thinking about some of these long-term effects,” Dugan said. “They might not be thinking about fertility or ‘What classes am I going to take next semester?’ because they're just trying to get through day-to-day.”

The evolution of awareness surrounding the unique needs of AYA patients represents a significant shift in cancer care. Dugan noted that increased attention to this demographic has led to greater recognition of the psychosocial and long-term consequences of cancer treatment.

“Fortunately and unfortunately, this group [of] young adults with cancer has been a little bit more pushed into the spotlight just because the statistics are showing there are so many more young adults that are being diagnosed with cancer,” Dugan said. “It's bringing more awareness. … Research-wise, it's great because we have this group of individuals that are now being focused on and really being paid attention to within the research field, which is wonderful. But at the same time, I think it's just the fact that we're seeing it more and more, and that so many more young adults are being diagnosed with cancer, that now people are paying a little bit more attention to this population.”

The severity and duration of late effects experienced by AYA patients are influenced by factors such as cancer type, stage and treatment regimens. Dugan emphasized the importance of early conversations between patients, families and care teams regarding long-term health implications and fertility preservation options. These discussions, though challenging, are vital in empowering young survivors to make informed decisions about their future care and well-being.

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