RESUMO
BACKGROUND: A feature often seen in adolescent patients with cancer is a lengthy symptom interval, especially in comparison with children. It has been suggested that inadequate awareness of cancer risk among adolescents may play an important role in this study. METHODS: The Società Italiana Adolescenti con Malattie Onco-ematologiche and the Fondazione Umberto Veronesi conducted a survey to investigate health awareness among healthy adolescents and their understanding of cancer and its signs and symptoms by commissioning a specialized agency (AstraRicerche). A questionnaire was administered to 500 Italian adolescents from the age group of 15 to 19 years using the computer-aided web interviewing method. RESULTS: Approximately 80% of the adolescents interviewed claimed to be well informed about their own health, 85% said they were aware that some lifestyle habits could influence their health, and 80% reported that they know that cancer can develop in adolescence too. It was also noted that, while some adolescents were worried about a given symptom, 22% of them reportedly preferred a wait-and-see approach (either to avoid alarming their parents, or they hoped that the symptom would be temporary). CONCLUSIONS: This study showed that a majority of adolescents are concerned about their own health, but sometimes prefer not to report their symptoms to anyone. Hence, it is important to develop information campaigns tailored to raise awareness among this age group and help them interpret their symptoms.
Assuntos
Diagnóstico Tardio , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias/diagnóstico , Neoplasias/prevenção & controle , Adolescente , Promoção da Saúde , Humanos , Relações Médico-Paciente , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Being able to have children could have an important positive effect on the future lives of pediatric cancer survivors. Working at a cancer institute makes us responsible for filling the gaps in our knowledge in this area of patient care. METHODS: We describe our activities in a series of young females diagnosed with cancer and evaluated for fertility preservation options. We discuss the developed skills and organization as well as the practical difficulties encountered in managing fertility preservation. RESULTS: Since September 2012, laparoscopy and cryopreservation of cortical ovarian tissue has been performed in 16 girls (with ovary transposition in 3, and after several cycles of chemotherapy in 5) and egg banking in 4 young women (before chemotherapy in 2 and several years after treatment in 2). CONCLUSIONS: Recommendations on fertility preservation indicate that discussing the problems early on is crucial to future success. It is unthinkable to simply provide information and offer the opportunity to choose a fertility preserving technique without helping and accompanying patients and their families in their decisions and choices on the matter.
Assuntos
Criopreservação , Preservação da Fertilidade , Infertilidade Feminina/prevenção & controle , Neoplasias/terapia , Oócitos , Ovário/cirurgia , Bancos de Tecidos , Adolescente , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Quimiorradioterapia/efeitos adversos , Criança , Feminino , Preservação da Fertilidade/economia , Preservação da Fertilidade/métodos , Preservação da Fertilidade/psicologia , Humanos , Infertilidade Feminina/etiologia , Cobertura do Seguro , Itália , Neoplasias/tratamento farmacológico , Neoplasias/radioterapia , Sobreviventes , Fatores de Tempo , Bancos de Tecidos/tendências , Coleta de Tecidos e ÓrgãosRESUMO
Adolescents with cancer are a particular group of patients who are less likely to gain access to optimal cancer services at comprehensive cancer Centers: many studies suggest adolescents fare less well than children with the same disease. The paper describes the key issues of the "Youth Project" of the Pediatric Oncology Unit IRCCS Fondazione Istituto Nazionale Tumori in Milan, dedicated to adolescents (over 15 years old) and young adults (up to 25 years old) with solid tumors. This project is a possible clinical and organizational model to address the unique needs of patients in this age group and for bridge the gap in access to care and in recruitment in clinical trials, in clinical and psycho-social management and in curves of healing. The paper also describes the activity of the Adolescent Commission established by the Italian Pediatric Hematology Oncology (AIEOP).
Assuntos
Academias e Institutos/organização & administração , Medicina do Adolescente/organização & administração , Institutos de Câncer/organização & administração , Hematologia/organização & administração , Oncologia/organização & administração , Sociedades Médicas/organização & administração , Academias e Institutos/economia , Adolescente , Institutos de Câncer/economia , Gerenciamento Clínico , Feminino , Preservação da Fertilidade , Organização do Financiamento , Necessidades e Demandas de Serviços de Saúde , Arquitetura Hospitalar , Humanos , Cooperação Internacional , Internet , Itália , Masculino , Modelos Organizacionais , Neoplasias/epidemiologia , Neoplasias/psicologia , Neoplasias/terapia , Apoio Social , Taxa de Sobrevida , Adulto JovemRESUMO
The paper describes the key issues of the Youth Project launched in 2011 at the pediatric oncology unit of the Istituto Nazionale Tumori in Milan dedicated to adolescents (over 15 years old) and young adults (up to 25 years old) with solid tumors. The Youth Project was developed within the pediatric oncology unit in the conviction that adolescent patients may benefit from the multidisciplinary team typical of the pediatric oncology setting, as well as the expertise in treating pediatric-type malignancies and enrolling patients in clinical trials. The project was an offshoot of existing activities, making no major changes to the hospital's organization and posing no major demands on the institution's administration and board. Patients are managed by the pediatric oncology staff, but they have access to particular services (e.g., regarding their psychosocial support, fertility preserving measures, access to care after completing therapy); dedicated, adequately equipped multifunctional rooms have been provided. The location of the pediatric unit within a cancer referral center and the cooperation with divisions dedicated to adults have played an important role in the project's creation.
Assuntos
Comportamento do Adolescente , Neoplasias/epidemiologia , Neoplasias/terapia , Adolescente , Adulto , Criança , Pré-Escolar , Fertilidade , Acessibilidade aos Serviços de Saúde , Humanos , Lactente , Itália/epidemiologia , Aprendizagem , Oncologia/métodos , Oncologia/organização & administração , Mortalidade/tendências , Neoplasias/mortalidade , Neoplasias/psicologia , Pediatria/métodos , Pediatria/organização & administração , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Sexualidade , Apoio Social , Taxa de Sobrevida , Adulto JovemRESUMO
AIMS AND BACKGROUND: This study investigates the psychological status in a population of female patients who received chest irradiation for a childhood cancer and were screened for second primary breast cancer. METHODS: Sixty-eight consecutive such young women were included. Compilation of the Crown-Crisp Index questionnaire was requested and 49/68 patients accepted to fill it in; 14 women in the sample had children (28%). RESULTS: Twenty-seven of 49 patients achieved a normal score, whereas in 22 the score was slightly above the normal range in at least one scale. Pathological scores were more frequent among the women without children. CONCLUSION: Quality of life in this series of long-term survivors does not seem to be severely affected by previous treatment for cancer nor by the concern for the onset of a second primary malignancy.