Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with Cancer
Open accessAbstract
Clinical guidelines aimed at cancer care for adolescents and young adults (AYAs) encourage early integration of palliative care, yet there are scarce data to support these recommendations. We conducted a retrospective chart review of AYA patients, aged 15 to 39 years, who were referred to the Integrated AYA Palliative Care and Psychiatry Clinic (IAPCPC) at the Princess Margaret Cancer Centre between May 2017 and November 2019 (n = 69). Demographic data, symptom prevalence, change in symptom scores between baseline consultation and first follow-up, and intensity of end-of-life care were collected from the patients’ medical charts, analyzed, and reported. Of the 69 patients, 59% were female, and sarcoma was the most common cancer. A majority of patients had at least one symptom scored as moderate to severe; tiredness, pain, and sleep problems were the highest scored symptoms. More than one-third used medical cannabis to manage their symptoms. Symptom scores improved in 61% after the first clinic visit. Out of the 69 patients, 50 (72.5%) had died by October 2020, with a median time between the initial clinic referral and death of 5 months (range 1–32). Three patients (6%) received chemotherapy, and eight (16%) were admitted to an intensive care unit during the last month of life. In conclusion, AYAs with advanced cancer have a high burden of palliative and psychosocial symptoms. Creating a specialized AYA palliative care clinic integrated with psychiatry showed promising results in improving symptom scores and end-of-life planning.
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Twenty percent of patients presenting to an AYA-specific palliative care program reported a premorbid history of mental illness, with more than one-third endorsing clinically significant symptoms of anxiety and/or depression at their first clinic visit.
“Twenty percent of patients presenting to an AYA-specific palliative care program reported a premorbid history of mental illness, with more than one-third endorsing clinically significant symptoms of anxiety and/or depression at their first clinic visit [54].”
From Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness (2022) · cites this paper as [54]
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Experimental — accuracy not yet measuredIntegrating psychiatry services within an AYA-directed palliative care program may help to improve and/or prevent the worsening of depressive and anxiety symptoms among patients with advanced cancer in as little as one visit.
“Early research also suggests that integrating psychiatry services within an AYA-directed palliative care program may help to improve and/or prevent the worsening of depressive and anxiety symptoms among patients with advanced cancer in as little as one visit [54].”
From Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness (2022) · cites this paper as [54]
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References 53 · Cited by 31
- Authors
- Abdelaal, M., Mosher, P. J., Gupta, A., Hannon, B., Cameron, C., Berman, M., Moineddin, R., Avery, J., Mitchell, L., Li, M., Zimmermann, C., & al-Awamer, A.
- Affiliations
- University Health Network (CA)
- University of Toronto (CA)
- University of British Columbia (CA)
- Department of Supportive Care, University Health Network, Toronto, ON M5G 2C4, Canada
- ORCID
- Venue
- Cancers
- Publisher
- MDPI AG
- Published
- 2021-02-12
- Volume
- 13
- Issue
- 4
- Pages
- 770
- ISSN
- 2072-6694 (ISSN-L)
- PMC
- PMC7918814
- OpenAlex
- W3131925035
- Cited by
- 31
- References
- 53
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 7 · 2023: 5 · 2022: 4 · 2021: 2
- FWCI
- 3.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancers (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion, cc-by)
- cIRcle (University of British Columbia) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Open Collections
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- adolescents and young adults, cancer, palliative care, symptom burden, end-of-life care, medical cannabis, sarcoma, psychosocial symptoms, symptom scores, end-of-life planning, intensive care unit admission
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