Medical research has made great progress in preventing, detecting and treating cancer over the past 25 years, but the benefits of that success do not extend to adolescents and young adults, according to a national report.
"We've seen virtually no improvements in cancer survival rates in young people between the ages of 15 and 39 during that same time period," says Dr. Michael Caligiuri, director of The Ohio State University Comprehensive Cancer Center.
Drug Clinical Trials
The reason? These patients have "fallen through the cracks on every front, including clinical, research, financial and psychosocial." That is the conclusion of Closing the Gap: A Strategic Plan, a comprehensive report published by the National Cancer Institute's Adolescent and Young Adult Oncology Progress Review Group and the Lance Armstrong Foundation's Livestrong Young Adult Alliance.
Caligiuri is one of four medical scientists selected by the NCI to lead the progress review group.
"The question is whether a cancer diagnosis in a child is different than the same diagnosis in an adolescent or a young adult," says Caligiuri, who is also CEO of the James Cancer Hospital and Solove Research Institute. "I believe that it most certainly is, but we need more researchers and more funding so we can ask and answer questions about the nature of these cancers and their potential treatments."
Besides slim access to appropriate clinical care, inadequate insurance, youthful feelings of invincibility, and delayed or missed clinical diagnoses, the report lists several other reasons for the dilemma:
A lack of awareness that cancer is the fourth leading cause of death after homicide, suicide and unintentional injury) among people aged 15 to 39;
Many in this age group are students or professionals who don't have primary care providers or take the time to visit them;
These patients are often referred to inappropriate medical specialists and are therefore less likely to benefit from advanced therapies.
To address these concerns, the report recommends providing education, training and communication to improve awareness, prevention, access and quality of care for adolescent and young adult cancer patients. It also encourages enhancing clinical-trial activity, developing standards-of-care guidelines, and strengthening and promoting advocacy and support for these cancer patients.
"The cancers of adolescents and young adults somehow seem to be different, and so they need their own clinical trials," says Caligiuri. "But few of these patients are directed to clinical trials, and that needs to change."