Nina Jackson Levin, Doctoral Student in Social Work and Anthropology, Writes Article Featured on Wiley Online Library
The first decade of adolescent and young adult (AYA) oncology psychosocial care and research (2005–2015) was driven by a normative, developmental framework that assumed a generalizable life experience for AYAs that is distinct from both younger children and older adults. As we proceed through a second decade, new considerations emerge regarding diversity of life experiences as occurring within and influenced by a complex global context. The purpose of this paper is to review and provide commentary on the impact of global and contextual conditions on AYAs. We expound upon the effects of precarious labor conditions, changing timetables and priorities for developmental tasks, sexual and gender plurality, and expanding cultural diversity. We discuss the implications of social genomics and technology and social media for enhancing precision psychosocial medicine. To build a forward‐looking approach, this paper calls for tailored, multilevel treatments that consider variability of AYAs within the social and global contexts in which they live.
Bleyer's seminal report on adolescents and young adults with cancer,1 the United States’ National Cancer Institute's subsequent establishment of an Adolescent and Young Adult (AYA) Oncology Progress Review Group,2 the advancement of practice guidelines and policy statements for AYAs globally,3-5 and an emergent body of empirical literature all distinguish an age‐defined population of cancer patients age 15–39 from both older and younger patient populations. These activities have brought warranted attention to a vulnerable and underserved population.Encountering cancer during a developmentally precarious time can complicate the experiences typical to this life phase: developing independence—both emotional and financial; cultivating self‐confidence, self‐sufficiency, and sense of identity; pursuing education, vocation, or career; experiencing social and romantic intimacy; and making sexual and reproductive choices appropriate to young adulthood. Reconciling disappointment in the thwarted vision for one's future and confronting mortality at such a young age can be particularly devastating to AYAs. Patients in this age group therefore differ from younger children and older adults diagnosed with cancer, especially in terms of psychosocial needs. This remains true throughout a continuum of care that initiates with diagnosis and persists through phases of active treatment and transitions to post‐treatment survivorship or, in many cases, the end of life.6