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Ferrari A, Perillo T, Milano GM, Silva M, Rutigliano C, Salvo A, Livellara V, Conte M, Coccoli L, Amore E, Pierobon M, Vietina F, Pagani Bagliacca E, Spinelli M, Massei MS, Massetti V, Legnani E, Puglisi I, Zucchetti G, Quarello P. The power of art and the powers of adolescents with cancer: Age-specific projects at Italian pediatric oncology centers. TUMORI JOURNAL 2024; 110:218-226. [PMID: 38591573 DOI: 10.1177/03008916241245005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
This article describes the oncology programs developed in Italy for adolescents and young adults with cancer, with a specific focus on the local projects created in pediatric oncology centers. A common feature of such projects is the emphasis on creative and artistic activities and laboratories (involving music, photography, novel writing, fashion design, and so on) designed to give young patients innovative means of expression.This article highlights the amazing powers of adolescents involved in these projects: the power to produce beautiful things in a place that is not normally associated with the idea of beauty; the power to make their doctors smile and grasp the profound sense of life; the power to make hospitals become places for producing culture.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Teresa Perillo
- Pediatric Hematology-Oncology Division, Department of Pediatrics, University of Bari, Bari, Italy
| | | | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Rutigliano
- Pediatric Hematology-Oncology Division, Department of Pediatrics, University of Bari, Bari, Italy
| | - Andrea Salvo
- Hematology/Oncology, Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italy
| | - Virginia Livellara
- Department of Pediatric Hematology/Oncology, Giannina Gaslini Children's Hospital, Genoa, Italy
| | - Massimo Conte
- Department of Pediatric Hematology/Oncology, Giannina Gaslini Children's Hospital, Genoa, Italy
| | - Luca Coccoli
- Pediatric Hematology-Oncology Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Elena Amore
- Pediatric Hematology-Oncology Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marta Pierobon
- Pediatric Hematology Oncology Division, University of Padua, Padua, Italy
| | - Francesco Vietina
- Pediatric Hematology Oncology Division, University of Padua, Padua, Italy
| | - Elena Pagani Bagliacca
- Pediatric Hematology-Oncology Department, Fondazione MBBM, Ospedale San Gerardo, Monza, Italy
| | - Marco Spinelli
- Pediatric Hematology-Oncology Department, Fondazione MBBM, Ospedale San Gerardo, Monza, Italy
| | - Maria Speranza Massei
- Pediatric Oncology-Hematology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Valentina Massetti
- Pediatric Oncology-Hematology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Elena Legnani
- Hematology-Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Ilaria Puglisi
- Hematology-Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulia Zucchetti
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy
| | - Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy
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Abraham O, McCarthy TJ. An Introduction to the OutSMART Cancer Serious Game: Current and Future Directions. JMIR Cancer 2024; 10:e56168. [PMID: 38809587 PMCID: PMC11170044 DOI: 10.2196/56168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/21/2024] [Accepted: 04/24/2024] [Indexed: 05/30/2024] Open
Abstract
Given that cancer is a challenging disease that plagues millions of individuals of all age groups and socioeconomic statuses globally, developmentally appropriate education is often lacking for young people, particularly adolescents. Increasing cancer awareness and prevention education among adolescents using innovative strategies, such as game-based learning, is critical in reducing the burden of this disease. Adolescents are understudied in the field of cancer prevention and control, yet vulnerable as they tackle creating life-long health behavior patterns. Targeting cancer prevention education for adolescents has the potential to support long-term healthy behavior and reduce their risk of cancer. This paper provides an overview of the Collaborative Research on MEdication use and family health (CRoME) Lab's novel game-based cancer prevention education tool. OutSMART Cancer is an innovative, novel educational intervention in the form of a serious game. Serious games are educational tools that seek to impart knowledge and improve behaviors in their players. This game covers information related to breast cancer, colon cancer, and lung cancer. This viewpoint is a summary of the developmental process for the OutSMART Cancer game. We describe in detail the work preceding initial game development, the current version of the game, future directions for the game, and its educational potential. The long-term goal of OutSMART Cancer is to improve cancer awareness and knowledge regarding prevention behaviors in adolescents and support a lifetime of health and wellness.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Tyler J McCarthy
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
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Marsh L, McNoe B, Venter N, Quigg R, Notoa F, Reeder AI. Awareness of cancer among adolescents: A study of nine focus groups in Aotearoa New Zealand. Health Promot J Austr 2023. [PMID: 37961934 DOI: 10.1002/hpja.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/22/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
ISSUE ADDRESSED One third of cancers are potentially preventable by modifying key risk factors that arise during adolescence. To help inform prevention efforts, we investigated adolescents' understanding of cancer risk factors, symptoms and signs and barriers to help-seeking. METHODS Nine focus groups were conducted with purposefully sampled, binary-gendered friendship groups of 12 to 17-year-olds. Interviews were analysed using a qualitative descriptive method based on the topic schedule, transcripts and field notes. RESULTS Behavioural, genetic and environmental factors were commonly explored as risk factors. Most cancer symptoms identified focused on physical indicators, such as lumps and skin appearance. Facilitators and barriers to good health choices involved both external and internal factors: education, affordability, attitudes and the social environment. Most participants indicated they would talk to trusted friends and family members about health issues, but only when the condition became 'serious'. The most common source of health information was the internet. CONCLUSIONS Adolescents have a good understanding of behavioural risk factors, but poor knowledge of some key cancer symptoms. A support system was recognised to be a substantive factor in dealing with health issues, as were youth-focused health services. Understanding of the preventability of many cancers was not widespread with participants. SO WHAT?: The results emphasise a requirement for appropriate, affordable and accessible youth-focused health services. There is a need for age- and culturally appropriate interventions that improve knowledge of cancer symptoms. Immunisation against the viruses implicated in cervical cancer is one example of a clinical cancer prevention intervention in adolescence.
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Affiliation(s)
- Louise Marsh
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Bronwen McNoe
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Noeleen Venter
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Robin Quigg
- Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Faith Notoa
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Anthony I Reeder
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Silva M, Rizzo S, Patriccioli A, Sironi G, Clerici CA, Massimino M, Ferrari A. Of soldiers and heroes. TUMORI JOURNAL 2023; 109:141-142. [PMID: 36314256 DOI: 10.1177/03008916221132590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Rizzo
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alice Patriccioli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo Alfredo Clerici
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Abraham O, Szela L, Feng E, Egbujor M, Gay S. Exploring Youth Perceptions About Cancer Prevention and Preferences for Education: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:50-59. [PMID: 34387834 PMCID: PMC8360774 DOI: 10.1007/s13187-021-02077-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/04/2021] [Indexed: 05/04/2023]
Abstract
This study aimed to characterize adolescents' perspectives on cancer and cancer prevention and to explore their preferences for cancer education. A total of 188 middle and high school students participated in 25 focus groups. Focus groups were led by study team members and included five to ten participants each. Adolescents were asked to discuss their cancer and cancer prevention knowledge, sources of cancer education, and preferences for cancer prevention education. Focus groups were audio-recorded, and professionally transcribed. Transcripts were content and thematically analyzed by two study team members using NVivo qualitative data software. Six themes were identified in focus groups: knowledge about cancer, negative perceptions of cancer, awareness of cancer prevention, engagement in cancer prevention, facilitators and barriers for action, and preferences for cancer education. Adolescents described a wide range of cancer education sources, including friends, family, healthcare professionals, school, technology, and pamphlets. Participants associated cancer with negative emotions, such as sadness and fear. Participants expressed interest in learning about cancer and cancer prevention, but also identified barriers to engaging in preventative behaviors, such as discomfort, lack of knowledge, and lack of personal connection to cancer. Adolescents preferred learning through personal presentations, online videos, school, educational games, and social situations. Adolescence is a critical period for learning and developing healthy behaviors. Awareness of cancer and cancer prevention is crucial to lowering cancer risk in the future. To be effective, cancer education for adolescents should target specific areas of cancer prevention and address barriers to engagement in preventative behaviors.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division , University of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, Suite 2515, Madison, USA.
| | - Lisa Szela
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, 53705, USA
| | - Emilie Feng
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, 53705, USA
| | - Maryann Egbujor
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, 53705, USA
| | - Sommer Gay
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, 53705, USA
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Abrahão R, Cooley JJ, Maguire FB, Parikh-Patel A, Morris CR, Schwarz EB, Wun T, Keegan TH. Stage at diagnosis and survival among adolescents and young adults with lymphomas following the Affordable Care Act implementation in California. Int J Cancer 2022; 150:1113-1122. [PMID: 34800045 PMCID: PMC8810606 DOI: 10.1002/ijc.33880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/27/2021] [Accepted: 11/10/2021] [Indexed: 12/19/2022]
Abstract
Adolescents and young adults (AYAs, 15-39 years) are the largest uninsured population in the Unites States, increasing the likelihood of late-stage cancer diagnosis and poor survival. We evaluated the associations between the Affordable Care Act (ACA), insurance coverage, stage at diagnosis and survival among AYAs with lymphoma. We used data from the California Cancer Registry linked to Medicaid enrollment files on AYAs diagnosed with a primary non-Hodgkin (NHL; n = 5959) or Hodgkin (n = 5378) lymphoma pre-ACA and in the early and full ACA eras. Health insurance was categorized as continuous Medicaid, discontinuous Medicaid, Medicaid enrollment at diagnosis/uninsurance, other public and private. We used multivariable regression models for statistical analyses. The proportion of AYAs uninsured/Medicaid enrolled at diagnosis decreased from 13.4% pre-ACA to 9.7% with full ACA implementation, while continuous Medicaid increased from 9.3% to 29.6% during this time (P < .001). After full ACA, AYAs with NHL were less likely to be diagnosed with Stage IV disease (adjusted odds ratio [aOR] = 0.84, 95% confidence interval [CI] = 0.73-0.97). AYAs with lymphoma were more likely to receive care at National Cancer Institute-Designated Cancer Centers (aOR = 1.42, 95% CI = 1.28-1.57) and had lower likelihood of death (adjusted hazard ratio = 0.54, 95% CI = 0.46-0.63) after full ACA. However, AYAs from the lowest socioeconomic neighborhoods, racial/ethnic minority groups and those with Medicaid continued to experience worse survival. In summary, AYAs with lymphomas experienced increased access to healthcare and better clinical outcomes following Medicaid expansion under the ACA. Yet, socioeconomic and racial/ethnic disparities remain, calling for additional efforts to decrease health inequities among underserved AYAs with lymphoma.
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Affiliation(s)
- Renata Abrahão
- Center for Healthcare Policy & Research, University of California Davis, Sacramento-CA
- Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Davis Comprehensive Cancer Center, Sacramento-CA
| | - Julianne J.P. Cooley
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento-CA
| | - Frances B. Maguire
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento-CA
| | - Arti Parikh-Patel
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento-CA
| | - Cyllene R. Morris
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento-CA
| | - Eleonor Bimla Schwarz
- Center for Healthcare Policy & Research, University of California Davis, Sacramento-CA
| | - Ted Wun
- Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Davis Comprehensive Cancer Center, Sacramento-CA
| | - Theresa H.M. Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Davis Comprehensive Cancer Center, Sacramento-CA
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Ingley KM, Maleddu A, Grange FL, Gerrand C, Bleyer A, Yasmin E, Whelan J, Strauss SJ. Current approaches to management of bone sarcoma in adolescent and young adult patients. Pediatr Blood Cancer 2022; 69:e29442. [PMID: 34767314 DOI: 10.1002/pbc.29442] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/02/2021] [Accepted: 10/16/2021] [Indexed: 01/05/2023]
Abstract
Bone tumors are a group of histologically diverse diseases that occur across all ages. Two of the commonest, osteosarcoma (OS) and Ewing sarcoma (ES), are regarded as characteristic adolescent and young adult (AYA) cancers with an incidence peak in AYAs. They are curable for some but associated with unacceptably high rates of treatment failure and morbidity. The introduction of effective new therapeutics for bone sarcomas is slow, and to date, complex biology has been insufficiently characterized to allow more rapid therapeutic exploitation. This review focuses on current standards of care, recent advances that have or may soon change that standard of care and challenges to the expert clinical research community that we suggest must be met.
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Affiliation(s)
- Katrina M Ingley
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK
| | - Alessandra Maleddu
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK
| | - Franel Le Grange
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK
| | - Craig Gerrand
- London Sarcoma Service, Department of Orthopaedic Oncology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - Archie Bleyer
- Oregon Health and Science University, Portland, Oregon
| | - Ephia Yasmin
- Reproductive Medicine Unit, University College London Hospitals NHS Trust, London, UK
| | - Jeremy Whelan
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK
| | - Sandra J Strauss
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK.,UCL Cancer Institute, London, UK
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Ferrari A, Quarello P, Mascarin M, Luigi Banna G, Toss A, Sironi G, Zecca M, Cinieri S, Alessandro Peccatori F. Italian pediatric and adult oncology communities join forces for a national project dedicated to adolescents and young adults with cancer. TUMORI JOURNAL 2021; 108:104-110. [PMID: 34841968 DOI: 10.1177/03008916211058790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adolescents and young adults with cancer have substantially different clinical and psychological needs compared to those of pediatric patients and of older adult patients. We describe the development of an Italian national project dedicated to adolescents and young adults with cancer.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Torino, University of Torino, Italy
| | - Maurizio Mascarin
- AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy
| | - Giuseppe Luigi Banna
- Interdisciplinary Group for Translational Research and Clinical Trials, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Angela Toss
- Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Italy
| | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marco Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Saverio Cinieri
- Medical Oncology Unit and Breast Unit, Ospedale Perrino ASL Brindisi, Italy
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9
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Quarello P, Ferrari A, Mascarin M, Milano GM, Tornesello A, Bertolotti M, Spinelli M, Pierobon M, Perillo T, Maule M, Zecca M, Pession A, Fagioli F. Diagnostic Delay in Adolescents with Cancer During COVID-19 Pandemic: A New Price for Our Patients to Pay. J Adolesc Young Adult Oncol 2021; 11:316-319. [PMID: 34677087 DOI: 10.1089/jayao.2021.0057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Worldwide, the coronavirus 19 disease pandemic caused a worse chance of a timely diagnosis for cancer patients. We conducted a retrospective analysis of new diagnoses registered in the national pediatric oncology database, comparing the first lockdown period (March-May 2020) with the same period of 2015-2019. The total number of cases (0-19 years) dropped by 20.8% (from 441 between 2015 and 2019 to 349 in 2020). A major reduction was observed for adolescents (15-19 years) (-32.9%) and for adolescents with solid tumors (-56.4%, p = 0.03). Our data suggest that the enforced lockdown reduced the possibility for these already vulnerable patients to access the referral centers.
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Affiliation(s)
- Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Department, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Regina Margherita Children's Hospital, Torino, Italy.,University of Torino, Torino, Italy
| | - Andrea Ferrari
- Pediatric Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Maurizio Mascarin
- AYA and Pediatric Radiotherapy Department, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Giuseppe M Milano
- Department of Pediatric Hematology and Oncology and of Cell and Gene Therapy, Scientific Institute for Research and Healthcare (IRCCS), Bambino Gesù Childrens' Hospital, Rome, Italy
| | | | - Marina Bertolotti
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Department, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Regina Margherita Children's Hospital, Torino, Italy
| | - Marco Spinelli
- Department of Pediatrics, University of Milano-Bicocca, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy
| | - Marta Pierobon
- Hematology and Oncology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Teresa Perillo
- Pediatric Hematology-Oncology Division, Department of Pediatrics, University of Bari, Bari, Italy
| | - Milena Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Marco Zecca
- Pediatric/Hematology/Oncology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Pession
- Pediatric Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Department, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Regina Margherita Children's Hospital, Torino, Italy.,University of Torino, Torino, Italy
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10
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Zecca M, Ferrari A, Quarello P, Rabusin M, Balduzzi A, Buldini B, Rostagno E, Prete A, Favre C, Massimino M, Biondi A, Porta F, Biffi A, Locatelli F, Pession A, Fagioli F. Childhood cancer in Italy: background, goals, and achievements of the Italian Paediatric Hematology Oncology Association (AIEOP). TUMORI JOURNAL 2021; 107:370-375. [PMID: 33876662 DOI: 10.1177/03008916211007934] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article reviews the primary goals and achievements of the Italian Association for Pediatric Hematology-Oncology (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]), a national cooperative group that has been working for children and adolescents with cancer in Italy since 1975.
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Affiliation(s)
- Marco Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Lombardia, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, University of Torino, Piemonte, Italy
| | - Marco Rabusin
- Institute for Maternal and Child Health, "IRCCS Burlo Garofolo" Trieste, Trieste, Friuli-Venezia Giulia, Italy
| | - Adriana Balduzzi
- Pediatric Department, University of Milano Bicocca, MBBM Foundation, ASST Monza Ospedale San Gerardo, Monza, Lombardia, Italy
| | - Barbara Buldini
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Mother and Child's Health Department, University of Padova, Padova, Veneto, Italy
| | - Elena Rostagno
- Hematology-Oncology Unit, Department of Pediatrics - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Arcangelo Prete
- Hematology-Oncology Unit, Department of Pediatrics - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Claudio Favre
- Paediatric Haematology/Oncology and HSCT Department, Anna Meyer Children's University Hospital, Firenze, Toscana, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Andrea Biondi
- Pediatric Department, University of Milano Bicocca, MBBM Foundation, ASST Monza Ospedale San Gerardo, Monza, Lombardia, Italy
| | - Fulvio Porta
- Pediatric Haematology Oncology and BMT Unit, Ospedale dei Bambini, ASST-Spedali Civili of Brescia, Brescia, Lombardia, Italy
| | - Alessandra Biffi
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Mother and Child's Health Department, University of Padova, Padova, Veneto, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology, Bambino Gesù Children's Hospital, Roma, Lazio, Italy
| | - Andrea Pession
- Hematology-Oncology Unit, Department of Pediatrics - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, University of Torino, Piemonte, Italy
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11
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Ferrari A, Stark D, Peccatori FA, Fern L, Laurence V, Gaspar N, Bozovic-Spasojevic I, Smith O, De Munter J, Derwich K, Hjorth L, van der Graaf WTA, Soanes L, Jezdic S, Blondeel A, Bielack S, Douillard JY, Mountzios G, Saloustros E. Adolescents and young adults (AYA) with cancer: a position paper from the AYA Working Group of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE). ESMO Open 2021; 6:100096. [PMID: 33926710 PMCID: PMC8103533 DOI: 10.1016/j.esmoop.2021.100096] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/17/2022] Open
Abstract
It is well recognised that adolescents and young adults (AYA) with cancer have inequitable access to oncology services that provide expert cancer care and consider their unique needs. Subsequently, survival gains in this patient population have improved only modestly compared with older adults and children with cancer. In 2015, the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE) established the joint Cancer in AYA Working Group in order to increase awareness among adult and paediatric oncology communities, enhance knowledge on specific issues in AYA and ultimately improve the standard of care for AYA with cancer across Europe. This manuscript reflects the position of this working group regarding current AYA cancer care, the challenges to be addressed and possible solutions. Key challenges include the lack of specific biological understanding of AYA cancers, the lack of access to specialised centres with age-appropriate multidisciplinary care and the lack of available clinical trials with novel therapeutics. Key recommendations include diversifying interprofessional cooperation in AYA care and specific measures to improve trial accrual, including centralising care where that is the best means to achieve trial accrual. This defines a common vision that can lead to improved outcomes for AYA with cancer in Europe.
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Affiliation(s)
- A Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - D Stark
- Leeds Institute of Medical Research, School of Medicine University of Leeds, Leeds, UK.
| | - F A Peccatori
- Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy
| | - L Fern
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - V Laurence
- Medical Oncology Department and SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, Paris, France
| | - N Gaspar
- Department of Oncology for Child and Adolescent, Gustave Roussy Cancer Campus, Villejuif, France
| | - I Bozovic-Spasojevic
- Medical Oncology Department, Institute for Oncology and Radiology of Serbia, Belgrade, Republic of Serbia
| | - O Smith
- National Children's Cancer Service, Children's Health Ireland at Crumlin and Systems Biology Ireland, University College Dublin, Dublin, Ireland
| | - J De Munter
- University Hospital Ghent Cancer Center, UZ Gent, Ghent, Belgium
| | - K Derwich
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - L Hjorth
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Pediatrics, Lund, Sweden
| | - W T A van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L Soanes
- Teenage Cancer Trust, London, UK
| | - S Jezdic
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - A Blondeel
- Department of Scientific Programme Coordination, European Society for Paediatric Oncology (SIOPE), Brussels, Belgium
| | - S Bielack
- Zentrum für Kinder, Jugend und Frauenmedizin Pädiatrie 5, KlinikumStuttgart - Olgahospital, Stuttgart, Germany
| | - J-Y Douillard
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Mountzios
- 2nd Department of Medical Oncology and Clinical Trial Unit, Henry Dunant Hospital, Athens, Greece
| | - E Saloustros
- Department of Oncology, University Hospital of Larissa, Larissa, Greece
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Abraham O, Rosenberger CA, LeMay SM, Bittner SJ. Adolescents' Perceptions About Cancer and Preferences for Cancer Education. Cancer Control 2021; 28:10732748211036057. [PMID: 34403277 PMCID: PMC8375333 DOI: 10.1177/10732748211036057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cancer is one of the leading causes of death within the United States. Adolescence remains a critical stage of development in which new cognitive skills and lifestyle factors related to cancer are acquired. It is critical to understand adolescents' knowledge of cancer and preferences for receiving clear and easy-to-comprehend information about cancer and cancer prevention. The purpose of this study was to explore adolescents' perceptions of cancer and cancer risk factors and identify their preferences for receiving cancer prevention education. METHODS The survey used in this study was based on the Health Belief Model framework, the Youth Risk Behavior Survey, and the Cancer, Clear & Simple (CC&S) Curriculum. The survey evaluated adolescents' knowledge, attitudes, and health-related behaviors regarding cancer and cancer prevention among adolescents. Three Midwestern middle and high schools were recruited, and 235 students completed the survey. Survey responses were analyzed using descriptive statistics. RESULTS Study participants had some basic knowledge of cancer; however, only 66% recognized that individuals have control over their risk of developing cancer. Participants (95%) reported that cancer prevention was important, yet only 37.3% stated they knew how to lower their risk of getting cancer and 50% indicated that they currently try to make decisions that lower their chances of getting cancer. About 82% stated that an educational game would be a useful tool to learn about cancer and prevention. CONCLUSION Study findings indicate the need for an increase in adolescent knowledge of cancer, specifically how they can control their cancer risk, and prevention strategies through development of game-based education to teach adolescents about cancer-related topics.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
- Olufunmilola Abraham, PhD, MS, BPharm, Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, Madison, WI 53705-2222, USA.
| | - Claire A. Rosenberger
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
| | - Sarah M. LeMay
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
| | - Sarah J. Bittner
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
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Giuseppe GD, Pelullo CP, Mitidieri M, Lioi G, Pavia M. Cancer Prevention: Knowledge, Attitudes and Lifestyle Cancer-Related Behaviors among Adolescents in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228294. [PMID: 33182588 PMCID: PMC7698075 DOI: 10.3390/ijerph17228294] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/24/2022]
Abstract
This study explores knowledge, attitudes and lifestyle behaviors related to cancer in a sample of adolescents. Data were collected through a self-administered questionnaire. 871 adolescents agreed to participate, with a response rate of 96.8%. Only 26.1% had a good level of knowledge on most risk factors for cancer. Adolescents with both parents employed, with a personal, familiar or friend history of cancer or having received information about cancer prevention from a physician, were more likely to have good knowledge about the risk factors for cancer. In total, 41% of participants declared that they consumed alcohol and 25.3% declared they were current smokers, 19.2% consumed fruits or vegetables more than once a day and 75.2% reported poor physical activity. Older adolescents, with a personal, familiar or friend history of cancer, not having one parent in the healthcare sector or not physically active were significantly more likely to be current smokers, whereas physical activity was significantly more likely in adolescents who had been informed by physicians on cancer prevention, and had one parent in the healthcare sector. This study highlights a need for improved education of adolescents about cancer prevention and lifestyle cancer-related behaviors.
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Affiliation(s)
| | | | | | | | - Maria Pavia
- Correspondence: ; Tel./Fax: +39-081-566-7716
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Casanova M, Pagani Bagliacca E, Silva M, Patriarca C, Veneroni L, Clerici CA, Spreafico F, Luksch R, Terenziani M, Meazza C, Podda M, Biassoni V, Schiavello E, Chiaravalli S, Puma N, Bergamaschi L, Gattuso G, Sironi G, Massimino M, Ferrari A. How young patients with cancer perceive the COVID-19 (coronavirus) epidemic in Milan, Italy: Is there room for other fears? Pediatr Blood Cancer 2020; 67:e28318. [PMID: 32240567 DOI: 10.1002/pbc.28318] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 01/26/2023]
Abstract
The rapid spread of coronavirus disease 2019 epidemic in Italy, in particular in the Milan focal point, required drastic measures and led to panic in the population. While in our center we did not change our approach to the treatment of our young patients with cancer, we developed a qualitative survey to assess their perception of the risk and level of stress. The survey showed that a relatively large proportion of young patients felt personally at risk of severe complications. We believe that we need to adequately inform our patients, focusing on hygienic measures and personal protection and prompt reporting of any suspicious symptoms.
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Affiliation(s)
- Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo Patriarca
- Pathology Unit, St. Anna Hospital (ASST Lariana), Como, Italy
| | - Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo Alfredo Clerici
- Faculty of Medicine, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Clinical Psychology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Luksch
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marta Podda
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nadia Puma
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Gattuso
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Pagani Bagliacca E, Sironi G, Veneroni L, Gaggiotti P, Silva M, Signoroni S, Casanova M, Cattaneo F, Chiaravalli S, Puma N, Gattuso G, Bergamaschi L, Schiavello E, Clerici CA, Massimino M, Ferrari A. Tumorial: Video Tutorials Produced by Young Patients on the Youth Project to Voice Their Experiences. J Adolesc Young Adult Oncol 2020; 9:436-440. [DOI: 10.1089/jayao.2020.0008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paola Gaggiotti
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Signoroni
- Hereditary Digestive Tract Tumors Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesca Cattaneo
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nadia Puma
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Gattuso
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo Alfredo Clerici
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- SSD Clinical Psychology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Zucchetti G, Tirtei E, Bertorello N, De Luna E, Vallero S, Fagioli F. Translation and cultural adaptation of the US National Cancer Institute's patient-reported outcome (PRO) version of the CTCAE for Italian pediatric oncology populations. Eur J Oncol Nurs 2018; 35:67-72. [PMID: 30057086 DOI: 10.1016/j.ejon.2018.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 05/16/2018] [Accepted: 05/21/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE This study intends to translate and make any necessary cultural adaptations of the Pediatric PRO-CTCAE version for Italian oncological patients aged 7-18 years and their caregivers. METHODS The questionnaire has been forward/backward translated into Italian and subjected to detailed verification by fluent Italian speakers, children and their parents, for use in clinical trials in Italian populations. The Italian version includes 130 questions that assess 62 symptoms. To verify the patients' comprehension some interviews were completed with 24 oncological children and adolescents in different age groups and 24 parents (Mage = 41.2). Caregivers were interviewed independently. RESULTS A final Italian version of the Pediatric PRO-CTCAE was produced. Across the age range, most patients and caregivers were able to understand and answer the questions. The 7-9 years old had greater challenges completing two terms which were retested in a second round of interviews. There were no comprehension differences on the basis of trials enrollment phase. CONCLUSIONS The translation and adaptation of the Pediatric PRO-CTCAE confirms that this instrument is also suitable for assessing symptom toxicities among Italian cancer patients. Its rapid integration into care pathways is necessary to guarantee an early response to patient symptoms and to facilitate drug tolerability assessment.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy.
| | - Elisa Tirtei
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Nicoletta Bertorello
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Elvira De Luna
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Stefano Vallero
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
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18
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Hughes N, Stark D. The management of adolescents and young adults with cancer. Cancer Treat Rev 2018; 67:45-53. [PMID: 29753962 DOI: 10.1016/j.ctrv.2018.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 12/11/2022]
Abstract
Adolescents and Young Adults (AYA) with cancer are young people developing serious illness when at the interface between the responsibilities of paediatric and adult cancer services. Personally, they are in a period of transition both biologically and in major social roles (Sawyer et al., 2018) [1]. For these and other reasons they present a unique set of clinical challenges in their management. Over the last 20 years the requirement for specific services to address their needs has been identified and this has become a growing field of research. Despite this survival rates still lag behind those of children and older adults with cancer (Gatta et al., 2009) [2]. Why do AYA patients have worse outcomes? The observation is that the reason is multifactorial with path to diagnosis, unique cancer biology, uncertainty of treatment protocol, compliance issues and poor recruitment to clinical trials all playing a part. In this review we will discuss the unique challenges faced by healthcare professionals when managing AYA patients who are commonly and accurately described as being in an 'interface' position.
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Affiliation(s)
- Nicola Hughes
- Leeds Institute of Cardiovascular and Molecular Medicine, University of Leeds, UK.
| | - Dan Stark
- Leeds Institute of Cancer and Pathology, St James's Institute of Oncology, Beckett Street, Leeds, UK
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A reflection on the work of Gianni Bonadonna from the viewpoint of the global challenge of adolescents and young adults with cancer. TUMORI JOURNAL 2017; 103:489-494. [PMID: 28967089 DOI: 10.5301/tj.5000682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2017] [Indexed: 11/20/2022]
Abstract
Adolescents and young adults (AYAs - ages 15 to 39) constitute approximately 40% of the world's population and contribute an estimated one million new cases of cancer annually, the great majority in low- and middle-income countries (LMICs). In high-income countries (HICs) cancer is the commonest cause of disease-related death in AYAs, though overall 5-year survival rates now exceed 80%. A very different circumstance likely holds in LMICs, but accurate assessments are not readily available.Breast cancer accounts for 40% of tumours in female AYAs and this age group includes the peak incidence of Hodgkin lymphoma. The late Professor Gianni Bonadonna contributed importantly to improved survival in patients with these two diseases. Accordingly, he would be justifiably proud of the advances in AYA oncology that are being made in Italy, especially the impact of his colleagues at the Istituto Nazionale dei Tumori (INT). The initiatives of the Associazione Italiana Ematologia Pediatrica and the Società Italiana Adolescenti con Malattie Onco-ematologiche are particularly noteworthy, with the accomplishment of productive collaboration between paediatric and adult cancer care providers serving as a model for other countries to emulate.Exporting these advances can be successful through the vehicle of "twinning": establishing sustainable cooperation between institutions in HICs and partners in LMICs. Colleagues in Monza and at INT have been leaders in such programmes for decades. Cancer in AYAs remains a global challenge to which Gianni Bonadonna surely would have risen with enthusiasm and leadership while securing measurable achievements.
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20
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Ferrari A, Barr RD. International evolution in AYA oncology: Current status and future expectations. Pediatr Blood Cancer 2017; 64. [PMID: 28370975 DOI: 10.1002/pbc.26528] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/02/2017] [Accepted: 02/15/2017] [Indexed: 01/22/2023]
Abstract
Adolescents and Young Adults (AYAs) contribute approximately 1 million incident cases globally, but the great majority are underserved. In high-income countries, overall survival exceeds 80%, but the needs of this population during and after their treatment experience are poorly met, though specialized clinical programs are evolving. Engagement of national governments is advantageous and deployment of multidisciplinary teams essential. Collaboration between pediatric and adult healthcare providers is mandatory and AYAs must be given a strong voice in program development. Building and sharing international experience will hasten advances in clinical care, education, and research, while a focus on developing countries is a worthy challenge.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nationale dei Tumori, Milan, Italy
| | - Ronald D Barr
- Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton, Ontario, Canada
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21
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Winners' Cup: A National Football Tournament Brings Together Adolescent Patients with Cancer from all over Italy. TUMORI JOURNAL 2017; 103:e25-e29. [DOI: 10.5301/tj.5000655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2017] [Indexed: 11/20/2022]
Abstract
Società Scientifiche Italiane Insieme per gli Adolescenti con Malattie Onco-ematologiche (SIAMO) is an Italian nationwide scheme that focuses on adolescent patients with cancer. Some of its activities include promoting dedicated local projects at the various oncology centers all over the country and organizing events to improve awareness regarding cancer in adolescence. It is with these aims in mind that it organized the Winners' Cup, a football tournament between Italian adolescents who had (or had had) pediatric cancers. There were 144 young people 15 to 24 years old who arrived from 16 different treatment centers around the country to take part in the tournament and share their stories. Such an event had never been attempted before, in Italy at least. The Winners' Cup was a great success and an opportunity to focus attention on the particular clinical, psychological, and social needs of cancer patients in this age group.
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22
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Gibson F, Pearce S, Fern L, Martins A, Kelly D. Improving the identification of cancer in young people: A scoping review. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23809000.2017.1307089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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23
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Vetsch J, Fardell JE, Wakefield CE, Signorelli C, Michel G, McLoone JK, Walwyn T, Tapp H, Truscott J, Cohn RJ. "Forewarned and forearmed": Long-term childhood cancer survivors' and parents' information needs and implications for survivorship models of care. PATIENT EDUCATION AND COUNSELING 2017; 100:355-363. [PMID: 27693083 DOI: 10.1016/j.pec.2016.09.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/02/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This mixed-method study assessed 1) survivors' and parents' information needs; and 2) associations between unmet information needs and clinical and socio-demographic characteristics. METHODS Stage 1: CCS and parents of CCS, >5years post-diagnosis completed a questionnaire on information needs, overall health and perceived risk. Predictors for unmet information needs were assessed by multivariable regression. Stage 2: participants were interviewed in-depth on these topics. RESULTS Questionnaires were completed by 485 participants comprising 322 survivors (mean age: 26.7years, SD=7.9; time since diagnosis: 19.7years, SD=8.8) and 163 parents (child age: 12.9years, SD=2.4; time since diagnosis: 9.7years, SD=2.3), and complemented by 70 interviews. Survivors reported unmet information needs about late effects (57.5%) and parents for fertility issues (62.5%). Survivors had more unmet needs for medical information whereas parents had significantly more regarding sexual issues and lifestyle. Being a parent (p=0.001), dissatisfaction with follow-up care (p=0.003), lower overall health (p=0.014), higher perceived risk of late effects (p<0.001), and greater anxiety/depression (p<0.001) were significantly associated with more unmet needs. CONCLUSION Unmet information needs were common for survivors and parents of CCS. PRACTICE IMPLICATIONS Future efforts towards tailoring information on potential late effects, healthy lifestyles and follow-up care may help to address unmet information needs.
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Affiliation(s)
- Janine Vetsch
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland; Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Joanna E Fardell
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Claire E Wakefield
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia.
| | - Christina Signorelli
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Gisela Michel
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland
| | - Jordana K McLoone
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Thomas Walwyn
- Department of Oncology and Haematology, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia
| | - Heather Tapp
- Department of Clinical Haematology/Oncology, Women's and Children's Hospital, Adelaide, Australia
| | - Jo Truscott
- Children's Haematology Oncology Centre, Christchurch Hospital, Christchurch, New Zealand
| | - Richard J Cohn
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
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Ferrari A, Silva M, Veneroni L, Magni C, Clerici CA, Meazza C, Terenziani M, Spreafico F, Chiaravalli S, Casanova M, Luksch R, Catania S, Schiavello E, Biassoni V, Podda M, Bergamaschi L, Puma N, Indini A, Proserpio T, Massimino M. Measuring the efficacy of a project for adolescents and young adults with cancer: A study from the Milan Youth Project. Pediatr Blood Cancer 2016; 63:2197-2204. [PMID: 27554940 DOI: 10.1002/pbc.26172] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/08/2016] [Accepted: 06/28/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Various projects dedicated specifically to adolescents and young adults (AYA) with cancer have been developed in recent years. A critical aspect of such programs is the ability to demonstrate its value, and therefore how to measure desired outcomes. METHODS A list of metrics to consider for demonstrating the advantages of an AYA program was identified and used to assess the activity of the Youth Project operating at the Pediatric Oncology Unit of the Istituto Nazionale Tumori in Milan. RESULTS The number of newly diagnosed AYA patients seen at the Unit has increased since the formal launch of the Youth Project, from 65 to 81.2 cases/year. Concerning the 78 AYA patients presenting with malignant neoplasms in 2015, 82% were included in clinical trials (the other 18% in prospective observational studies). Fertility preservation measures were implemented for 59% of AYA patients considered at risk, and specific psychological support was provided in 70.6% of cases; 72.5% of patients actively participated in support activities. Other parameters considered were a preliminary satisfaction questionnaire administered to patients and the program's scientific recognition and acknowledgment by the community. CONCLUSIONS The study proposed a number of potentially reproducible, practical parameters to consider in assessing the value of a program dedicated to AYA. These metrics were examined in terms of the activities of our Youth Project, and confirmed its efficacy. To be sustainable over time, AYA projects have to be accepted as a standard of care at the community and government levels.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy.
| | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Chiara Magni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Carlo Alfredo Clerici
- Clinical Biology, Oncology and Hemato-Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Roberto Luksch
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Serena Catania
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Marta Podda
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Nadia Puma
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Alice Indini
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Tullio Proserpio
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
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Magni C, Veneroni L, Silva M, Casanova M, Chiaravalli S, Massimino M, Clerici CA, Ferrari A. Model of Care for Adolescents and Young Adults with Cancer: The Youth Project in Milan. Front Pediatr 2016; 4:88. [PMID: 27606308 PMCID: PMC4995202 DOI: 10.3389/fped.2016.00088] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/09/2016] [Indexed: 01/01/2023] Open
Abstract
Adolescents and young adults (AYA) with cancer form a particular group of patients with unique characteristics, who inhabit a so-called "no man's land" between pediatric and adult services. In the last 10 years, the scientific oncology community has started to pay attention to these patients, implementing dedicated programs. A standardized model of care directed toward patients in this age range has yet to be developed and neither the pediatric nor the adult oncologic systems perfectly fit these patients' needs. The Youth Project of the Istituto Nazionale Tumori in Milan, dedicated to AYA with pediatric-type solid tumors, can be seen as a model of care for AYA patients, with its heterogeneous multidisciplinary staff and close cooperation with adult medical oncologists and surgeons. Further progress in the care of AYA cancer patients is still needed to improve their outcomes.
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Affiliation(s)
- Chiara Magni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Carlo Alfredo Clerici
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Hemato-Oncology, University of Milan, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
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