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Holderness A, Magrath C, Hatcher H, Critoph D. "Absolutely No One Else, Other Than Yourself": Experiences of Adolescents and Young Adults with Cancer During the COVID-19 Pandemic. J Adolesc Young Adult Oncol 2024; 13:251-261. [PMID: 38019159 DOI: 10.1089/jayao.2023.0046] [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: 11/30/2023] Open
Abstract
Introduction: The COVID-19 pandemic caused widespread disruption to the provision of health care in the United Kingdom. It posed two risks to AYACs: disruption of care and long-term adverse consequences compounding late effects. This study sought to better understand the experiences of AYACs receiving care during the pandemic and identify areas where greater support is needed. Methods: In-depth semistructured interviews with AYACs (n = 6), 16-22 years at diagnosis. Interviews were transcribed verbatim and analyzed using the principles of Giorgi's phenomenological analysis. Results: Four major themes and an interconnected theme were identified. Changes to health care meant AYACs were isolated and loss of in-person follow-up caused anxiety (theme 1). AYACs had to adapt to life with COVID-19 restrictions (theme 2). Support during the pandemic came from a variety of sources (theme 3). AYACs reported poor mental health due to a fear of relapse and contracting COVID-19 (theme 4). An additional burden for AYACs was the loss of the third person (e.g., parent) in consultations (interconnected theme). Conclusion: This study has wider implications for delivery of AYAC care, despite being set during the COVID-19 pandemic. The mental health implications will impact long-term care of these patients, and health care professionals must be aware of these to meet AYACs' holistic care needs.
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Affiliation(s)
- Ayesha Holderness
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Cameron Magrath
- Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire Royal Hospital, Gloucester, United Kingdom
| | - Helen Hatcher
- Department of Oncology and TYA Cancer Service, University of Cambridge, Cambridge, United Kingdom
| | - Deborah Critoph
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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Wong SL, Johnston E, Rossell N, Malogolowkin M, Rios L, Gómez García W, Antillon-Klussmann F, Fu L, Fuentes-Alabi S, Quintero Delgado K, Ortiz Morales D, Rodriguez-Loza C, Apesoa-Varano EC, Friedrich P, Alvarez E. The Effect of COVID-19 on Oncology Care for Adolescents and Young Adults in Latin America. J Adolesc Young Adult Oncol 2024. [PMID: 38502817 DOI: 10.1089/jayao.2023.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Children with cancer in low- and middle-income countries were disproportionately impacted by the COVID-19 pandemic, but little is known about how adolescents and young adults (AYAs) with cancer were affected. Sixty-seven physicians and nonphysician providers were interviewed about their experiences caring for AYAs with cancer in Latin America. Quotes related to the COVID-19 pandemic were identified and grouped into themes. Barriers from the COVID-19 pandemic included limited space, restrictions on travel, reduced funding, limited staff, limited services, and changes to treatment. However, improvements to care that arose from the COVID-19 pandemic included better access to distance learning and telemedicine.
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Affiliation(s)
- Samantha L Wong
- School of Medicine, University of California Davis, Sacramento, California, USA
| | - Emily Johnston
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nuria Rossell
- Independent Medical Anthropology Researcher, San Salvador, El Salvador
| | - Marcio Malogolowkin
- Division of Pediatric Hematology and Oncology, Davis School of Medicine, University of California, Sacramento, California, USA
| | - Ligia Rios
- Department of Pediatrics, Unidad de Oncología Pediátrica y del Adolescente, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú
| | - Wendy Gómez García
- Department of Oncology, Dr. Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
- National Cancer Institute, INCART, Santo Domingo, Dominican Republic
| | - Federico Antillon-Klussmann
- Department of Hematology/Oncology, Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
- School of Medicine, Francisco Marroquín University, Guatemala City, Guatemala
| | - Ligia Fu
- Department of Pediatrics, Hospital Escuela, Tegucigalpa, Honduras
| | - Soad Fuentes-Alabi
- Department of Pediatric Oncology, National Program for Childhood Cancer, Ayudame a Vivir Foundation/National Children's Hospital Benjamin Bloom, San Salvador, El Salvador
| | - Karina Quintero Delgado
- Department of Pediatrics, Hospital del Niño Dr. José Renán Esquivel, Oncología, Panama City, Panama
| | | | - Carolina Rodriguez-Loza
- Department of Pediatric Oncology, National Program for Childhood Cancer, Ayudame a Vivir Foundation/National Children's Hospital Benjamin Bloom, San Salvador, El Salvador
| | | | - Paola Friedrich
- St. Jude Children's Research Hospital, Global Pediatric Medicine, Memphis, Tennessee, USA
| | - Elysia Alvarez
- Division of Pediatric Hematology and Oncology, Davis School of Medicine, University of California, Sacramento, California, USA
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3
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Rao P, Kazak AE, Doerksen SE, Koehly LM, Verdery AM, Heitzenrater J, Harding BA, Byrnes CL, Costigan HJ, Rovniak LS, Sciamanna CN, Van Scoy LJ, Schmitz KH. AYA-UNITE: Lessons Learned on Intervention Development Promoting Social and Physical Health of Adolescent/Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2023; 12:929-934. [PMID: 37815633 PMCID: PMC10777817 DOI: 10.1089/jayao.2023.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023] Open
Abstract
Adolescent/young adult cancer survivors (AYACS) struggle with poor psychosocial health related to social disruptions due to cancer diagnosis, impacting long-term goal achievement and overall health. In particular, social health promotion is overlooked in AYACS' care. AYA-UNITE, a sociobehavioral exercise intervention pilot for AYACS 15-21 years of age at cancer diagnosis, was designed to foster AYACS' social and physical health. AYA-UNITE was a 12-week group-based virtual exercise program incorporating strength training and aerobic activity. In this brief report, we account AYA-UNITE's conceptual design, lessons learned through AYA-UNITE intervention development, and opportunities for improvement in implementing effective AYACS psychosocial interventions (NCT03778658).
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Affiliation(s)
- Pooja Rao
- Division of Pediatric Hematology/Oncology, Penn State Health Children's Hospital, Hershey, Pennsylvania, USA
| | - Anne E. Kazak
- Center for Healthcare Delivery Science, A.I. du Pont Hospital for Children, Wilmington, Delaware, USA
| | - Shawna E. Doerksen
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Laura M. Koehly
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ashton M. Verdery
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jared Heitzenrater
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Brennen A. Harding
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Courtney L. Byrnes
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Heather J. Costigan
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Liza S. Rovniak
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Lauren J. Van Scoy
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kathryn H. Schmitz
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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4
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Vlooswijk C, Janssen SHM, van de Poll-Franse LV, Bijlsma R, Kaal SEJ, Kerst JM, Tromp JM, Bos MEMM, Lalisang RI, Nuver J, Kouwenhoven MCM, van der Graaf WTA, Husson O. Health-related quality of life of Adolescent and Young Adult Cancer Survivors before and during the COVID-19 pandemic: longitudinal improvements on social functioning and fatigue. J Patient Rep Outcomes 2023; 7:93. [PMID: 37702884 PMCID: PMC10499718 DOI: 10.1186/s41687-023-00629-0] [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] [Received: 12/26/2022] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
The health-related quality of life (HRQoL) among long-term Adolescent and Young Adult Cancer Survivors (AYACS) and an age- and sex-matched normative population was examined. Although the HRQoL of AYACS was worse compared to the normative population before and during the COVID-19 pandemic, the scores of AYACS improved over time in contrast to the normative population. Presumably, AYACS are used to adjusting their lives to stressful life events. Furthermore, the lockdown may have been beneficial for AYACS who face difficulties fully participating in society due to the impact of cancer. AYACS who encounter HRQoL issues could benefit from support interventions to empower them and build resilience.
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Affiliation(s)
- Carla Vlooswijk
- Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| | - Silvie H M Janssen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
| | - Lonneke V van de Poll-Franse
- Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, 5037 AB, Tilburg, The Netherlands
| | - Rhodé Bijlsma
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - J Martijn Kerst
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
| | - Jacqueline M Tromp
- Department of Medical Oncology, Amsterdam University Medical Centers, 1105 AZ, Amsterdam, The Netherlands
| | - Monique E M M Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD, Rotterdam, The Netherlands
| | - Roy I Lalisang
- Department of Internal Medicine, Division of Medical Oncology, GROW-School of Oncology and Reproduction, Maastricht UMC+ Comprehensive Cancer Center, 6229 HX, Maastricht, The Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Mathilde C M Kouwenhoven
- Department of Neurology, Amsterdam UMC, Amsterdam University Medical Centers, Location VUmc, 1081 HV, Amsterdam, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD, Rotterdam, The Netherlands
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands.
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD, Rotterdam, The Netherlands.
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Castellanos-Montealegre M, Rivera-Theruel F, García-Coll V, Rioja-Collado N, Gil-Herrero L, López-Tarruella S, Montealegre Sanz M, Cerezo González S, Fernández Aramburo A, Ruiz-Casado A, Laundos R, Casla-Barrio S. Impact of the COVID-19 Lockdown on Physical Activity Levels and Health Parameters in Young Adults with Cancer. Curr Oncol 2023; 30:5395-5408. [PMID: 37366892 DOI: 10.3390/curroncol30060409] [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: 04/07/2023] [Revised: 05/17/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023] Open
Abstract
The lockdown of the COVID-19 pandemic impacted physical activity (PA) levels around the world, affecting health parameters in young adults with cancer (YAC). To our knowledge, there is no evidence of the impact of the lockdown on the Spanish YAC. To analyse the changes in PA levels before, during, and after the lockdown of the YAC and its impact on health metrics in Spain, in this study, we utilized a self-reported web survey. PA levels decreased during the lockdown, and a significant increase in PA was observed after the lockdown. Moderate PA had the largest reduction (49%). Significant increases in moderate PA were noted after the lockdown (85.2%). Participants self-reported more than 9 h of sitting per day. HQoL and fatigue levels were significantly worse during the lockdown. The impact of the COVID-19 pandemic in this cohort of Spanish YAC showed a decrease in PA levels during the lockdown, affecting sedentarism, fatigue and HQoL. After lockdown, PA levels partially recovered, while HQoL and fatigue levels remained altered. This may have long-term physical effects such as cardiovascular comorbidities associated with sedentarism and psychosocial effects. It is necessary to implement strategies such as cardio-oncology rehabilitation (CORE), an intervention that can be delivered online, potentially improving participants' health behaviours and outcomes.
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Affiliation(s)
- Mónica Castellanos-Montealegre
- Department of Science of Physical Activity and Sport, Castilla-La Mancha University Toledo Av de Carlos III, n 21, 45004 Toledo, Spain
| | - Fernando Rivera-Theruel
- Toronto Rehabilitation Institute Rumsey Centre Cardiac Rehabilitation, University Health Network, Toronto, ON M4G 2V6, Canada
| | - Virginia García-Coll
- Department of Science of Physical Activity and Sport, Castilla-La Mancha University Toledo Av de Carlos III, n 21, 45004 Toledo, Spain
| | - Natalia Rioja-Collado
- Department of Science of Physical Activity and Sport, Castilla-La Mancha University Toledo Av de Carlos III, n 21, 45004 Toledo, Spain
| | - Lucía Gil-Herrero
- Spanish Cancer Association, Av Federico Rubio y Galí, n 84, 28040 Madrid, Spain
| | - Sara López-Tarruella
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- CiberOnc, Universidad Complutense, 28040 Madrid, Spain
- GEICAM, 28703 Madrid, Spain
| | | | | | | | - Ana Ruiz-Casado
- HU Puerta de Hierro Majadahonda, IDIPHISA, 28222 Madrid, Spain
| | - Rebecca Laundos
- Toronto Rehabilitation Institute Rumsey Centre Cardiac Rehabilitation, University Health Network, Toronto, ON M4G 2V6, Canada
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Ogland-Hand C, Ciesielski TH, Daunov K, Bean MK, Nock NL. Food Insecurity and Nutritional Challenges in Adolescent and Young Adult Cancer Survivors in the U.S.A.: A Narrative Review and Call to Action. Nutrients 2023; 15:nu15071731. [PMID: 37049571 PMCID: PMC10096609 DOI: 10.3390/nu15071731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Advancements in cancer treatments over the past several decades have led to improved cancer survival in adolescents and young adults (AYAs, ages 15–39 years). However, AYA cancer survivors are at an increased risk for “late effects”, including cardiovascular, pulmonary and bone diseases as well as fatigue, infertility and secondary cancers. The treatments for cancer may also alter taste, lead to nutritional deficiencies and increase financial burdens that, when taken together, may increase the risk of food and nutrition security in AYA cancer survivors. Furthermore, although AYAs are often merged together in cancer survivorship studies, adolescents and young adults have distinct developmental, psychosocial and pathophysiological differences that may modify their risk of nutritional challenges. In this narrative review and “Call to Action”, rationale is provided for why there is a need to better understand nutritional challenges and food insecurity in AYA cancer survivors as a special population. Then, recommendations for next steps to advance knowledge and policy in this field are provided. In particular, integrating screening for food and nutrition insecurity and enhancing awareness of existing resources (e.g., the Supplemental Nutrition Assistance Program, SNAP) might help AYA cancer survivors combat nutritional deficiencies and reduce late effects while improving their overall survival and quality of life.
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Affiliation(s)
- Callie Ogland-Hand
- Mary Ann Swetland Center for Environmental Health, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Timothy H. Ciesielski
- Mary Ann Swetland Center for Environmental Health, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Katherine Daunov
- Oncofertility and Young Adult Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH 44106, USA
| | - Melanie K. Bean
- Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23219, USA
| | - Nora L. Nock
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
- Population and Cancer Prevention Program, Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
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7
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Sarfraz M, Waqas H, Ahmed S, Rurush-Asencio R, Mushtaque I. Cancer-Related Stigmatization, Quality of Life, and Fear of Death Among Newly Diagnosed Cancer Patients. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221140650. [PMID: 36409065 DOI: 10.1177/00302228221140650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
The purpose of the study is to investigate the gender differences among newly diagnosed cancer patients from the cultural perspective of Pakistan. The data comprised two equal groups: men (50%) and women (50%). Most participants were 31-45 years old, and the duration of the cancer diagnosis was less than 6 months (74.6%). The data was collected on the following scales: the discrimination and stigma scale, the internalized stigma scale, the WHO-quality of life scale, and the fear of death scale. Data was analyzed using SPSS v.25; descriptive statistics, an independent sample t-test, and simple linear regression were applied to the data. The results revealed that men and women are both experiencing cancer-related stigmatization in Pakistan. However, women face a higher level of stigmatization, lower quality of life, and higher fear of death than men. Furthermore, the regression analysis result confirms that the cancer-related stigma faced by the diagnosed patients decreases the patient's quality of life and induces the fear of death.
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Affiliation(s)
| | - Hamid Waqas
- School of Business and Management, Westminster International Universityin Tashkent, Uzbekistan
| | - Saba Ahmed
- Fatima Jinnah Women University, Rawalpindi, Pakistan
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The Transformation of Adolescent and Young Adult Oncological and Supportive Care in Canada: A Mixed Methods Study. Curr Oncol 2022; 29:5126-5138. [PMID: 35877266 PMCID: PMC9321170 DOI: 10.3390/curroncol29070406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/04/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Due to ongoing disparity in the specialized care available to adolescents and young adults (AYAs) with cancer, this study aimed to understand the gaps and barriers to accessing care and preferences on types of solutions at a national Canadian level. Methods: A mixed-methods study involving an online survey and focus groups (FGs) was conducted among AYAs residing in different regions of Canada. Results: There were a total of 174 survey respondents, of whom the majority were between 30–39 years of age (n = 125, 71.8%). Of the 174 respondents, 36 (20.7%) participated in one of seven FGs. Triangulation of the results illustrated that AYAs are not appropriately informed about the long-term health risks of being treated for cancer and where/how to seek support. These results culminated into three themes: (1) the need for AYA relevant and timely information about health risks; by (a) producing health risk-related content with the AYA life stage in mind; (b) providing a guided “map” to help AYAs anticipate what they may experience, and (c) providing checklists to help AYAs navigate their experience; (2) need for tailored and timely supportive care including (a) establishing ongoing check-ins and (b) receiving navigation support, and (3) need for enhanced connections by creating (a) a space to gather, connect and seek mentorship and (b) a hub to access information. Conclusion: AYAs continue to lack sufficient support both during and following cancer and mechanisms are required to ensure longitudinal support is provided across jurisdictions and in all stages of the cancer journey.
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