Psychosocial Issues in Adolescent and Young Adult Patients and Survivors

Abstract

This chapter focuses on the psychosocial impact of cancer on adolescents and young adults (AYAs) aged 15–39 years and provides an insight into therapeutic approaches. It examines unique developmental and psychosocial issues and subsequent needs of these young people as they occur throughout a continuum of survivorship, as well as approaches to address those needs. A diagnosis of cancer challenges young people’s views about their invulnerability, threatens their self-esteem, and compromises all aspects of quality of life. Long-term educational and career goals can be seriously compromised by hospitalization and health complications. These obstacles and roadblocks may derail normal development, interfere with transition into adulthood, and significantly impact on family life and financial stability. There has been substantial progress in the understanding of the psychosocial aspects of AYA cancer in the past 5–10 years. In the long run, the majority of young adult cancer survivors appear to be psychologically well adjusted, even when acknowledging visible and limiting physical effects of treatments. Overall, these young people experience emotions and behave in ways that are normative for this age population. However, a substantial minority experience post-traumatic stress, a form of emotional and psychosocial disability requiring psychological counseling of some form. An important minority appears to experience post-traumatic growth and are able to transform their lives in ways that represent more positive outlooks and competencies that one would have expected prior to their diagnosis and treatment. Given the full range of these responses, including the possibility that some teenagers and young adults surviving cancer can exhibit signs of greater emotional stability and security, intervention programs that historically have focused on alleviating stress and preventing negative outcomes (such as post-traumatic stress symptoms) must be complemented by programs focusing on promoting successful achievement of age-appropriate developmental tasks and positive psychological and emotional growth.