Teenage and young adult cancer Dr. Novak Gupta

Q1 : WHAT IS TYA? World Health Organization : adolescent as someone between 10–19 years of age, and youth as someone aged 15–24 years of age. The National Cancer Institute (U.S.) : identifies 15- to 39-year age group, now referred by NCI as adolescents and young adults (AYA). The National service delivery framework, Australia : defines ‘adolescents and young adults’ as young people between 15 and 25 years of age. Indian context : age group of 15-30, is taken as Teenage and young adults

Q2: WHY FOCUS ON TYA’s? PATIENT FACTORS : DISEASE FACTORS Age Developmental issues Psychological issues Fertility Dependence Co -morbidities. DISEASE FACTORS Embryonal tumos early on Epithelial tumors later on No screening methods may result from late effects of paediatric cancers TREATMENT FACTORS can tolerate intensive treatment long term side effects

Our Study We collected the data of Sri Aurobindo Medical College and P.G Institute for the year 2013. A proforma was created and filled. Education, economic status, duration of symptoms, contact with primary doctor and oncologist, treatment, abandonment, alive/ dead. Tele- conversation with either the patient or the relative. Period of study – May 2016 till date Plan to collect data for patients till 2016

Telephonic conversation tried with – 85 Not responding/wrong numbers – 29 Total data for – 56

SAIMS cancer patients (2013) - 1562 TYA patients 01 Jan to 31 Dec 2013 – 186 Male – 104 Female – 82 TYA : total ratio - 186/1562 = 11.2% Paediatric cancers ( y2013) - 24 Pead : TYA ratio - 24/186 = 1:8

Age distribution ( N = 186 ) AGE Number of cases 15 -19 years - 17 (9%) 20- 24 years - 27 (14%) 25-29 years - 35 (19%) 30-35 years - 107 (58%)

TYPE OF MALIGNANCY ( N = 186 ) Head and neck – 56 Tongue – 21 Buccal mucosa – 16 Lip – 3 Tonsil – 2 Others – 14 Breast – 28 Genito urinay – 23 Ovary – 9 Cervix – 7 RCC – 2 Prostate – 1 Vagina – 1 Testicular – 2 Uterus – 1 CNS - 22 Hematological – 22 HD – 5 ALL – 4 NHL – 5 CML – 3 Others – 5 Sarcomas – 20 Bone sarcoma – 16 Soft tissue – 4 GIT – 10 Anorectal – 5 Stomach – 2 Esophagus – 2 Colon - 1 Thyroid – 2 Melanoma – 2 Lung - 1

( N = 186 )

Abandonment Definition : Failure to start treatment or to complete treatment ( N = 56 ) 12 (21.4%) Unknown : 15 (26.7%) Completed treatment: 29 (51.7%)

Survival ( as of MAY 2016 ) N = 56 Alive : 27 (48.2%) Unknown : 4 (7.4%) Dead : 25 (44.6%)

2016 Head and neck – 14 Sarcoma – 12 Breast -9 Colorectal -8 Gynaecological – 8 CNS -7 Renal -2 Thymoma -1 HCC – 1 Total number of TYA patients (till Sept. 2016) : 102 Haematological : 40 ALL-18 NHL- 12 AML- 6 HD -4

2013 VS 2016

Comparison between 2013 and 2016 Abandonment - 12 (21.4%) Dead - 25 (44.6%) Abandonment – 7 (6.8%) Dead – 13 (12.7%)