CANCER TREATMENT Survival rates lower for teenage patients

More attention needs to be paid to this age group.
By SHARI ROAN
LOS ANGELES TIMES
For children and adults, survival rates for many types of cancers have risen steadily over the last two decades. But missing in this success story are adolescents and young adults: They don't fare as well on average.
Oncologists around the country are trying to draw attention to this discrepancy, setting up clinics for adolescent and young adult cancer patients.
"We have these horrible diseases killing young adults. Why aren't we doing better?" says Dr. Leonard Sender, medical director of the Cancer Institute at Children's Hospital of Orange County, Calif. "We should be encouraging them to be in clinical trials. We should be getting more money from the National Cancer Institute for research on this age group."
The hospital's Cancer Institute recently joined the ranks of cancer centers focusing on this age group, launching a program to steer patients 15 to 30 into treatments that could improve their chances of beating the disease.
More research
Increasing the amount of research is at the core of plans to improve survival rates for teens and young adults. Because cancer is relatively rare in those younger than 30, Sender said, grouping young cancer patients at specialized hospitals and clinics could help doctors better understand how to treat them. Not only could they undergo the most promising clinical trials, but the results could be collected and analyzed specifically for their age group.
Doctors also now think that many adolescents and young adults may have better outcomes with pediatric treatment guidelines rather than with adult guidelines. Pediatric cancer centers have long enrolled children into clinical trials that test standard treatments with experimental treatments. Experts credit this aggressive practice with increasing the survival rate of cancer patients younger than 14.
Information recently gathered by Dr. Archie Bleyer, an adolescent and young adult cancer expert at M.D. Anderson Cancer Center in Houston, showed that teens and young adults are not usually enrolled in clinical trials and could be missing out on the best therapies.
"We didn't realize how far we'd fallen behind," says Bleyer. "We'd worked so hard to help the younger children, going back to the '50s. And in the last 20 years we've been focusing on the adults. The fact that we didn't pay attention to the age group in between has led to some pretty dismal outcomes."
Other reasons
But the fact that adolescents and young adults generally don't live as long as other cancer patients is due to more than a lack of awareness by doctors and researchers, Bleyer says. Young adults are the least likely of any age group to have insurance or the financial resources to obtain optimal care. They often can't travel easily to cancer centers specializing in their age group, and they are the least likely to comply with their treatments.