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Young Adult

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     There are a growing number of organizations that support adolescents and young adults who have cancer.  Here are links to relevant websites and most trusted sources for AYA cancers information and services for both patients and healthcare professionals.

    Young Adult

    Music's relevance for adolescents and young adults with cancer: a constructivist research approach.
    Support Care Cancer. 2011 Feb 11;
    Authors: O'Callaghan C, Barry P, Thompson K
    PURPOSE: Music is one of the most widely used activities amongst young people, significant in personal and group identity, motivation, physical release, and emotional support. Adolescents and young adults with cancer (AYA) require specialized care because of intensified challenges related to developmental vulnerability, treatment toxicity effects, and slower improvements in survival rates compared to other age groups. To advance effective supportive care for AYA, understanding their thoughts about music is necessary. This study examines AYAs' perspectives about music's role in their lives. METHODS: A constructivist research approach with grounded theory design was applied. Twelve people, 15 to 25 years old, known to onTrac@PeterMac Victorian Adolescent & Young Adult Cancer Service, participated. Respondents completed a brief music demographic questionnaire and participated in a semi-structured interview. Qualitative inter-rater reliability was integrated. RESULTS: Participants mostly reported music's calming, supportive, and relaxing effects, which alleviated hardship associated with their cancer diagnoses. Themes encompassed: music backgrounds, changed "musicking", endurance and adjustment, time with music therapists, and wisdom. Music provided supportive messages, enabled personal and shared understandings about cancer's effects, and elicited helpful physical, emotional, and imagery states. Music therapy could also promote normalized and supportive connections with others. A musician, however, struggled to get music "back" post-treatment. Supportive music-based strategies were recommended for other AYA and their health care providers. CONCLUSIONS: Music can signify and creatively enable AYAs' hope, endurance, identity development, and adjustment through cancer treatment and post-treatment phases. Health professionals are encouraged to support AYAs' music-based self-care and "normalized" activities.
    PMID: 21311914 [PubMed - as supplied by publisher]

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    Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis.
    Lancet. 2011 Oct 22;378(9801):1461-84
    Authors: Forouzanfar MH, Foreman KJ, Delossantos AM, Lozano R, Lopez AD, Murray CJ, Naghavi M
    Abstract
    BACKGROUND: Breast and cervical cancer are important causes of mortality in women aged ≥15 years. We undertook annual age-specific assessments of breast and cervical cancer in 187 countries.
    METHODS: We systematically collected cancer registry data on mortality and incidence, vital registration, and verbal autopsy data for the period 1980-2010. We modelled the mortality-to-incidence (MI) ratio using a hierarchical model. Vital registration and verbal autopsy were supplemented with incidence multiplied by the MI ratio to yield a comprehensive database of mortality rates. We used Gaussian process regression to develop estimates of mortality with uncertainty by age, sex, country, and year. We used out-of-sample predictive validity to select the final model. Estimates of incidence with uncertainty were also generated with mortality and MI ratios.
    FINDINGS: Global breast cancer incidence increased from 641,000 (95% uncertainty intervals 610,000-750,000) cases in 1980 to 1,643,000 (1,421,000-1,782,000) cases in 2010, an annual rate of increase of 3·1%. Global cervical cancer incidence increased from 378,000 (256,000-489,000) cases per year in 1980 to 454,000 (318,000-620,000) cases per year in 2010-a 0·6% annual rate of increase. Breast cancer killed 425,000 (359,000-453,000) women in 2010, of whom 68,000 (62,000-74,000) were aged 15-49 years in developing countries. Cervical cancer death rates have been decreasing but the disease still killed 200,000 (139,000-276,000) women in 2010, of whom 46,000 (33,000-64,000) were aged 15-49 years in developing countries. We recorded pronounced variation in the trend in breast cancer mortality across regions and countries.
    INTERPRETATION: More policy attention is needed to strengthen established health-system responses to reduce breast and cervical cancer, especially in developing countries.
    FUNDING: Susan G Komen for the Cure and the Bill & Melinda Gates Foundation.
    PMID: 21924486 [PubMed - indexed for MEDLINE]

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    Clinical predictors of facial nerve outcome after translabyrinthine resection of acoustic neuromas.
    Clin Invest Med. 2007;30(6):E233-9
    Authors: Shamji MF, Schramm DR, Benoit BG
    The translabyrinthine approach to acoustic neuroma resection offers excellent exposure for facial nerve dissection with 95% preservation of anatomic continuity. Acceptable outcome in facial asymptomatic patients is reported at 64-90%, but transient postoperative deterioration often occurs. The objective of this study was to identify preoperative clinical presentation and intraoperative surgical findings that predispose patients to facial nerve dysfunction after acoustic neuroma surgery.
    PMID: 18053390 [PubMed - indexed for MEDLINE]

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    Knowledge of cervical cancer and screening practices of nurses at a regional hospital in Tanzania.
    Afr Health Sci. 2011 Mar;11(1):48-57
    Authors: Urasa M, Darj E
    Cervical cancer, the most common cancer among women in Tanzania is strongly linked to Human Papilloma Virus. Precancerous lesions can be detected by Papanicolau smear screening. Nurses, being the largest group of health workers, have an important role in promotion of cervical cancer screening.
    PMID: 21572857 [PubMed - indexed for MEDLINE]

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    Organizing wilderness medicine on a regional scale.
    Wilderness Environ Med. 2008;19(4):305-9
    Authors: Hawkins SC, McGinnis H, Visser P

    PMID: 19099338 [PubMed - indexed for MEDLINE]

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    Recommendations of the Fertility Task Force of the European Society of Gynecologic Oncology about the conservative management of ovarian malignant tumors.
    Int J Gynecol Cancer. 2011 Jul;21(5):951-63
    Authors: Morice P, Denschlag D, Rodolakis A, Reed N, Schneider A, Kesic V, Colombo N,
    Abstract
    In young patients with borderline ovarian tumor a conservative treatment approach does not seem to have a significant impact on survival, and the outcome regarding fertility is good in general. It can be considered even if noninvasive peritoneal implants are discovered at the time of the initial surgery. In contrast, in patients with epithelial ovarian cancer, conservative surgery should be considered only in adequately staged patients, with a stage IA grade 1 (and probably 2) serous, mucinous or an endometrioid tumor, including a careful follow-up. Such an approach could also probably be discussed in stage IC grade 1 disease.In patients with nonepithelial malignant ovarian tumors, conservative surgery is also feasible, particularly in patients with malignant germ cell tumors because of their high chemosensitivity leading to an excellent prognosis in general.
    PMID: 21697684 [PubMed - indexed for MEDLINE]

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    Adolescents with acute lymphoblastic leukaemia: emerging from the shadow of paediatric and adult treatment protocols.
    Pediatr Blood Cancer. 2006 Nov;47(6):748-56
    Authors: Ramanujachar R, Richards S, Hann I, Webb D
    Adolescents and young adults (AYA) with acute lymphoblastic leukaemia (ALL) constitute a distinct population from children and older adults. Based on patterns of referral, they may be treated by either paediatric or adult oncologists. As a group, AYA with ALL have a worse survival and event-free survival (EFS) compared to that achieved by younger children. A systematic review of all published clinical trials, which provide data on treatment and outcome of adolescents with ALL, has been summarised in an effort to determine whether they should be treated on paediatric or adult type protocols. Adolescents appear to have a consistent survival advantage when treated on paediatric regimens.
    PMID: 16470520 [PubMed - indexed for MEDLINE]

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    I’m 15 years old and a survivor of cancer. It started when I was 12 years old and in 7th grade. I developed a large goiter on my lower neck. After many tests that came out suspisious I went in to surgery early morning of July 2005. It lasted 6 hours. I had my whole thyroid, 4 lymphoids, and 9 nodules removed all consisting of cancer cells and tumors. I’ll never forget that night when the nurse was wheeling me in to my room and my Mom told me that I did have cancer. I didn’t know how to react or what to say. I was nervous and I didn’t know what was coming up next. I was full of questions but too afraid to ask. I stayed quiet and I didn’t talk about it much at first but I have found out lately that talking and sharing my story can help me deal with everything better and help relate with a lot of other people facing similar things.

    After 4 days in the hospital recovering from surgery I started 8th grade and even a new school. A week later I started treatment. The best treatment to cure my kind of cancer was radioactive Iodine. I had to be in isolation for about 5 days straight. No one was allowed in my room and I was not even allowed out!! I got through it and went in to remission for about a year until I got the news in September 2006 that they found hot spots, which are possible cancer cells. I went through treatments a second time. I just recently got back in to remission November 2007 and happier than ever.

    Although the treatments have caused many small problems I thank God each and everyday for helping me get rid of the big problem I had to face.  Although it is such a horrible thing it has gave me some of the best experiences I could ever ask for. Every year now I go to different cancer camps such as Boggy Creek, Miracle Camp, and Imus Ranch all in which I have meet many young kids all around the United States.  Each and everyday that I spend at these camps I always learn something new or do something that I never thought I could do. I dont have any friends at my school that have cancer so when I go to cancer camp it shows me that there are so many kids that are haveing to go through the same thing and I feel like im not so alone anymore. Every single one of the people all have something in common and we all look up to each other. All of these experiences are so great and meeting all of these amazing people that lift my spirits really make me stronger and keep me going. Cancer has taught me the life lesson that I think everyone should learn and that is to live life to it’s fullest. It has changed my outlook on life completely, made me stronger and showed me how to handle some of the normal struggles every kid goes through. Deep down I am still just a normal teenager with big dreams of becoming an actress, goals of making straight A’s all through High school, and hopes that I can help anyone that is going through a hard time.

    My name is Kasie.

    Kasie is an adolescent cancer survivor from Florida.

    Originally posted in July 2008.

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    Stop A Doc

    Get Involved and Stop A Doc.

    • If you are a patient, print the Stop A Doc Kit and be sure your healthcare professional can answer "yes" to all five questions.
    • If you are a healthcare professional, download the Stop A Doc Flyer and display it proudly in your office for all AYA patients to see.

     

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    Palliative care in adolescents and young adults with cancer.
    Cancer. 2011 May 15;117(10 Suppl):2323-8
    Authors: Pritchard S, Cuvelier G, Harlos M, Barr R
    Adolescents and young adults (AYA) with advanced or terminal cancer have distinctive medical and psychosocial needs that may not have been adequately provided by either pediatric or adult palliative care services. A discussion group, as part of a larger workshop on AYA with cancer, was held in Toronto on March 11-13, 2010;117:-. Recommendations were as follows: Develop a specific AYA screening tool designed to detect increased anxiety or new symptoms and to initiate discussion about palliative or symptom care; Set Canadian standards for palliative care in AYA patients. These standards should be included in hospital accreditation; Involve the palliative/symptom care team early in the disease trajectory to help manage clinically important symptoms that may not be associated with imminent death; Establish specific AYA multidisciplinary palliative care teams throughout Canada that are flexible and can work in both pediatric and adult facilities, and are able to work in a "virtual" environment to support patients being cared for at home; Improve physical facilities in hospices and hospitals to meet the distinctive needs of terminally ill AYA patients; Enhance support for palliative care at home by: changing legislation to improve Compassionate Care Benefits and developing "virtual palliative care support teams". Adequate provision of AYA palliative care and symptom management services will likely confer notable benefits to AYA patients and their families, and is likely to be cost saving to the tax payer by avoiding prolonged hospitalization and promoting easier return to work for the families and caregivers.
    PMID: 21523753 [PubMed - indexed for MEDLINE]

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    Human papillomavirus and cervical screening: misconceptions undermine adherence.
    Am J Health Promot. 2011 Sep-Oct;26(1):6-9
    Authors: Panagopoulou E, Giata O, Montgomery A, Dinas K, Benos A
    Abstract
    PURPOSE: Prophylactic vaccination programs in conjunction with cervical screening can significantly reduce the incidence of cervical cancer worldwide. This study tested the hypothesis that human papillomavirus (HPV) vaccination can adversely affect adherence to cervical screening if the public develops the misconception that the HPV vaccination has removed the need for screening.
    DESIGN: A postal survey using a stratified random sample was employed.
    PARTICIPANTS: Overall, 500 medical students and 500 nonmedical students of the Aristotle University of Thessaloniki were invited to participate. The response rate was 82%.
    MEASURES: A questionnaire was developed assessing demographic characteristics, adherence to cervical screening, and awareness and attitudes toward HPV.
    ANALYSIS: Logistic regression was used to assess the impact of HPV awareness and attitudes towards HPV vaccination on adherence to Papanicolaou screening, controlling for place of origin and mother's screening behavior.
    RESULTS: Students who believed that vaccination against HPV obviated the need for a Papanicolaou test were two times less likely to adhere to cervical screening (adjusted odds ratio, 1.89; 95% confidence interval, 1.37-2.57; p  =  .0004). The effect was stronger in the nonmedical subgroup (adjusted odds ratio, 3.05; 95% confidence interval, 1.85-5.160; p  =  .0003).
    CONCLUSION: Findings highlight that misconceptions can adversely affect preventive behaviors and reduce the probability of an early diagnosis of cervical cancer.
    PMID: 21879936 [PubMed - indexed for MEDLINE]

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    Acute lymphoblastic leukemia in adolescents and young adults.
    Hematol Oncol Clin North Am. 2009 Oct;23(5):1033-42, vi
    Authors: Ribera JM, Oriol A
    Today, long-term survival is achieved in more than 80% of children 1 to 10 years old with acute lymphoblastic leukemia (ALL). However, cure rates for adults and adolescents and young adults (AYA) with ALL remain relatively low, at only 40% to 50%. Age is a continuous prognostic variable in ALL, with no single age at which prognosis deteriorates markedly. Within childhood ALL populations, older children have shown inferior outcomes, whereas younger adults have shown superior outcomes among adult ALL patients. The type of treatment (pediatric-based versus adult-based) for AYA has recently been a matter of debate. In this article the biology and treatment of ALL in AYA is reviewed.
    PMID: 19825451 [PubMed - indexed for MEDLINE]

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    TipText: 
    Fertility Preservation for AYA Cancers - For Men 15-39, frequent cause of impaired fertility is chemotherapy or radiation damage to sperm. Female survivors may be impaired by treatment that damages immature eggs, affects hormonal balance, or injures reproductive organs. Fertility guidelines: http://www.cancer.gov/ncicancerbulletin/011111/page5
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    Coping strategies and patterns of alcohol and drug use among HIV-infected patients in the United States Southeast.
    AIDS Patient Care STDS. 2008 Nov;22(11):869-77
    Authors: Pence BW, Thielman NM, Whetten K, Ostermann J, Kumar V, Mugavero MJ
    Alcohol and drug use are common among HIV-infected patients and are important determinants of secondary transmission risk and medication adherence. As part of the Coping with HIV/AIDS in the Southeast (CHASE) Study, 611 HIV-infected patients were consecutively recruited from eight clinical care sites in five southeastern U.S. states in 2001-2002. We examined the distribution and predictors of alcohol and drug use in this sample with an emphasis on psychosocial predictors of use. In the prior 9 months, 27% of participants drank alcohol and 7% drank to intoxication at least weekly. The most common drugs used at least weekly were marijuana (12%) and crack (5%); 11% used a non-marijuana drug. 7% reported polysubstance use (use of multiple substances at one time) at least weekly. Injection drug use was rare (2% injected at least once in the past 9 months). There were few differences in alcohol and drug use across sociodemographic characteristics. Stronger adaptive coping strategies were the most consistent predictor of less frequent alcohol and drug use, in particular coping through action and coping through relying on religion. Stronger maladaptive coping strategies predicted greater frequency of drinking to intoxication but not other measures of alcohol and drug use. Those with more lifetime traumatic experiences also reported higher substance use. Interventions that teach adaptive coping strategies may be effective in reducing alcohol and substance use among HIV-positive persons.
    PMID: 19025481 [PubMed - indexed for MEDLINE]

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    Journal of Adolescent and Young Adult Oncology Jun 2011, Vol. 1, No. 2: 103-106.

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    Early events in transformation of human cord leukobytes by Epstain-Barr virus: induction of DNA synthesis, mitosis and the virus-associated nuclear antigen synthesis.
    Int J Cancer. 1974 Sep 15;14(3):341-7
    Authors: Aya T, Osato T

    PMID: 4376517 [PubMed - indexed for MEDLINE]

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    Clinical Trial Participation and Time to Treatment Among Adolescents and Young Adults With Cancer: Does Age at Diagnosis or Insurance Make a Difference?
    J Clin Oncol. 2011 Sep 19;
    Authors: Parsons HM, Harlan LC, Seibel NL, Stevens JL, Keegan TH
    Abstract
    PURPOSEBecause adolescent and young adult (AYA) patients with cancer have experienced variable improvement in survival over the past two decades, enhancing the quality and timeliness of cancer care in this population has emerged as a priority area. To identify current trends in AYA care, we examined patterns of clinical trial participation, time to treatment, and provider characteristics in a population-based sample of AYA patients with cancer. METHODSUsing the National Cancer Institute Patterns of Care Study, we used multivariate logistic regression to evaluate demographic and provider characteristics associated with clinical trial enrollment and time to treatment among 1,358 AYA patients with cancer (age 15 to 39 years) identified through the Surveillance, Epidemiology, and End Results Program.ResultsIn our study, 14% of patients age 15 to 39 years had enrolled onto a clinical trial; participation varied by type of cancer, with the highest participation in those diagnosed with acute lymphoblastic leukemia (37%) and sarcoma (32%). Multivariate analyses demonstrated that uninsured, older patients and those treated by nonpediatric oncologists were less likely to enroll onto clinical trials. Median time from pathologic confirmation to first treatment was 3 days, but this varied by race/ethnicity and cancer site. In multivariate analyses, advanced cancer stage and outpatient treatment alone were associated with longer time from pathologic confirmation to treatment. CONCLUSIONOur study identified factors associated with low clinical trial participation in AYA patients with cancer. These findings support the continued need to improve access to clinical trials and innovative treatments for this population, which may ultimately translate into improved survival.
    PMID: 21931022 [PubMed - as supplied by publisher]

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    Journal of Adolescent and Young Adult Oncology Jan 2011, Vol. 1, No. 1: 25-29.

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    [Female fertility preservation: Feasibility of emergency IVF for embryo freezing.]
    Gynecol Obstet Fertil. 2011 Aug 3;
    Authors: Courbiere B, Saias-Magnan J, Metzler-Guillemain C, Perrin J, Noizet A, Gamerre M
    With the improvement of the anticancerous treatments, the preservation of the feminine fertility before gonadotoxic treatment tends at present to stand out as a legal obligation, with a duty of information to patients. When emergency IVF can be performed, the cryopreservation of embryos is the best mastered method which offers most chances to patients to obtain a pregnancy after cancer remission thanks to the transfer of frozen embryos. This article proposes an overview about the indications, the feasibility and the ethical and practical limitations of IVF emergency for embryo freezing before gonadotoxic anticancerous treatment.
    PMID: 21820346 [PubMed - as supplied by publisher]

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    Melanoma is the 7th most common cancer in women and 6th most common cancer in men in the United States. The incidence of melanoma in California, a state with high sun-exposure, is the second most common of all cancers in young people under the age of 40. The 5-year overall survival for young people with malignant melanoma, presenting as a localized region, exceeds 90%.  However, despite the lesser disease status, localized melanoma accounts for approximately 10% of all melanoma deaths in young people. Even worse, the 5-year overall survival for regional disease and distant metastatic disease is 65% and 15% respectively. Despite the fact that adolescents and young adults can tolerate high doses of treatment therapies they continue to be treated under less aggressive treatment adult-based guidelines. As we look forward it is important to continue to understand and learn more about the biology of melanomas in these different age groups especially through the role of immunotherapies as well as genetic lesions and progression markers of melanoma.

    Source: Kirkwood J, Jukic D, Averbook B et al. Melanoma in Pediatric, Adolescent, and Young Adult Patients. Semin Oncol. 2009; 36:419-431.

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    Adolescents and young adults with acute lymphoblastic leukemia have a better outcome when treated with pediatric-inspired regimens: Systematic review and meta-analysis.
    Am J Hematol. 2012 Feb 8;
    Authors: Ram R, Wolach O, Vidal L, Gafter-Gvili A, Shpilberg O, Raanani P
    Abstract
    Survival of adults with acute lymphoblastic leukemia (ALL) is inferior to that of pediatric patients. Strategies to improve the outcome of adult population are warranted. This study aims to evaluate the efficacy and safety of pediatric-inspired regimens given to adolescents and young adults (AYA), usually defined as 16-39 years, with ALL. Systematic review and meta-analysis of comparative trials of AYA patients with ALL given induction chemotherapy with either pediatric-inspired regimens or conventional-adult chemotherapy was conducted. Relative risks (RR) with 95% confidence intervals (CIs) were estimated and pooled. Our search yielded 11 trials, including 2,489 patients. AYA patients given pediatric-inspired regimens had a statistically significant lower all cause mortality rate at 3 years (RR 0.58; 95% CI 0.51-0.67). Complete remission rate after induction chemotherapy and event free survival were superior in the pediatric-inspired regimens arm (RR 1.05; 95% CI 1.01-1.10 and RR 1.66; 95% CI 1.39-1.99, respectively). Relapse rate was also lower in patients given pediatric-inspired regimens (RR 0.51; 95% CI 0.39-0.66) with comparable nonrelapse mortality between the two groups (RR 0.53, 95% CI 0.19-1.48). Pediatric-inspired regimens are superior to conventional-adult chemotherapy in AYA ALL patients. Further randomized controlled studies to investigate this approach in adult ALL patients are warranted. © 2012 Wiley Periodicals, Inc.
    PMID: 22388572 [PubMed - as supplied by publisher]

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    Palliative care in adolescents and young adults with cancer.
    Cancer. 2011 May 15;117(10 Suppl):2323-8
    Authors: Pritchard S, Cuvelier G, Harlos M, Barr R
    Adolescents and young adults (AYA) with advanced or terminal cancer have distinctive medical and psychosocial needs that may not have been adequately provided by either pediatric or adult palliative care services. A discussion group, as part of a larger workshop on AYA with cancer, was held in Toronto on March 11-13, 2010;117:-. Recommendations were as follows: Develop a specific AYA screening tool designed to detect increased anxiety or new symptoms and to initiate discussion about palliative or symptom care; Set Canadian standards for palliative care in AYA patients. These standards should be included in hospital accreditation; Involve the palliative/symptom care team early in the disease trajectory to help manage clinically important symptoms that may not be associated with imminent death; Establish specific AYA multidisciplinary palliative care teams throughout Canada that are flexible and can work in both pediatric and adult facilities, and are able to work in a "virtual" environment to support patients being cared for at home; Improve physical facilities in hospices and hospitals to meet the distinctive needs of terminally ill AYA patients; Enhance support for palliative care at home by: changing legislation to improve Compassionate Care Benefits and developing "virtual palliative care support teams". Adequate provision of AYA palliative care and symptom management services will likely confer notable benefits to AYA patients and their families, and is likely to be cost saving to the tax payer by avoiding prolonged hospitalization and promoting easier return to work for the families and caregivers.
    PMID: 21523753 [PubMed - indexed for MEDLINE]

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    [Ovarian yolk sac tumour: general review].
    Bull Cancer. 2011 Aug 1;98(8):963-75
    Authors: Even C, Lhommé C, Duvillard P, Morice P, Balleyguier C, Pautier P, Troalen F, de La Motte Rouge T
    Abstract
    Ovarian yolk sac tumour (OYST) is a very rare malignancy arising most often in young women. Preoperative clinical, biological (alpha-foetoprotein) and radiological findings should help to establish the diagnosis of OYST, in order to propose adequate surgical treatment. The aim of surgery is to remove the primary tumour, to obtain an accurate histological diagnosis and to assess the disease extent. In young women, fertility-sparing surgery should be performed, in order to preserve the possibility of pregnancy later on. Chemotherapy has substantially modified the prognosis of these tumours, and practically all patients will be cured. The overall 5-year survival rate is 94% when patients are treated with BEP chemotherapy. Depending on the clinical situation, two to four cycles of the BEP regimen should be administered after surgery. Identification of prognostic factors may help to propose risk-adapted treatment in order to increase the cure rate in patients with a poor prognosis and to decrease toxicity in patients with a low risk of relapse. Fertility preservation represents a major objective in women treated for OYSTs.
    PMID: 21708513 [PubMed - indexed for MEDLINE]

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    Unique characteristics of adolescent and young adult acute lymphoblastic leukemia, breast cancer, and colon cancer.
    J Natl Cancer Inst. 2011 Apr 20;103(8):628-35
    Authors: Tricoli JV, Seibel NL, Blair DG, Albritton K, Hayes-Lattin B
    Each year in the United States, nearly 70 000 individuals between the ages of 15 and 40 years are diagnosed with cancer. Although overall cancer survival rates among pediatric and older adult patients have increased in recent decades, there has been little improvement in survival of adolescent and young adult (AYA) cancer patients since 1975 when collected data became adequate to evaluate this issue. In 2006, the AYA Oncology Progress Review Group made recommendations for addressing the needs of this population that were later implemented by the LIVESTRONG Young Adult Alliance. One of their overriding questions was whether the cancers seen in AYA patients were biologically different than the same cancers in adult and/or pediatric patients. On June 9-10, 2009, the National Cancer Institute (NCI) and the Lance Armstrong Foundation (LAF) convened a workshop in Bethesda, MD, entitled "Unique Characteristics of AYA Cancers: Focus on Acute Lymphocytic Leukemia (ALL), Breast Cancer and Colon Cancer" that aimed to examine the current state of basic and translational research on these cancers and to discuss the next steps to improve their prognosis and treatment.
    PMID: 21436065 [PubMed - indexed for MEDLINE]

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    Early adenocarcinoma of the cervix: Is radical vaginal trachelectomy safe?
    Gynecol Oncol. 2011 Jul 18;
    Authors: Helpman L, Grisaru D, Covens A
    OBJECTIVE: Radical vaginal trachelectomy (RVT) is a revolutionary option for fertility preservation in young women with early cervical tumors. Several series have demonstrated outcomes comparable to radical hysterectomy (RH), but none has addressed the influence of histology. We evaluated the safety of RVT in adenocarcinomas. METHODS: Data on surgically treated adenocarcinoma (AC) and squamous cell carcinoma (SCC) cases was taken from a centralized Toronto Cervical Cancer Database. Prognostically important tumor features, lymph node status, and the use of adjuvant therapies were compared. Adenocarcinoma cases treated with RVT were compared to AC cases treated with RH, and to SCC cases that had RVT. Recurrence-free survival was calculated from the date of surgery. Medians, proportions, and survival curves were compared with the Mann Whitney test, the Chi-square test, and the Log Rank test, respectively. RESULTS: 74 patients with AC and 66 patients with SCC undergoing RVT, and 187 cases of AC undergoing RH were analyzed. Patients undergoing RVT were younger than patients having RH (31 vs. 40, p<0.001). Tumor characteristics were similar, but depth of invasion and the frequency of high grade lesions were higher in the RH group (5mm vs. 3mm, p<0.001; and 36% vs. 22%, p=0.04). Adjuvant treatment was given more frequently after RH (12% vs. 3%, p<0.05). There was no significant difference in recurrence-free survival between RH and RVT for AC, or between AC and SCC patients treated by RVT. CONCLUSIONS: RVT is a safe alternative for early stage cervical adenocarcinoma in appropriately selected patients wishing to preserve fertility.
    PMID: 21774971 [PubMed - as supplied by publisher]

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    A chief concern affecting quality of life among young adult (YA) cancer survivors is fertility. Although discussions regarding the possibility of infertility and methods to decrease the risk are crucial at the time of diagnosis, many YAs don’t remember having adequate discussions regarding these topics before the initiation of their treatment. Embryo cryopreservation in women and sperm cryopreservation in men before cancer therapy remains to be the most effective ways in which fertility is preserved in the YA population. Although female and male gonadal tissue cryopreservation and transplantation remain experimental, such options are explored and continuously researched through programs such as the Oncofertility Consortium at Northwestern University.

    Sources: Levine J, Canada A, Stern C. Fertility Preservation in Adolescents and Young Adults With Cancer.  J Clin Oncol. 2010; 28:4831-4841.

    Bleyer A, Barr R. Cancer in Young Adults 20 to 39 Years of Age: Overview. Semin Oncol. 2009; 36:194-206.

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    Recruitment and follow-up of adolescent and young adult cancer survivors: the AYA HOPE Study.
    J Cancer Surviv. 2011 Jan 28;
    Authors: Harlan LC, Lynch CF, Keegan TH, Hamilton AS, Wu XC, Kato I, West MM, Cress RD, Schwartz SM, Smith AW, Deapen D, Stringer SM, Potosky AL,
    INTRODUCTION: Cancer is rare in adolescents and young adults (AYA), but these patients have seen little improvement in survival in contrast to most other age groups. Furthermore, participation in research by AYAs is typically low. We conducted a study to examine the feasibility of recruiting a population-based sample of AYA survivors to examine issues of treatment and health outcomes. METHODS: Individuals diagnosed in 2007-08 and age 15-39 at the time of diagnosis with acute lymphocytic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, germ cell cancer or sarcoma were identified by 7 Surveillance, Epidemiology, and End-Results (SEER) cancer registries, mailed surveys within 14 months after diagnosis and again a year later, and had medical records reviewed. RESULTS: 525 (43%) of the eligible patients responded, 39% refused and 17% were lost to follow-up. Extensive efforts were required for most potential respondents (87%). 76% of respondents completed the paper rather than online survey version. In a multivariate model, age, cancer site, education and months from diagnosis to the first mailing of the survey were not associated with participation, although males (p < 0.01), Hispanics and non-Hispanic blacks (p < 0.001) were less likely to participate. 91% of survivors completing the initial survey completed the subsequent survey. DISCUSSION: Despite the response rate, those who participated adequately reflected the population of AYA cancer survivors. The study demonstrates that cancer registries are valuable foundations for conducting observational, longitudinal population-based research on AYA cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Achieving a reasonable response rate in this population is possible, but requires extensive resources.
    PMID: 21274648 [PubMed - as supplied by publisher]

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    Did changing primary care delivery models change performance? A population based study using health administrative data.
    BMC Fam Pract. 2011;12:44
    Authors: Jaakkimainen RL, Barnsley J, Klein-Geltink J, Kopp A, Glazier RH
    Abstract
    BACKGROUND: Primary care reform in Ontario, Canada started with the introduction of new enrollment models, the two largest of which are Family Health Networks (FHNs), a capitation-based model, and Family Health Groups (FHGs), a blended fee-for-service model. The purpose of this study was to evaluate differences in performance between FHNs and FHGs and to compare performance before and after physicians joined these new primary care groups.
    METHODS: This study used Ontario administrative claims data to compare performance measures in FHGs and FHNs. The study population included physicians who belonged to a FHN or FHG for at least two years. Patients were included in the analyses if they enrolled with a physician in the two years after the physician joined a FHN or FHG, and also if they saw the physician in a two year period prior to the physician joining a FHN or FHG. Performance was derived from the administrative data, and included measures of preventive screening for cancer (breast, cervical, colorectal) and chronic disease management (diabetes, heart failure, asthma).
    RESULTS: Performance measures did not vary consistently between models. In some cases, performance approached current benchmarks (Pap smears, mammograms). In other cases it was improving in relation to previous measures (colorectal cancer screening). There were no changes in screening for cervical cancer or breast cancer after joining either a FHN or FHG. Colorectal cancer screening increased in both FHNs and FHGs. After enrolling in either a FHG or a FHN, prescribing performance measures for diabetes care improved. However, annual eye examinations decreased for younger people with diabetes after joining a FHG or FHN. There were no changes in performance measures for heart failure management or asthma care after enrolling in either a FHG or FHN.
    CONCLUSIONS: Some improvements in preventive screening and diabetes management which were seen amongst people after they enrolled may be attributed to incentive payments offered to physicians within FHGs and FHNs. However, these primary care delivery models need to be compared with other delivery models and fee for service practices in order to describe more specifically what aspects of model delivery and incentives affect care.
    PMID: 21639883 [PubMed - indexed for MEDLINE]

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    Challenges in the recruitment of adolescents and young adults to cancer clinical trials.
    Cancer. 2007 Dec 1;110(11):2385-93
    Authors: Burke ME, Albritton K, Marina N
    The adolescent and young adult (AYA) oncology population has seen inferior progress in cancer survival compared with younger children and older adults over the past 25 years. Previously, AYAs had the best survival rates due to the prevalence of highly curable diseases including Hodgkin lymphoma and germ cell tumors, yet today AYAs have inferior survival rates to children and some adult cohorts. Survival rates are particularly poor for AYA-specific diseases such as sarcomas. Research involving children and adults diagnosed with common malignancies such as acute lymphoblastic leukemia has resulted in improved survival rates. However, AYAs have not directly benefited from such research due to low rates of access to and accrual on clinical trials. AYAs are less likely to have insurance or access to healthcare, are more likely to see providers who are not part of research institutions, and are less likely to be referred to or to join clinical trials, all of which may contribute to worse outcomes. Few clinical trials target AYA-specific diseases, leading to little information regarding how these diseases behave and what role the host plays. Tumor samples for this population are underrepresented in national tumor banks. Coupled with the need for more clinical trials that focus on AYA-specific cancers, better collaboration between adult and pediatric cooperative groups as well as increased education among community oncologists and primary care providers will be needed to enhance participation in clinical trials with the goal to increase survival and improve quality of that survival.
    PMID: 17918260 [PubMed - indexed for MEDLINE]

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    Stop A Doc Tip 3

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    A novel real-time genotyping assay for detection of the E6-350G HPV 16 variant.
    J Virol Methods. 2011 May;173(2):357-63
    Authors: Perez S, Cid A, Araujo A, Lamas MJ, Saran MT, Alvarez MJ, Lopez-Miragaya I, Gonzalez S, Torres J, Melon S
    It has been suggested that some E6 human papillomavirus (HPV) type 16 variants could be involved in viral persistence and progression of HPV infection. A novel one-step allelic discrimination real-time PCR was evaluated for E6-350G variant detection in 102 endocervical HPV 16 positive samples. This assay was also used to assess the distribution of this variant in Spanish women with cervical cancer related to HPV 16. The detection limit for the allelic discrimination assay was 50 copies per reaction, even where the E6-350G variant represents only 20% of the variants in the sample. Complete concordance was observed between DNA sequencing and the novel AD RT-PCR assay. Fourteen E6-350T reference strains and 18 E6-350G variants were detected out of 32 endocervical samples from women with cervical cancer. The average age of women who were infected by the E6-350G HPV 16 variant was 10 years lower in these samples than in women who were infected by the reference strain. This novel allelic discrimination assay is a fast, sensitive and specific method for detection of the E6-350G HPV 16 variant.
    PMID: 21419166 [PubMed - indexed for MEDLINE]

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    Adolescents and young adults with cancer: An orphaned population.
    Paediatr Child Health. 2006 Feb;11(2):103-6
    Authors: Fernandez CV, Barr RD
    Adolescents and young adults (AYAs [15 to 29 years of age]) with cancer have a distinct cancer epidemiology, evolving hormonal milieu, maturing development, transitions in autonomy, increasing demands in education, entry into the workplace and family responsibilities. The prevalence of epithelial cancers in AYA patients represents a major shift from the embryonal cancers that predominate in early childhood. Thus, one would expect a specialized expertise to be required in caring for these patients, who typically fall between paediatric and oncology spheres of practice. Complex issues contribute to the lower survival rates noted for AYAs compared with those of younger patients, even with the same cancer. Cooperative group clinical trial participation has been crucial in advancing the excellent outcomes accomplished in paediatric oncology, yet participation by adolescents in clinical trials (either adult or paediatric) is typically low. There is increasing evidence that both appropriate location of care and access to specialists in paediatric or adult oncology contribute to favourable outcomes. Issues specific to AYA patients should be studied rigorously so that evidence-based approaches may be used to reduce waiting times, ensure prompt referral to appropriate centres, increase accrual to clinical trials, foster compliance, provide comprehensive supportive care and promote programs designed to enhance survivorship.
    PMID: 19030262 [PubMed]

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    Enhancement of neoangiogenesis and follicle survival by sphingosine-1-phosphate in human ovarian tissue xenotransplants.
    PLoS One. 2011;6(4):e19475
    Authors: Soleimani R, Heytens E, Oktay K
    Abstract
    Ovarian transplantation is one of the key approaches to restoring fertility in women who became menopausal as a result of cancer treatments. A major limitation of human ovarian transplants is massive follicular loss during revascularization. Here we investigated whether sphingosine-1-phosphate or its receptor agonists could enhance neoangiogenesis and follicle survival in ovarian transplants in a xenograft model. Human ovarian tissue xenografts in severe-combined-immunodeficient mice were treated with sphingosine-1-phosphate, its analogs, or vehicle for 1-10 days. We found that sphingosine-1-phosphate treatment increased vascular density in ovarian transplants significantly whereas FTY720 and SEW2871 had the opposite effect. In addition, sphingosine-1-phosphate accelerated the angiogenic process compared to vehicle-treated controls. Furthermore, sphingosine-1-phosphate treatment was associated with a significant proliferation of ovarian stromal cell as well as reduced necrosis and tissue hypoxia compared to the vehicle-treated controls. This resulted in a significantly lower percentage of apoptotic follicles in sphingosine-1-phosphate-treated transplants. We conclude that while sphingosine-1-phosphate promotes neoangiogenesis in ovarian transplants and reduces ischemic reperfusion injury, sphingosine-1-phosphate receptor agonists appear to functionally antagonize this process. Sphingosine-1-phosphate holds great promise to clinically enhance the survival and longevity of human autologous ovarian transplants.
    PMID: 21559342 [PubMed - indexed for MEDLINE]

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    [Conversion of acute leukemia from a T-lymphoid to a myeloid phenotype].
    Rinsho Ketsueki. 1989 Dec;30(12):2163-8
    Authors: Sugita K, Nakazawa S, Saito M, Gonda T, Kusumoto Y, Aya M, Osano M, Shimizu M, Okazaki T, Inaba T
    A 7-year-old girl with an acute leukemia was reported whose blasts showed conversion from a T-lymphoid to a myeloid phenotype. At the onset of the disease, the blasts were negative for peroxidase and displayed FAB L1 morphology. Surface marker analysis revealed only CD7 antigen. Although complete remission was achieved, an extramedullary relapse was identified as having a several subcutaneous tumors 15 months later. Tumor cells showed the same marker expression as that of the blasts at the onset. After short term culture without an addition of any differentiation stimulators, the blast cells expressed CD2, CD3, CD4, CD8, and CD25 antigens. The karyotype was 46, XX, t(12; 21) (p11; q22). The intensive chemotherapy and radiation therapy were carried out, however, a hematological relapse occurred 12 months later. At this time, the blasts were strongly positive for peroxidase and expressed HLA-DR and CD33 antigens with disappearance of the CD7 antigen. Chromosome analysis revealed the additional abnormalities (del (7) (p15), -17, +der (17) t (17;?) (p13;?].
    PMID: 2621798 [PubMed - indexed for MEDLINE]

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    In December of 2007 I was diagnosed with Breast Cancer. Somehow I always actually thought that my daily dedication at the gym in the morning, the healthy lifestyle, constant positive attitude and attention to the golden rule I kept worked as some magical cloak around my shoulders that would protect me from things just like this. I couldn’t believe it, the words hit me like a ton of bricks.

    Within a week I had a biopsy, and later that week I had a double mastectomy, the layer that was once my chest muscle removed, and the first stage of reconstruction done at the same time of the surgery; which meant placing expanders in between my skin and ribcage which would later be breast implants. I’ve suffered some serious wreckage and broken bones in my day (6 broken collarbones to name a few) but I’ve never in my life experienced pain like the following week brought. I can’t speak or think about it without my eyes welling with tears, kind of pain. Talk about getting knocked of your high horse- I’ve just been leveled.

    I had to wait almost a month to begin chemotherapy, in that month I was given another strike from the great umpire of the universe, I started having vision fluctuations in my eyes. I went to the ophthalmologist and he informed me that I had tumors pressing on each retina and that the breast cancer was metastasizing. Within days, I had lost vision completely in my left eye, and could only see wavy lines and spots out of my right eye. Now I was sitting, unable to read, watch TV, read books, or drive in a car as it all made me nauseas. It stayed this way for 6 weeks. This was the point when I really started to freak out, for some reason even with the surgery, it wasn’t until this doctor’s visit that it hit me. I have Cancer.

    My ophthalmologist called my specialist immediately. I could hear her loudly moan over the telephone in disbelief, the next day I was taken to the Utah Cancer Center and given a PET/CT scan which can identify and pinpoint cancer throughout your body. I found out I had it everywhere except my brain and my feet. At least I couldthink about how crazy this was, and run out of there!  It had completely taken over my eyes, neck, sternum, ribs, lungs, spine, hips, legs, and my liver was swollen to twice its size. They informed me I was a stage 4 cancer patient, with an extremely aggressive and rare form of  breast cancer; the worst there was with the smallest percentage of living. I was speechless, and anyone who knows me knows I’m never speechless. After this, I went home to write a will and start goodbye letters to my husband and my family. Okay, this was real. Very real, and I was FU#@ING petrified for the first time in my life.

    Around that same time I started having sever pain in my left hip. So much so, that I became in need of a cane to walk. In keeping with my sense of humor, I purchased a carbon fiber cane sword. Yes, the handle was a 21/2-foot stainless steel sword that stealthily hid away in the bottom of the cane. So if I got the chance to joust my cancer, I was ready.

    Now I am about 3 weeks into this bizarre experience, and so much has happened that it really is making me wonder if I didn’t just get into a car accident on the way home from work and I’m actually in a coma just dreaming all of this. In less than a month I went from powering full throttle through life, work, and sport, to being a blinded cancer patient hobbling around on a cane! How could this be? I just learned switch front side airs skateboarding, I can’t have cancer!

    It was hard for me not to get bummed, really bummed, but for some reason I didn’t. In fact, one of the first things I did when I was told the stage of my cancer was buy Rosetta Stone for French, because I thought it would be a nice use of this time to start on a third language. I’m not saying that when no one was around, I didn’t cry, a lot, because I did, but I never really lost it, and I never really got depressed. Actually cancer was like the crowbar that pried my heart open and let me feel the strongest most wonderful connection with my family, my friends, and God. It enabled me to look past everything I was going through and keep my focus on living through this. It was like life was a car I was driving, and I chose only to look  at cancer through the rear view mirror.

    Next chapter was chemotherapy, equally a modern marvel of science, and a special delivery straight from the fiery depths of hell. I’d love to pretend it is anything less than that, but it’s not. I was prescribed intensive intravenous chemotherapy, so every 3 weeks I would sit in a lazy boy, stuffed with warm blankets and endless episodes of Lost, while I received 7 hours worth of IV bags. It kills your cells, both healthy and cancerous. It takes you within an inch of your life for about 9 horrible days, and just when you start to feel a little better, it is just in time to go back for your next treatment. Chemo taught me a lot. There’s something about lying in your bed wondering if this unfamiliar feeling your having is you dying that gives a person some time to think and reorganize priorities. It was the ultimate boot camp for survival, patience, faith, and self control. Chemo is bone pain, namely femur pain, nausea, vomiting, fever, cold sweats, muscle cramps and spasms, losing all of your hair, and a constant terrible stomachache. My 5’8” body was coming in at under 110 pounds most of the time, it felt straight extraterrestrial, not Hollywood thin. Every muscle on my entire body, a lifetime of training and sports, is completely gone.  Chemo was hell. I wish there was something I could do to make it so that no person gets cancer because Cancer is complete bullshit. If I could be the sacrificial lamb to stop anyone from having to go through any of this ever again, I would do it.

    The action sports community in Salt Lake City is extraordinary and I’m so proud to be a part of it. I had a beautiful display of love, support, and friendship. I wish I could enter the lot of them in some humanitarian contest. They would win, hands down. Almost every day, I had an amazing person visit me and bring with them nothing but selflessness and optimism. My sweet mom flew back and forth all the way from New York for every treatment to help us around the house. My amazing husband could write a book on how to do everything 100% right for your wife when she is sick and really needs you. I was given a Mormon blessing by two dear friends, and even though I’m not technically Mormon, I was welcomed in and placed on every prayer list at every church from here to NY. I had friends that had benefits for me and collectively they donated over $22,000 to cancer research organizations in my name. It was an optimism and faith fest, and I was in the center of it, and it made my cancer seem worth something somehow.

    May 12 was the date of my last chemotherapy, and I had equal parts excitement and fear. Going in there that morning I imagine must have been something like what the Spartans felt lining up for battle with the Persians in the war of Thermopylae. Day’s prior I had another PET/CT scan to see what the end result of all of these chemotherapies was. I had only expected the cancer count (through blood tests, it is the measure of the cancer concentration in your body) to continue to go down. But when the doctors told me they couldn’t find one trace of cancer on my last scan, he looked shocked. I was in shock. I still am. I graciously accepted his teary eyed hug and the pat on the back for being the only case like these he has ever seen.  I guess it’s miraculous, and it’s really hard for my brain to digest. I’m still working on it.

    Today it has been only one month since my last chemotherapy. Looking back, there’s only one thing I would have done differently. I detected the lump in my breast after a bad slam on a rail snowboarding at Park City in December of 2006. I immediately went to my general doctor, and continued to do so for a year, with the same complaint. I was told during each visit that  I was way to fit, young, and healthy to be concerned. So we just said we’d “watch it”, and “watch it” we did. I watched it turn into the size of a plum, and then turn into a painful and potentially life threatening cancer before anyone took me seriously, because I was young, because I was healthy, and because I was fit. Who chose for 40 to be the magical age where a doctor will order testing for you or your health insurance will even cover it for you? This all should have been prevented. I went early enough for this to be detected.

    If I had it to do over I would have forced someone to listen to me, to look at me, to try to help me save my own life before I had to go through everything I did, and come within such  a close step of it. Now all I do is receive two drugs, intravenously every 3 weeks for no less than 5 years. I get the PET/CT scan every 3 months to ensure cancer isn’t coming back, and try to figure out how to live now, stress free, and not let myself worry about getting cancer again.

    There is an organization called Seventy K which is petitioning for an adolescent and young adult cancer bill of rights. Wherein the #1 statement it makes and defends is “The right to be taken seriously when seeking medical attention to avoid late diagnosis or misdiagnosis, despite age.” Enough said, things would have been different for me if that were a law.  iI you feel so inclined please sign your name on their petition at www.seventyk.org.

    I’ve just found that It’s not easy to share such personal things in print, but If my story can help someone, in some way, either catching cancer early, forcing your doctor to listen to you, or to console you if you are amidst this struggle, than I am happy to help. I want to help. I’ve written about such a serious thing with such a light heart and an air toward humor, because that is the way I got through this whole mess.

    Why does it take something like cancer to make us slow down or just STOP for a minute, enjoy the people around us, enjoy ourselves, and prioritize in accordance to what really is important? To realize the real way we need to live and how to live with those around us. How to take care of our bodies and the way we need to care for our minds. Optimism, faith in God and myself, surrounding myself with wonderful people, and keeping the right thoughts in my mind saved me. Imagine what it can do for you, in your life, every single day. 

    “Your life is what your thoughts make it” –Marcus Aurelius

    Krista Moroge is a young adult cancer survivor from the Pacific Northwest. She is also a Territory Manager for SLKC Sales Agency- Burton, Red, Anon, Analog, Gravis. She is also a volunteer for SeventyK and is currently helping  to grow the organization.

     

    Originally posted in June 2008.

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    Stop A Doc Kit

     

    Stop A Doc Video Contest

    Winners have been announced and cash prizes were awarded in two cateorgies:

    • Patients and caregivers made videos that can be used to teach doctors and other healthcare professionals about treating AYA cancer patients.
    • Healthcare professionals made videos to demonstrate that they know about treating AYA cancer patients.

    VIEW ALL CONTEST WINNERS!

     

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    Active therapy and models of care for adolescents and young adults with cancer.
    Cancer. 2011 May 15;117(10 Suppl):2316-22
    Authors: Ramphal R, Meyer R, Schacter B, Rogers P, Pinkerton R
    The reduction in the cancer mortality rate in adolescents and young adults (AYA) with cancer has lagged behind the reduction noted in children and older adults. Studies investigating reasons for this are limited but causes appear to be multifactorial. Host factors such as developmental stage, compliance, and tolerance to therapy; provider factors such as lack of awareness of cancer in AYA and referral patterns; differences in disease biology and treatment strategies; low accrual onto clinical trials; and lack of psychosocial support and education programs for AYA all likely play a role. Recommendations for change from a recent international workshop include education of physicians and patients concerning AYA cancer, improved cooperation between pediatric and adult centers, age-appropriate psychosocial support services, programs to help AYA with issues relevant to them, dedicated AYA hospital space, improved accrual to clinical trials, the use of technology to educate patients and enhance communication between patients and the health care team, and ensuring that resident and fellowship training programs provide adequate education in AYA oncology. The longer term goal is to develop AYA oncology into a distinct subspecialist discipline within oncology. The ideal model of care would incorporate medical care, psychosocial support services, and a physical environment that are age-appropriate. When this is not feasible, the development of "virtual units" connecting patients to the health care team or a combination of physical and virtual models are alternative options. The assessment of outcome measures is necessary to determine whether the interventions implemented result in improved survival and better quality of life, and are cost-effective.
    PMID: 21523752 [PubMed - indexed for MEDLINE]

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    Risk of seropositivity to multiple oncogenic human papillomavirus types among human immunodeficiency virus-positive and -negative Ugandan women.
    J Gen Virol. 2011 Dec;92(Pt 12):2776-83
    Authors: Namujju PB, Waterboer T, Banura C, Muwonge R, Mbidde EK, Byaruhanga R, Muwanga M, Surcel HM, Pawlita M, Lehtinen M
    Abstract
    To understand the prospects for human papillomavirus (HPV) mass vaccination in the setting of a developing country, we studied the co-occurrence of seropositivity to multiple high-risk (hr) HPV types among HIV-positive and HIV-negative Ugandan women. Our seroepidemiological study was conducted among 2053 women attending antenatal clinics. Sera were analysed for antibodies to eight hrHPV types of the α-7 (18/45) and α-9 (16/31/33/35/52/58) species of HPV by using a multiplex serology assay. Our results show that seropositivity for greater than one hrHPV type was as common (18 %) as for a single type (18 %). HIV-positive women had higher HPV16, HPV18 and HPV45 seroprevalences than HIV-negative women. In multivariate logistic regression analysis, age (>30 years) and level of education (secondary school and above) reduced the risk, whereas parity (>5) and HIV-positivity increased the risk for multiple hrHPV seropositivity. However, in stepwise logistic regression analyses, HIV-status remained the only independent, stand-alone risk factor [odds ratio (OR) 1.7, 95 % confidence interval (CI) 1.0-2.8). On the other hand, the risk of HPV16 or HPV18 seropositive women, as compared to HPV16 or HPV18 seronegative women, for being seropositive to other hrHPV types was not significantly different when they were grouped by HIV-status (ORHPV16/HIV+ 12, 95 % CI 4.5-32 versus ORHPV16/HIV- 22, 95 % CI 15-31 and ORHPV18/HIV+ 58, 95 % CI 14-242 versus ORHPV18/HIV- 45, 95 % CI 31-65). In conclusion, seropositivity to HPV16, HPV18 and to non-vaccine hrHPV types is common in Ugandan women, suggesting that there is little natural cross-protective immunity between the types. HIV-positivity was an independent, stand-alone, albeit moderate risk factor for multiple hrHPV seropositivity. HPV mass vaccination may be the most appropriate method in the fight against cervical cancer in the Ugandan population.
    PMID: 21832008 [PubMed - indexed for MEDLINE]

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    Diversity of T-cell receptor gene rearrangements in South Indian patients with common acute lymphoblastic leukemia.
    Iran J Immunol. 2009 Sep;6(3):141-6
    Authors: Sudhakar N, Nancy NK, Rajalekshmy KR, Rajkumar T
    Precursor B-Acute Lymphoblastic Leukemia (precursor B-ALL) occurs due to the uncontrolled proliferation of B-lymphoid precursors arrested at a particular stage of B-cell development. Precursor-B-ALL is classified mainly into pro-B-ALL, common-ALL and pre-B-ALL. The Common Acute Lymphoblastic Antigen CD10 is the marker for common-ALL.
    PMID: 19801787 [PubMed - indexed for MEDLINE]

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    TipText: 
    As a healthcare professional dealing with AYA cancer it's important to remember the young adult is the patient and not the parents, respect the patients age and intelligence. For health care professionals, here is an article on "Psychosocial Adjustment in Adolescent Cancer Survivors" http://jpepsy.oxfordjournals.org/content/22/1/29.abstract
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    Current issues in adolescent and young adult cancer survivorship.
    Cancer Control. 2008 Jan;15(1):55-62
    Authors: Soliman H, Agresta SV
    Overall, the survival rate for cancer patients has continued to improve over the past several decades. However, those aged 15 to 29 years have not experienced the same improvements in survival. This review explores some of the challenges faced by adolescent and young adult (AYA) cancer patients and their survivorship needs.
    PMID: 18094661 [PubMed - indexed for MEDLINE]

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    Journal of Adolescent and Young Adult Oncology Jun 2011, Vol. 1, No. 2: 107-108.

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    [Antigen of EB virus-infected cells - expression of the virus and development of tumor].
    Uirusu. 1974 Apr;24(1):115-23
    Authors: Osato S, Sugawara K, Mizuno F, Aya T, Yamamoto K

    PMID: 4377349 [PubMed - indexed for MEDLINE]

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    Increasing rates of cervical cancer in young women in England: an analysis of national data 1982-2006.
    Br J Cancer. 2011 Jun 28;105(1):177-84
    Authors: Foley G, Alston R, Geraci M, Brabin L, Kitchener H, Birch J
    Abstract
    BACKGROUND: In England, cervical cancer is the second most common cancer in women aged under 35 years. Overall incidence of cervical cancer has decreased since the introduction of the national screening programme in 1988 but recent trends of incidence in young women have not been studied in detail.
    METHODS: Information on 71,511 incident cases of cervical cancer in England, 1982-2006, in 20-79-year-olds was extracted from a national cancer registration database. Changes in incidence were analysed by age group, time period and birth cohort. Poisson regression was used to estimate annual percentage change (APC).
    RESULTS: Overall incidence, during 1982-2006, fell significantly from 213 to 112 per million person years. However, in 20-29-year-olds, after an initial fall, incidence increased significantly during 1992-2006, (APC 2.16). In 30-39-year-olds incidence stabilised during the latter part of the study period. The pattern was most marked in the North East, Yorkshire and the Humber and East Midlands regions. Birth cohorts that were initially called for screening between 60-64 and 35-39 years of age show an incidence peak soon after the age of presumed first screen, whereas younger birth cohorts show a peak at about 35 years of age. Incidence in the 1977-1981 birth cohort has increased relative to that among women born between 1962 and 1976.
    CONCLUSION: These results have implications for cervical screening, human papilloma virus vaccination and other public health interventions targeting young people.
    PMID: 21654675 [PubMed - indexed for MEDLINE]

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    Journal of Adolescent and Young Adult Oncology Jan 2011, Vol. 1, No. 1: 31-35.

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    Why the Pap test? Awareness and use of the Pap test among women in the United States.
    J Womens Health (Larchmt). 2011 Apr;20(4):511-5
    Authors: Hawkins NA, Cooper CP, Saraiya M, Gelb CA, Polonec L
    To inform campaign development by assessing awareness, previous receipt, and knowledge of the purpose of Papanicolaou (Pap) testing among women aged ≥ 18 years and to identify differences in awareness, receipt, and knowledge by demographic characteristics.
    PMID: 21443450 [PubMed - indexed for MEDLINE]

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    Globally, the incidence of sarcoma in young adults is approximately 2/100,000 persons with a greater incidence in males over females by a 2:1 ratio. Previous radiation and chemotherapy exposure before the age of 20, as well as exposure to certain chemical agents, has been linked to an increased risk in the development of sarcoma in the young adult population. Young adult sarcoma patients seem to do worse then their pediatric counterparts for a variety of reasons, one being the differences in the biology of their cancers. These differences in biology need to be accounted for when establishing treatment plans in this age group in determining pediatric- versus adult-based protocols.

    Source: Soliman H, Ferrari A, Thomas D. Sarcoma in the Young Adult Population: An International View. Semin Oncol. 2009; 36:227-236.

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    Women's awareness of the human papilloma virus and related health problems.
    J Adv Nurs. 2011 Dec;67(12):2703-12
    Authors: Akyuz A, Yılmaz C, Yenen MC, Yavan T, Kılıç A
    Abstract
    AIM: This paper is a report of a study of women's awareness of the human papilloma virus and related health problems.
    BACKGROUND: Cervical cancer is an important cause of mortality, making up approximately 12% of all cancers in women. Awareness on the part of carriers of human papilloma virus is crucial in preventing transmission of the infection and protecting against cervical cancer.
    METHOD: The study was performed as a cross-sectional descriptive study. The study consists of 79 human papilloma virus-positive women who had not been diagnosed with cervical cancer and 150 women who had not been diagnosed with human papilloma virus. Data were collected via questionnaires between November 2007 and April 2008. Percentages and chi-square test were used.
    FINDINGS: A significantly higher percentage of women with positive human papilloma virus knew the definition of human papilloma virus, the fact that it is transmitted via sexual contact and that it can lead to cervical cancer than did women with negative human papilloma virus. It was established that approximately half the women with positive human papilloma virus presented at the hospital with a genital wart. None of the women knew that a Pap smear test was a necessary tool in the prevention of cervical cancer.
    CONCLUSION: Women with positive human papilloma virus have insufficient knowledge of human papilloma virus, sexually transmitted diseases, the health risks associated with human papilloma virus and the means of preventing these risks. It is therefore necessary to evaluate the education of health workers, and especially of nurses, on human papilloma virus and its prevention.
    PMID: 21615458 [PubMed - indexed for MEDLINE]

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    Role of palliative care in adolescent and young adult oncology.
    J Clin Oncol. 2010 Nov 10;28(32):4819-24
    Authors: Wein S, Pery S, Zer A
    Adolescents and young adults (AYAs) with cancer are a heterogeneous group. Nevertheless, there are sufficient unifying characteristics to form a distinct clinical entity. Management of this special group requires a broad-based interdisciplinary clinical team, which should include palliative care (PC), psychology, social work, oncology, and nursing representatives. The function of PC is to provide impeccable pain and other symptom control and to coordinate care as the disease progresses. Features unique to AYAs with cancer include the psychosocial developmental phases, a young person facing death, grief, and bereavement. Pharmacologic and medical interventions by PC in AYAs are broadly similar to adults. Developing trust and being flexible are key skills that PC must use with AYAs. There is a paucity of high-quality controlled studies in the PC literature in general and AYA-PC in particular. Therefore, the methodology of this article is largely based on the narrative and clinical experience. The experience is based on clinicians' work with AYAs with cancer in Israel and Australia. Clinical lessons will be drawn by comparing and contrasting the cultures. Nevertheless, most PC clinical interventions, both pharmacologic and psychosocial, are derived from literature where there is a good evidence base. Future development of PC within AYAs should be coordinated at a national level via appropriate palliative and oncology professional organizations.
    PMID: 20212259 [PubMed - indexed for MEDLINE]

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    A social-ecological model of readiness for transition to adult-oriented care for adolescents and young adults with chronic health conditions.
    Child Care Health Dev. 2011 Nov;37(6):883-95
    Authors: Schwartz LA, Tuchman LK, Hobbie WL, Ginsberg JP
    Abstract
    Background  Policy and research related to transition to adult care for adolescents and young adults (AYAs) has focused primarily on patient age, disease skills and knowledge. Objective  In an effort to broaden conceptualization of transition and move beyond isolated patient variables, a new social-ecological model of AYA readiness for transition (SMART) was developed. Methods  SMART development was informed by related theories, literature, expert opinion and pilot data collection using a questionnaire developed to assess provider report of SMART components with 100 consecutive patients in a childhood cancer survivorship clinic. Results  The literature, expert opinion and pilot data collection support the relevance of SMART components and a social-ecological conceptualization of transition. Provider report revealed that many components, representing more than age, disease knowledge and skills, related to provider plans for transferring patients. Conclusions  SMART consists of inter-related constructs of patients, parents and providers with emphasis on variables amenable to intervention. Results support SMART's broadened conceptualization of transition readiness and need for assessment of multiple stakeholders' perspectives of patient transition readiness. A companion measure of SMART, which will be able to be completed by patients, parents and providers, will be developed to target areas of intervention to facilitate optimal transition readiness. Similar research programmes to establish evidence-based transition measures and interventions are needed.
    PMID: 22007989 [PubMed - in process]

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    Fatigue, pain, and functional status during outpatient chemotherapy.
    Oncol Nurs Forum. 2010 Mar;37(2):E114-23
    Authors: Siefert ML
    To examine the relationship of fatigue and pain with functional status and the pattern of the two symptoms' occurrence over time in individuals with cancer who were receiving outpatient chemotherapy. The aims were to describe the levels of fatigue and pain with functional status and the inter-relationships with each other and with demographic and clinical variables over time.
    PMID: 20189910 [PubMed - indexed for MEDLINE]

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    Risk factors for HPV infection among American Indian and White women in the Northern Plains.
    Gynecol Oncol. 2011 Jun 1;121(3):532-6
    Authors: Bell MC, Schmidt-Grimminger D, Jacobsen C, Chauhan SC, Maher DM, Buchwald DS
    American Indian (AI) women living in the Northern Plains have high incidence and mortality rates for cervical cancer. We assessed risk factors for human papillomavirus (HPV) infection among AI and White women.
    PMID: 21414655 [PubMed - indexed for MEDLINE]

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    One of the challenges for the adolescent and young adult (AYA) cancer population is the transition of adolescent cancer survivors treated at pediatric institutions to adult-based providers in their young adult years. Unfortunately, most AYA survivors are not enrolled and followed in survivorship programs and are oftentimes treated by primary care physicians who are unfamiliar with AYA cancers and the long-term effects and issues associated with them.

    Source: Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults with Cancer, Report of the Adolescent and Young Adult Oncology Progress Review Group. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, National Institutes of Health, National Cancer Institute, LIVESTRONG™ Young Adult Alliance; NIH Pub. 06-6067; 2006.

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    Clinical and molecular features of papillary thyroid cancer in adolescents and young adults.
    Cancer. 2011 Jan 15;117(2):259-67
    Authors: Vriens MR, Moses W, Weng J, Peng M, Griffin A, Bleyer A, Pollock BH, Indelicato DJ, Hwang J, Kebebew E
    Age disparities in thyroid cancer incidence and outcome among adolescents and young adults (AYAs) with thyroid cancer are under reported. In this study, the authors compared the molecular and clinical features of papillary thyroid cancer (PTC) in AYAs with the same features among patients in other age groups.
    PMID: 20824721 [PubMed - indexed for MEDLINE]

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    [Human papillomavirus genotyping of cervical uterine preneoplastic lesions in a high risk area].
    Rev Med Chil. 2010 Nov;138(11):1343-50
    Authors: López M J, Ili G CG, Brebi M P, García M P, Capurro V I, Guzmán G P, Suárez P E, Ojeda F JM, Roa S JC
    Abstract
    BACKGROUND: The relationship between human papillomavirus (HPV) and uterine cervical cancer (UCC) is widely known and accepted.
    AIM: To determine the frequency of genotypes of HPV in cervical preneoplastic lesions in a high risk area of UCC.
    MATERIAL AND METHODS: Using a combination of PCR and Reverse Line Blot technique, 235 formalin fixed paraffin embedded samples, with diagnosis of low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL) were genotyped.
    RESULTS: HPV was detected in 61.2% of LSIL and 78.1% of HSIL. The main genotypes found were HPV 16, 18, 31, 45, 56 y 58. HPV 16 was the most common in both LSIL (18.1%) and HSIL (36.9%). HPV 16 or 18 were present in 25.1% and 47.1% of the LSIL and HSIL respectively. In both LSIL and HSIL, the predominant viral genotypes were those types classified as with a high oncogenic risk.
    CONCLUSIONS: HPV genotypes 16, 18, 31, 45, 56 y 58 were the most common in our series. HPV 16 and 18, viral types with high oncogenic risk and included in commercial vaccines, were found in 25.1% and 47.1% of LSIL and HSIL, respectively.
    PMID: 21279245 [PubMed - indexed for MEDLINE]

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    Best cases from the AFIP: glioblastoma multiforme.
    Radiographics. 2007 May-Jun;27(3):883-8
    Authors: Altman DA, Atkinson DS, Brat DJ

    PMID: 17495298 [PubMed - indexed for MEDLINE]

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    Stop A Doc Tip 4

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    HPV vaccination in France: uptake, costs and issues for the National Health Insurance.
    Vaccine. 2011 Apr 27;29(19):3610-6
    Authors: Fagot JP, Boutrelle A, Ricordeau P, Weill A, Allemand H
    Two vaccines for primary prevention of cervical cancer are available in France, Gardasil® and Cervarix®, since 2007 and 2008 respectively. Currently, the French guidelines indicate vaccination of girls aged 14 with a catch-up program for females from 15 to 23 years old. In France, the reimbursement rate for these vaccines is 65% of the vaccine price, resulting in Gardasil® being the fifth highest drug expenditure of the main scheme of the French National Health Insurance in 2008. The purpose of this study is to provide data on vaccination coverage and costs in France until 31 December 2009. In addition, the current vaccination coverage rate is compared with the coverage rates assumed in cost-effectiveness studies.
    PMID: 21382486 [PubMed - indexed for MEDLINE]

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    Cancer in adolescents and young adults in north Netherlands (1989-2003): increased incidence, stable survival and high incidence of second primary tumours.
    Ann Oncol. 2009 Feb;20(2):365-73
    Authors: van Gaal JC, Bastiaannet E, Schaapveld M, Otter R, Kluin-Nelemans JC, de Bont ES, van der Graaf WT
    Lack of survival improvement in adolescents and young adults (AYA) with cancer has led to increased awareness of this young population. Design: We carried out a population-based study of incidence and survival of primary tumours and second primary tumours in patients aged 12-24 in north Netherlands. Age-specific incidence rates per 100,000 and 3-year moving means were calculated. Factors associated with incidence and survival were assessed using a Poisson model, log-rank test and multivariate Cox proportional hazards analysis.
    PMID: 18725392 [PubMed - indexed for MEDLINE]

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    Antitumor effects of YM155, a novel survivin suppressant, against human aggressive non-Hodgkin lymphoma.
    Leuk Res. 2011 Jun;35(6):787-92
    Authors: Kita A, Nakahara T, Yamanaka K, Nakano K, Nakata M, Mori M, Kaneko N, Koutoku H, Izumisawa N, Sasamata M
    Abstract
    YM155, a novel small-molecule that down-regulates survivin, exhibits broad, potent antitumor activity against a range of human tumors. We evaluated the activity of YM155 in aggressive non-Hodgkin lymphoma. In a number of diffuse large B-cell lymphoma lines, YM155 exhibited 50% growth inhibition with values between 0.23 and 3.9 nM. Within in vivo xenograft models, continuous infusion of YM155 eradicated large, established subcutaneous WSU-DLCL-2 and Ramos tumors, with sustained efficacy observed through 4 cycles of YM155 therapy. YM155 increased survival significantly versus rituximab in disseminated Ramos models. This study suggests that YM155 may represent an effective treatment for aggressive lymphomas.
    PMID: 21237508 [PubMed - indexed for MEDLINE]

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    [Monocytic crisis in chronic myeloid leukemia: a case report].
    Rinsho Ketsueki. 1989 Mar;30(3):376-81
    Authors: Sugita K, Nakazawa S, Mori T, Nishino K, Abe T, Gonda T, Aya M, Osano M, Takane K, Okazaki T
    We report a 17-year-old female with chronic myeloid leukemia (CML) who developed monocytic crisis. She was diagnosed as chronic phase of Ph1-chromosome positive CML at 14 years old. Three years after the diagnosis of the disease, she was admitted to the hospital because of low grade fever, lethargy and marked splenomegaly. Small dose of Ara-C relieved her symptoms and splenomegaly. Six months later, however, a marked leukocytosis over 70,000/microliters were observed, and the peripheral blood smear disclosed that about 80% of the leukocytes were relatively mature monocytoid cells. Chromosomal analysis revealed additional abnormalities (double Ph1, +8, +9, +19). Lysozyme levels in serum and urine were high and NAP score was elevated. These monocytoid cells expressed receptors for IgG-Fc and C3, phagocytic activity, and monocytoid antigens which were determined by monoclonal antibodies (MY4, Mo2, OKM5). Cytochemically, almost all of monocytoid cells were positive for peroxidase and naphthol-ASD-chloroacetate esterase (CAE), but the monocytoid cells positive for non-specific esterase were limited. These data suggested that this case was monocytic crisis in CML with proliferation of CAE positive monocytoid cells. Among several types of blast crisis, monocytic crisis is extremely rare condition. The definite monocytic crisis demonstrated by this case may support the hypothesis that target cells of CML are pluripotent hematopoietic precursors.
    PMID: 2769961 [PubMed - indexed for MEDLINE]

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    Can you tell us a little about yourself and your personal motivation? 

    Dr. Sender: I am an Adolescent and Young Adult Cancer specialist. I work at the Children’s Hospital of Orange County, California and at the University of California Irvine. Also, I direct the Adolescent and Young Adult Cancer Program in both institutions and I am passionately concerned about the well-being of adolescent young adult cancer patients. What has driven me in the last 15 years is the lack of infrastructure available nationwide to address the needs of this patient population. Unfortunately, when we look at the data in many of the cancers that this group develops, there has been a lack of progress in understanding the cause of their cancer or how to treat them. As a result, the outcomes are worse than can be expected in older adults or very young children under the age of 15.

    What do you hope for SeventyK?

    Dr. Sender: The SeventyK project is sponsored by me personally, so that our Bill of Rights can be seen as neutral. Therefore, we invite every hospital, every institution, every organization, and every person to join us in signing up to support this bill. We hope that we are able to get as many signatories as possible in support of the bill and therefore through the numbers game we will be able to effect change.

    Why SeventyK, what does it represent?

    Dr. Sender: SeventyK represents approximately 70,000 children, adolescent and young adult patients in this country who are diagnosed with cancer every year. The adolescent and young adult patient population is also known as the AYA population. As you probably know, there are 1.4 million Americans who are diagnosed with cancer on a yearly basis. 70,000 represents the group of patients who are under the age of 40 and who we now know have poorer outcomes and are given much less attention.

    Why is SeventyK important?

    Dr. Sender: The goal of the SeventyK campaign is to raise awareness to the lack of rights that these patients have in the organized medical world. There is a Patients’ Bill of Rights in every hospital that is given to all patients when they are admitted. However, when you review the Bill of Rights of most institutions in the country, you will find that the Bill of Rights does not reflect the needs of this AYA patient population specifically.

    We do know from research that has been done and published by Dr. Archie Bleyer and other professionals, as well as through work done at our own university and children’s hospital, that this group of patients do not get the type of care that they should get in terms of access to experienced and educated practitioners in the field of adolescent and young adult cancer. They do not get access to clinical trials when there is a paucity of clinical trials available. There are very few biobank opportunities to store material in order for research to be done to try and understand the etiology of their cancer. There is very little work done involving the epidemiology or the study of the cause of their cancer. We also know that we have not paid attention to the fertility issues related to being a young adult cancer patient and survivor.

    What are the goals of SeventyK, what do you hope to accomplish?

    Dr. Sender: The SeventyK campaign allows people to review the Bill of Rights and then digitally sign in support. The campaign is designed to raise awareness of the plight of the AYA population. Our goal is to have the Bill of Rights implemented at all hospitals, so that in the future when a young patient is admitted, this Bill of Rights is the standard for any young adult cancer patient.

    Finally, we hope that the SeventyK campaign is more than just a Bill of Rights but a platform to advocate for adolescent and young adult cancer issues.

     

    Originally posted in March 2010.

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    Awareness and advocacy for adolescents and young adults with cancer.
    Cancer. 2011 May 15;117(10 Suppl):2311-5
    Authors: McGoldrick D, Gordon P, Whiteson M, Adams H, Rogers P, Sutcliffe S
    Increasing the awareness of the clinical and psychosocial needs that are particular to adolescents and young adults (AYA) was a top priority, as was strengthening advocacy efforts to empower and support this group. To date, AYA advocates had some success in generating public awareness and building a solid clinical justification for increased focus on this population. It had been established that the economic burden of their mortality was significant, their cancers were unusual, their medical care was often inadequate, and their outcomes for many cancers had not improved in the past 3 decades. As the awareness and advocacy campaign continued to grow and evolve across the globe, it was an important goal to integrate the efforts of all stakeholders to ensure that it progressed with a single, consensual, focused message identifying a common priority for action. By coordinating the efforts of the scientific, medical, and advocacy communities, it was possible to amplify their separate efforts and activities and more efficiently achieve large-scale change in the world of AYA oncology.
    PMID: 21523751 [PubMed - indexed for MEDLINE]

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    Randomized trial of the immunogenicity and safety of the Hepatitis B vaccine given in an accelerated schedule coadministered with the human papillomavirus type 16/18 AS04-adjuvanted cervical cancer vaccine.
    Clin Vaccine Immunol. 2011 Sep;18(9):1510-8
    Authors: Leroux-Roels G, Haelterman E, Maes C, Levy J, De Boever F, Licini L, David MP, Dobbelaere K, Descamps D
    Abstract
    The human papillomavirus type 16/18 (HPV-16/18) AS04-adjuvanted cervical cancer vaccine is licensed for females aged 10 years and above and is therefore likely to be coadministered with other licensed vaccines, such as hepatitis B. In this randomized, open-label study, we compared the immunogenicity of the hepatitis B vaccine administered alone (HepB group) or with the HPV-16/18 AS04-adjuvanted vaccine (HepB+HPV group) in healthy women aged 20 to 25 years (clinical trial NCT00637195). The hepatitis B vaccine was given at 0, 1, 2, and 12 months (an accelerated schedule which may be required by women at high risk), and the HPV-16/18 vaccine was given at 0, 1, and 6 months. One month after the third dose of hepatitis B vaccine, in the according-to-protocol cohort (n = 72 HepB+HPV; n = 76 HepB), hepatitis B seroprotection rates (titer of ≥10 mIU/ml) were 96.4% (95% confidence interval [CI], 87.5 to 99.6) and 96.9% (CI, 89.2 to 99.6) in the HepB+HPV and HepB groups, respectively, in women initially seronegative for anti-hepatitis B surface antigen (HBs) and anti-hepatitis B core antigen (HBc). Corresponding geometric mean titers of anti-HBs antibodies were 60.2 mIU/ml (CI, 40.0 to 90.5) and 71.3 mIU/ml (CI, 53.9 to 94.3). Anti-HBs antibody titers rose substantially after the fourth dose of hepatitis B vaccine. All women initially seronegative for anti-HPV-16 and anti-HPV-18 antibodies seroconverted after the second HPV-16/18 vaccine dose and remained seropositive up to 1 month after the third dose. Both vaccines were generally well tolerated, with no difference in reactogenicity between groups. In conclusion, coadministration of the HPV-16/18 AS04-adjuvanted vaccine did not affect the immunogenicity or safety of the hepatitis B vaccine administered in an accelerated schedule in young women.
    PMID: 21734063 [PubMed - indexed for MEDLINE]

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    Challenges in the recruitment of adolescents and young adults to cancer clinical trials.
    Cancer. 2007 Dec 1;110(11):2385-93
    Authors: Burke ME, Albritton K, Marina N
    The adolescent and young adult (AYA) oncology population has seen inferior progress in cancer survival compared with younger children and older adults over the past 25 years. Previously, AYAs had the best survival rates due to the prevalence of highly curable diseases including Hodgkin lymphoma and germ cell tumors, yet today AYAs have inferior survival rates to children and some adult cohorts. Survival rates are particularly poor for AYA-specific diseases such as sarcomas. Research involving children and adults diagnosed with common malignancies such as acute lymphoblastic leukemia has resulted in improved survival rates. However, AYAs have not directly benefited from such research due to low rates of access to and accrual on clinical trials. AYAs are less likely to have insurance or access to healthcare, are more likely to see providers who are not part of research institutions, and are less likely to be referred to or to join clinical trials, all of which may contribute to worse outcomes. Few clinical trials target AYA-specific diseases, leading to little information regarding how these diseases behave and what role the host plays. Tumor samples for this population are underrepresented in national tumor banks. Coupled with the need for more clinical trials that focus on AYA-specific cancers, better collaboration between adult and pediatric cooperative groups as well as increased education among community oncologists and primary care providers will be needed to enhance participation in clinical trials with the goal to increase survival and improve quality of that survival.
    PMID: 17918260 [PubMed - indexed for MEDLINE]

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    TipText: 
    When dealing with the specific challenges of an AYA cancer patient and fertility, a place for assistance as a health care professional is the myoncofertility website. It's an excellent resource for patients as well as HCPs - http://myoncofertility.org/
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    Psychosocial predictors of sexual initiation and high-risk sexual behaviors in early adolescence.
    Child Adolesc Psychiatry Ment Health. 2007;1(1):14
    Authors: Caminis A, Henrich C, Ruchkin V, Schwab-Stone M, Martin A
    This longitudinal study examined psychosocial factors associated with risky sexual behavior in early adolescence.
    PMID: 18034904 [PubMed]

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    Journal of Adolescent and Young Adult Oncology Jun 2011, Vol. 1, No. 2: 109-111.

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    Immunotherapy for malignant melanoma--tracing Ariadne's thread through the labyrinth.
    Eur J Cancer. 2009 Sep;45(13):2266-73
    Authors: Grange JM, Krone B, Stanford JL
    A working group (FEBIM) within the European Organisation for Research and Treatment of Cancer undertook extensive studies on the possible association of infectious diseases and the risk of malignant melanoma. These studies provided evidence that several infectious diseases and also some vaccines including the anti-tuberculosis vaccine, BCG, derived from Mycobacterium bovis, confer a significant level of protection against this form of cancer. In recent years, the importance of immunoregulatory networks in the establishment of tolerance to tumour antigens and the key role of the innate immune system in the development of such networks have been recognised. The molecular patterns of micro-organisms activate pattern recognition receptors on antigen presenting cells and determine the qualitative nature of the ensuing immune response. Bacteria in the actinomycetales family, notably members of the genus Mycobacterium, exhibit particularly powerful adjuvant activity and profoundly affect underlying patterns of immune reactivity. In particular, there is growing evidence that a heat-killed preparation of a strain of Mycobacterium vaccae is able to down-regulate patterns of immune reactivity that favour the tumour and to induce those that lead to anti-cancer immune responses. The results of preliminary clinical observations with melanoma patients, and published studies on other cancers, point to the need for more formal clinical trials.
    PMID: 19497734 [PubMed - indexed for MEDLINE]

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    Television news coverage about cervical cancer: impact on female viewers' vulnerability perceptions and fear.
    Eur J Public Health. 2011 Jun;21(3):381-6
    Authors: Lemal M, Van den Bulck J
    Abstract
    BACKGROUND: The objective of this study was to examine the relationship between exposure to television news messages about cervical cancer and women's vulnerability perceptions and fear.
    METHODS: Five-hundred women aged 18-85 years were randomly recruited to participate in a survey-interview. A standardized questionnaire assessed risk perception, fear of cervical cancer, exposure to cervical cancer messages in television news and a number of potential confounders such as demographics and trait anxiety.
    RESULTS: Results from multinomial regression analyses showed that women who had been occasionally exposed to cervical cancer messages were two times more likely to be very afraid of getting cervical cancer. Women who had been frequently exposed were three times more likely to be very afraid and three times more likely to be extremely afraid. Women who had been regularly exposure to cervical cancer messages were also three times more likely to perceive a moderate risk and seven times more likely to perceive a large risk of being diagnosed with cervical cancer.
    CONCLUSION: These results suggest that television news may be an effective means for health education.
    PMID: 20504951 [PubMed - indexed for MEDLINE]

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    Journal of Adolescent and Young Adult Oncology Jan 2011, Vol. 1, No. 1: 37-42.

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    Patterns of care for cervical cancer in Auckland, New Zealand, 2003-2007.
    J Med Imaging Radiat Oncol. 2011 Feb;55(1):82-9
    Authors: Capelle L, Stevens W, Brooks S
    The purpose of this review is to document current patterns of care for the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 to IVA cervical cancer in a New Zealand cancer centre.
    PMID: 21382193 [PubMed - indexed for MEDLINE]

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    The most common solid tumor in males ages 20-39 is testicular cancer. Testicular cancer is highly curable with 5-year survival rates above 96%. Long-term effects of both the testicular cancer and its treatment are important in understanding survivorship in this population. Chemotherapy poses its own specific risks such as vascular toxicity, lung disease and renal dysfunction. Also important is the understanding of fertility after testicular cancer and even prior to a cancer diagnosis patients may face issues with sperm count and testosterone level abnormalities. It is also critical to be aware of the possibility of developing a second malignancy after testicular cancer with the contralateral testis being a high-risk occurrence.

    Source: Hayes-Lattin B, Nichols C. Testicular Cancer: A Prototypic Tumor of Young Adults. Semin Oncol. 2009; 36:432-438.

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    Surveillance and survival among adolescents and young adults with cancer in Ontario, Canada.
    Int J Cancer. 2012 Mar 7;
    Authors: Furlong W, Rae C, Greenberg ML, Barr RD
    Abstract
    Gains in survival rates among adolescents and young adults (AYA) are reported from the USA to be lower than in both younger and older patients. Limiting factors include low accrual to clinical trials related to the type of institutional care. This study aimed to determine the incidence of cancer in the 15-29 age group in Ontario, and the 5 year survival of these cases by disease class, age at diagnosis group and highest level of institutional complexity of care. The primary data source was Cancer Care Ontario (CCO). Diseases were classified according to an AYA-specific system. Age at diagnosis was grouped as 15-19, 20-24 and 25-29 years; and institutional site of care was categorized as Pediatric Oncology Group of Ontario (POGO) centers, regional cancer centers (RCC - tertiary care centers associated with CCO), RCC affiliate and satellite institutions, and other institutions having no specialized cancer services. More than 10,000 incident cases were identified during 1990-2001. Carcinomas and lymphomas each accounted for > 20% of the total. Overall 5 year survival rate was 83%; significantly higher for lymphomas at POGO centers and RCC than elsewhere. About 40% of eligible AYA cases were treated at a POGO center and 25% of those were accrued to clinical trials. The low proportion of adolescents referred to pediatric cancer centers may result in a survival disadvantage for this group. All AYA, especially with lymphomas, should be referred to specialized centers. Accrual of AYA to clinical trials must be improved substantially. © 2012 Wiley-Liss, Inc.
    PMID: 22396183 [PubMed - as supplied by publisher]

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    Can't do this no more.
    Patient Educ Couns. 2008 Jul;72(1):3-4
    Authors: Jones K

    PMID: 18436415 [PubMed - indexed for MEDLINE]

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    Is male intent to be vaccinated against HPV a function of the promotion message?
    Int J STD AIDS. 2011 Jun;22(6):332-4
    Authors: DiClemente RJ, Crosby RA, Salazar LF, Nash R, Younge S
    Abstract
    We aimed to determine whether the type of outcome expectation, stemming from HPV vaccination, would have any effect on young men's HPV vaccine intent. We recruited young men (18-24 years of age) from two university campuses (n = 150). After answering a series of questions they were randomly assigned to one of three information conditions (all delivered by computer): (1) how women may benefit from men's HPV vaccination, (2) preventing genital warts and (3) preventing head and neck cancers. Intent to be vaccinated against HPV in the next 12 months was assessed before and after receiving the informational session corresponding to the assigned condition. A repeated-measures t-test indicated that a significant increase in young men's intent to be vaccinated after they received the assigned information (t = 9.48, [147], P = 0.0001). However, the increase in intent to be vaccinated did not vary by group assignment as there were no significant differences in mean intent scores between the three groups (F = 0.59, [2/144], P = 0.56). Information that promotes the outcome expectations of protecting women from cervical cancer, preventing genital warts for men and preventing head and neck cancers for men may be equally effective in promoting increased intent for HPV vaccine acceptance among young university men.
    PMID: 21680669 [PubMed - indexed for MEDLINE]

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    Can't do this no more.
    Patient Educ Couns. 2008 Jul;72(1):3-4
    Authors: Jones K

    PMID: 18436415 [PubMed - indexed for MEDLINE]

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    Age distribution of HPV genotypes in cervical intraepithelial neoplasia.
    Gynecol Oncol. 2011 Jun 1;121(3):510-3
    Authors: Sideri M, Igidbashian S, Boveri S, Radice D, Casadio C, Spolti N, Sandri MT
    Recent data showed that HPV16 infections in young women can lead to CIN3 formation very quickly and questioned the common assumption that invasive cervical cancer develops through slowly progressing pre-cancer lesions, CIN1, CIN2 and CIN3. The aim of the study is to compare the age distribution of HPV 16/18 related and HPV16/18 not related CIN.
    PMID: 21396686 [PubMed - indexed for MEDLINE]

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    Adolescents and young adults (AYA) with cancer have often been described as a medically underserved population, falling through the gap between pediatric and adult oncology. As AYAs transition from childhood or adulthood the normal concerns they may have – development of body image, dating, separating from parents, career and education decisions – are compounded when they are faced with cancer. AYA cancer patients may face issues such as infertility, loss of employment/breaks in education due to treatment, increased dependence on parents, and other health concerns that may be exceptionally difficult for this group to cope with.

    Source: Zebrack B, Hamilton R, Smith A. Psychosocial Outcomes and Service Use Among Young Adults With Cancer. Semin Oncol. 2009; 36:468-477.

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    Socioeconomic Impacts on Survival Differ by Race/Ethnicity among Adolescents and Young Adults with Non-Hodgkin's Lymphoma.
    J Cancer Epidemiol. 2010;2010:824691
    Authors: Kent EE, Morris RA, Largent JA, Ziogas A, Sender LS, Anton-Culver H
    Shorter survival has been associated with low socioeconomic status (SES) among elderly non-Hodgkin's lymphoma (NHL) patients; however it remains unknown whether the same relationship holds for younger patients. We explored the California Cancer Registry (CCR), to investigate this relationship in adolescent and young adult (AYA) NHL patients diagnosed from 1996 to 2005. A case-only survival analysis was conducted to examine demographic and clinical variables hypothesized to be related to survival. Included in the final analysis were 3,489 incident NHL cases. In the multivariate analyses, all-cause mortality (ACM) was higher in individuals who had later stage at diagnosis (P < .05) or did not receive first-course chemotherapy (P < .05). There was also a significant gradient decrease in survival, with higher ACM at each decreasing quintile of SES (P < .001). Overall results were similar for lymphoma-specific mortality. In the race/ethnicity stratified analyses, only non-Hispanic Whites (NHWs) had a significant SES-ACM trend (P < .001). Reduced overall and lymphoma-specific survival was associated with lower SES in AYAs with NHL, although a significant trend was only observed for NHWs.
    PMID: 20652048 [PubMed]

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    Dr. Leonard Sender, the founder of SeventyK, shares his insight as the Medical Director of the Adolescent and Young Adult (AYA) Cancer Program in the Hyundai Cancer Institute at CHOC Children's and UC Irvine's Chao Family Comprehensive Cancer Center. In order to take a step in the right direction, to improve the survival rates of AYAs with cancer, much of what needs to be changed is the training received by healthcare providers to care for their patients.

    Read more about what Dr. Sender shares about AYA cancer here.

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    A 32-year-old man with copious, watery diarrhea.
    N C Med J. 2001 May-Jun;62(3):134-9
    Authors: Smith CS, Houston M, Jensen B, Mlinar K, Toulson C, Tillotson LG

    PMID: 11370315 [PubMed - indexed for MEDLINE]

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    Stop A Doc Tip 5

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    Lack of HPV 16 and 18 detection in serum of colposcopy clinic patients.
    J Clin Virol. 2011 Apr;50(4):342-4
    Authors: Patel DA, Unger ER, Walline H, Opipari AW, Lee DR, Flowers LC, Ruffin MT
    Persistent infection with high-risk human papillomavirus (HPV) types is necessary for the development of high-grade cervical dysplasia and cervical carcinoma. The presence of HPV DNA in the blood of cervical cancer patients has been reported; however, whether HPV DNA is detectable in the blood of patients with pre-invasive cervical disease is unclear.
    PMID: 21306941 [PubMed - indexed for MEDLINE]

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    [Structure and dynamics of the mangrove forest in the Rancheria River delta, Colombian Caribbean].
    Rev Biol Trop. 2007 Mar;55(1):11-21
    Authors: Lema Vélez LF, Polanía J
    We registered seedling survival and biomass increase for Rhizophora mangle L., Avicennia germinans L. and Laguncularia racemosa (L.) Gaertn. f, main mangrove species in the Rancheria River delta, Colombia. Only seedlings of R. mangle were found to survive. We also measured maximum rate of litterfall. We estimated annual litterfall through interpolation within an exponential regression performed with maximum and annual litterfall data published in other sources; the value of annual litterfall for the area was estimated to be 12.9 mgha(-1)y(-1). We found a 7.4 mgha(-1)y(-1)(-1) increase in biomass. Litterfall constitutes the larger fraction of the 20.2 mgha(-1)y(-1) productivity of this mangrove. We believe this is a very high value for a forest under unfavorable natural and human conditions, such as high seasonality and continuous use of the forest to feed goats and sheep. We consider that the high productivity is a response to both natural and anthropogenic stress.
    PMID: 18457110 [PubMed - indexed for MEDLINE]

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    [Results of the first human papilloma virus center in Hungary (2007-2011)].
    Orv Hetil. 2011 Nov 6;152(45):1804-7
    Authors: Galamb A, Pajor A, Langmár Z, Sobel G
    Abstract
    UNLABELLED: Human papilloma virus (HPV) is the most common sexually transmitted infection in the 21st century. It has been established that infections with specific HPV types are contributing factors to cervical cancer. Approximately 99.7% of cervical cancers are associated with high risk HPV types. HPV testing plays an important role in the prevention, by decreasing the prevalence and the mortality of cervical cancer. There are 16 HPV-centers operating in Hungary, in which patients undergo HPV screening, cervical exams, and treatment based on standardized guidelines.
    PATIENTS AND METHODS: The first HPV-center was founded in 2007 in Budapest, at the 2nd Department of Obstetrics and Gynecology, Semmelweis University. This study aimed to define the presence and prevalence of HPV-DNA in the cervical swab samples obtained from patients in our center. Authors conducted to assess the age-specific-prevalence, and HPV type distribution, the associated cervical abnormalities, comparing our results with international data.
    RESULTS: Overall 1155 woman underwent HPV-testing and genotyping, using polymerase chain reaction. Overall, 55.5% of patients had positive test for HPV DNA types, in which 38.5% for high-risk HPV DNA. Overall prevalence was the highest among females aged 15 to 25 years (62.9%). The most common HPV type found was the high risk type 16 (19.5% among the patients with positive HPV testing). Presence of high risk HPV with concurrent cervical cytological abnormality was in 32%. More than two-thirds of woman with cytological atypia (70.6%) were infected with two or more high risk HPV types. HPV 16 was detected in 32% of patients with cytological abnormalities.
    CONCLUSIONS: The results suggest that the prevalence of HPV in this study population exceeds the international data. The results attracts the attention the peak prevalence of the high risk types in the youngest age-group, and the higher risk of cervical abnormality in case of presence of two or more HPV types. The dominance of type 16 and 18 was predictable, but the strong attendance of type 51 and 31 among patients who had cytological atypia, was slightly surprising.
    PMID: 22011366 [PubMed - indexed for MEDLINE]

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    Establishment and characterization of Ph1-positive and Ph1-negative lymphoblastoid cell lines from a patient with chronic myelogenous leukemia.
    Jpn J Cancer Res. 1985 May;76(5):365-73
    Authors: Yamada T, Sasaki M, Yoshida MC, Aya T, Koizumi S, Osato T
    Two continuously growing in vito cell lines, PB-1049 and LN-1049, were established from a patient with Ph1-positive chronic myelogenous leukemia in extramedullary blastic crisis. PB-1049 was established from Epstein-Barr virus (EBV)-infected peripheral lymphocytes of the patient and had a 46,XY,t(9;22) karyotype. This cell line was shown to be tumorigenic in nude mice, and cultured cells recovered from the tumor nodule showed a 46,XY,6p+,t(9;22) stem line karyotype. LN-1049 was derived from a lymph node culture of the same patient, and was found to be non-tumorigenic in nude mice and karyotypically normal. Immunological examinations on EBV-induced antigens, surface and cytoplasmic immunoglobulin, and monoclonal antibodies, and some enzymatic and electron microscopic studies revealed that both cell lines had attained differentiation into late-B cell stage.
    PMID: 2989064 [PubMed - indexed for MEDLINE]

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    Prevalence of human papillomavirus infection among female sex workers in Bulgaria.
    Int J STD AIDS. 2011 May;22(5):278-80
    Authors: Shikova E, Todorova I, Ganchev G, Kouseva-Dragneva V, Kalascheva-Zaimova P
    Abstract
    The present study estimates the prevalence and risk factors of human papillomavirus (HPV) infection among female sex workers (FSWs) in Bulgaria. HPV DNA was detected by polymerase chain reaction (PCR) in 43.4% of FSWs. HPV16 was the most common type, found in 17.0% of samples, followed by HPV31 (9.4%). Age and smoking were associated with a significantly greater risk of being infected. The results of this study indicate that FSWs in Bulgaria are at increased risk for cervical cancer and represent an important source of HPV infection for the general population in the country. They should be considered as a priority group in cervical cancer control programmes.
    PMID: 21571976 [PubMed - indexed for MEDLINE]

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    Malignant hematologic diseases in adolescents and young adults.
    Blood. 2011 Jun 2;117(22):5803-15
    Authors: Wood WA, Lee SJ
    Adolescents and young adults (AYA) with cancer have been designated as a vulnerable population by the National Cancer Institute. This group, defined by the ages of 16-39 years, has not enjoyed the same survival improvements over the past several decades as older and younger cohorts. Several barriers prevent the optimal delivery of oncologic care in this subpopulation. This review will describe these challenges in the context of the major hematologic malignancies affecting this population (acute lymphoblastic leukemia [ALL], acute myeloid leukemia [AML], Hodgkin lymphoma [HL], and non-Hodgkin lymphoma [NHL]). For example, historical differences in care delivery between pediatric and adult health care systems have created confusion about optimal treatment planning for AYAs, a population that spans the pediatric-adult divide. In the case of ALL, retrospective studies have demonstrated significantly better outcomes when AYAs are treated according to pediatric and not adult protocols. Additional challenges more specific to AYAs include increased treatment-related toxicity relative to younger patients; less access to care and, specifically, access to clinical trials; lower adherence to medications and treatment plans; and psychosocial stressors relevant to individuals at this stage of life. Recognizing and responding to these challenges in AYAs may create opportunities to improve the cancer outcomes of this group.
    PMID: 21398581 [PubMed - in process]

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    Improved clinical trial enrollment in adolescent and young adult (AYA) oncology patients after the establishment of an AYA oncology program uniting pediatric and medical oncology divisions.
    Cancer. 2011 Dec 27;
    Authors: Shaw PH, Boyiadzis M, Tawbi H, Welsh A, Kemerer A, Davidson NE, Kim Ritchey A
    Abstract
    BACKGROUND: Since 1975, there has been a dramatic increase in the survival rates of pediatric and older cancer patients, but adolescent and young adult (AYA) patients ages 15 to 40 years have not had a similar improvement. Data indicate a direct correlation between increased cure rates and clinical trial enrollment. METHODS: The authors previously published data indicating inferior clinical trial enrollment when AYA patients were treated at an adult oncology center versus a pediatric oncology center. To address this deficit, a joint pediatric and adult AYA Oncology Program was established in July 2006 with the primary objective of improving outcomes by increasing therapeutic clinical trial enrollment in this population. Patients who were referred to that program from July 2006 through June 2010 were examined retrospectively to establish whether clinical trial enrollment increased compared with historic controls. RESULTS: Fifty-seven patients were referred to the program from 2006 to 2010 (range, 12-16 new patients per year). Eight patients were referred for consultation only and were not treated at the University of Pittsburgh Cancer Institute or Children's Hospital of Pittsburgh. Five of 22 patients (23%) who received treatment at the pediatric cancer center were enrolled onto a clinical trial, whereas 9 of 27 patients (33%) patients who received treatment at the adult cancer center were enrolled. There was superior trial participation compared with the previous 3 years for those shared AYA patients who were treated at the adult center (P < .001). CONCLUSIONS: Data from this study demonstrated that establishing a unified AYA oncology program can lead to improved clinical trial enrollment for patients who are treated at medical oncology centers. Cancer 2011. © 2011 American Cancer Society.
    PMID: 22213134 [PubMed - as supplied by publisher]

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    Adolescents with acute lymphoblastic leukaemia: emerging from the shadow of paediatric and adult treatment protocols.
    Pediatr Blood Cancer. 2006 Nov;47(6):748-56
    Authors: Ramanujachar R, Richards S, Hann I, Webb D
    Adolescents and young adults (AYA) with acute lymphoblastic leukaemia (ALL) constitute a distinct population from children and older adults. Based on patterns of referral, they may be treated by either paediatric or adult oncologists. As a group, AYA with ALL have a worse survival and event-free survival (EFS) compared to that achieved by younger children. A systematic review of all published clinical trials, which provide data on treatment and outcome of adolescents with ALL, has been summarised in an effort to determine whether they should be treated on paediatric or adult type protocols. Adolescents appear to have a consistent survival advantage when treated on paediatric regimens.
    PMID: 16470520 [PubMed - indexed for MEDLINE]

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    TipText: 
    Assess a patients' overall condition and how a social worker can help a patient navigate through their job/school with cancer. Though not exclusively focused on AYA Cancers, this publication may be helpful for HPCs diagnosing symptoms http://www.ncbi.nlm.nih.gov/pubmed/20538189
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    The influence of psychosocial characteristics and race/ethnicity on the use, duration, and success of antiretroviral therapy.
    J Acquir Immune Defic Syndr. 2008 Feb 1;47(2):194-201
    Authors: Pence BW, Ostermann J, Kumar V, Whetten K, Thielman N, Mugavero MJ
    Expanded access to antiretroviral therapy (ART) has produced dramatic reductions in HIV-associated morbidity and mortality. Disparities in access to and benefit from ART have been observed by race, gender, and mental health status, however.
    PMID: 17971712 [PubMed - indexed for MEDLINE]

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    Effect of cryopreservation and transplantation on the expression of kit ligand and anti-Mullerian hormone in human ovarian tissue.
    Hum Reprod. 2012 Feb 7;
    Authors: David A, Van Langendonckt A, Gilliaux S, Dolmans MM, Donnez J, Amorim CA
    Abstract
    BACKGROUNDAlthough cryopreservation and transplantation of ovarian tissue represent a promising alternative to safeguard fertility in cancer patients, low recovery rates of oocytes aspirated from antral follicles and a significant number of empty follicles have been observed in women with transplanted frozen-thawed ovarian tissue. In order to understand how freezing and/or grafting may affect follicular development, the follicular expression of kit ligand (KL) and anti-Müllerian hormone (AMH), two key factors activating and inhibiting follicle growth, were assessed after long-term grafting in severe combined immunodeficient (SCID) mice.METHODSOvarian biopsies from eight patients were used for fresh and frozen-thawed tissue xenografting in 13 SCID mice for a period of 28 weeks, including 2 weeks of gonadotrophin stimulation. KL, AMH and proliferating cell nuclear antigen (PCNA) immunostaining were quantified before and after grafting in the two treatment groups (fresh and frozen-thawed grafted ovarian tissue).RESULTSLower expression of KL was found in primordial and primary follicles after grafting of both fresh and frozen-thawed tissue. Consistent expression of AMH was found in most growing follicles at a similar rate in both graft types. In fresh and frozen-thawed grafts, 13-14% of primordial follicles were PCNA-positive, indicating a similar maintenance of quiescent follicles despite follicle activation.CONCLUSIONSGrafting and/or gonadotrophin stimulation appear to affect the follicular expression of KL, which may alter oocyte quality. AMH expression in growing follicles after ovarian tissue transplantation may be one of the factors contributing to the preservation of resting follicles in 28-week-old grafts.
    PMID: 22313872 [PubMed - as supplied by publisher]

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    Recruitment and follow-up of adolescent and young adult cancer survivors: the AYA HOPE Study.
    J Cancer Surviv. 2011 Jan 28;
    Authors: Harlan LC, Lynch CF, Keegan TH, Hamilton AS, Wu XC, Kato I, West MM, Cress RD, Schwartz SM, Smith AW, Deapen D, Stringer SM, Potosky AL,
    INTRODUCTION: Cancer is rare in adolescents and young adults (AYA), but these patients have seen little improvement in survival in contrast to most other age groups. Furthermore, participation in research by AYAs is typically low. We conducted a study to examine the feasibility of recruiting a population-based sample of AYA survivors to examine issues of treatment and health outcomes. METHODS: Individuals diagnosed in 2007-08 and age 15-39 at the time of diagnosis with acute lymphocytic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, germ cell cancer or sarcoma were identified by 7 Surveillance, Epidemiology, and End-Results (SEER) cancer registries, mailed surveys within 14 months after diagnosis and again a year later, and had medical records reviewed. RESULTS: 525 (43%) of the eligible patients responded, 39% refused and 17% were lost to follow-up. Extensive efforts were required for most potential respondents (87%). 76% of respondents completed the paper rather than online survey version. In a multivariate model, age, cancer site, education and months from diagnosis to the first mailing of the survey were not associated with participation, although males (p < 0.01), Hispanics and non-Hispanic blacks (p < 0.001) were less likely to participate. 91% of survivors completing the initial survey completed the subsequent survey. DISCUSSION: Despite the response rate, those who participated adequately reflected the population of AYA cancer survivors. The study demonstrates that cancer registries are valuable foundations for conducting observational, longitudinal population-based research on AYA cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Achieving a reasonable response rate in this population is possible, but requires extensive resources.
    PMID: 21274648 [PubMed - as supplied by publisher]

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    The Oncofertility Consortium has launched the FIRST national long-term study to examine how different cancers and treatments affect the fertility and reproductive health of women cancer patients and survivors.

    Women ages 18-44 who received their cancer diagnosis within 3 years qualify for the study. There is an online questionnaire about women's reproductive health that the participant answers on a yearly basis.

    This study is funded by the National Institutes of Health and has been approved by the UCSD Institutional Review Board.

    http://oncofertility.northwestern.edu/how-you-can-participate-joint-firs...

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    Journal of Adolescent and Young Adult Oncology Jan 2011, Vol. 1, No. 1: 43-47.

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    Single and multiple human papillomavirus infections in cervical abnormalities in Portuguese women.
    Clin Microbiol Infect. 2011 Jun;17(6):941-6
    Authors: Pista A, Oliveira A, Verdasca N, Ribeiro F
    Persistent infection with high-risk (HR) human papillomavirus (HPV) types is necessary for cervical cancer development. However, little is known about the influence of multiple HPV infections on cervical lesion risk. The aim of this study was to evaluate the frequency of single and multiple HPV infections in Portuguese women, and to assess the frequency of multiple infections in cervical intraepithelial neoplasia (CIN). HPV prevalence, type-specific prevalence and extent of multiple infections were assessed in 1057 cervical samples. The Clinical Array HPV assay was used to detect 35 HPV types. According to histological diagnosis, 425 samples were normal, 375 were CIN1, and 257 were CIN2+. HPV status was studied in relation to age and lesion severity. The prevalence of HPV infection was 52.7%; 25.4%, 67.2% and 76.7% were positive for any HPV type in the normal, CIN1 and CIN2+ cases, respectively. Among HPV-positive cases, 32.0% were associated with multiple infections. Among multiple infections, 96.1% harboured HR HPV types and 38.2% HR-low risk (LR) HPV types. Overall, 33 different HPV types (18 HR and 15 LR) were detected. HR HPV types (44.1%) were significantly more prevalent than LR HPV types (8.6%). The most frequent genotype was HPV 16 (25.5%), followed by HPV 31, 53, 66, 58, and 51. Multiple infections showed a significant increase (p 0.005) according to severity of neoplasia, particularly for HR-HR HPV infections (p 0.003). No association between age and multiple HPV infections was observed (p 0.812). However, multiple HR HPV infections were more frequent in women under 30 years of age (35.3%).
    PMID: 21040156 [PubMed - indexed for MEDLINE]

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    Almost one third of all new thyroid cancers diagnosed are in young adults ages 20 to 40 and thyroid carcinomas represent approximately 6-12% of all malignancies diagnosed in this age group. Thyroid carcinomas are 5 times more common in females than males among 20 to 40 year olds, accounting for 4% of all cancers in women. Thyroid cancer is also one of the most common malignancies to occur during pregnancy and therefore it is imperative to assess the treatment and management of such cases individually with possible delay in surgery and radioactive iodine therapy. Overall survival rates are exceptional with 5-year survival rates for individuals diagnosed before the age of 40 above 99%. Future research will hopefully shed light to understanding the long-term and potentially adverse effects of different thyroid treatment therapies as well as their effects on reproduction, which may impact the survivorship of this community.

    Source: Ying A, Huh W, Bottomley S, et al. Thyroid Cancer in Young Adults. Semin Oncol. 2009; 36:258-274.

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    Oncologists' use of patient educational materials about cancer and fertility preservation.
    Psychooncology. 2011 Jul 14;
    Authors: Quinn GP, Vadaparampil ST, Malo T, Reinecke J, Bower B, Albrecht T, Clayman ML
    BACKGROUND: This study sought to determine the prevalence of distribution of fertility preservation (FP) materials, source of the materials, and providers' perceived relevance of the materials among a sample of US oncologists. METHODS: A 53-item survey was administered via mail and the Web to a stratified sample of oncologists from the American Medical Association Masterfile. This study represents a subset of results, reporting on three survey items. RESULTS: Among the 511 oncologists (32% response rate), only 13.5% (n = 69) reported 'always or often' giving their patients educational materials about FP. Among those who reported ever distributing materials, 39.5% used American Cancer Society materials, 11.0% used Fertile Hope, 6.4% used Lance Armstrong Foundation, and 11.8% used 'other'. Among those who provided materials, only 27.4% believe the FP materials they provide are 'relevant to patient's specific cancer diagnosis'. CONCLUSION: There is need to improve oncologists' distribution of FP educational materials to patients with cancer. Copyright © 2011 John Wiley & Sons, Ltd.
    PMID: 21755572 [PubMed - as supplied by publisher]

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    Psychosocial care for adolescent and young adult hematopoietic cell transplant patients.
    J Psychosoc Oncol. 2011 Jul-Aug;29(4):394-414
    Authors: Cooke L, Chung C, Grant M
    Abstract
    Psychological issues following hematopoietic cell transplantation (HCT) are unfortunately common. Literature specific to the transplant experience for the needs of adolescents and young adults (AYA) is lacking. The purpose of this article is to (1) describe the allogeneic transplant experience for AYA transplant patients during the first year following transplantation including demographic and treatment characteristics, (2) present AYA data obtained during and following a six-part posttransplant discharge study, (3) illustrate typical AYA experiences using case studies, and (4) propose AYA intervention strategies within Erickson's stages of psychosocial development. A quality of life model provided the research conceptual framework, and the content analysis framework for the qualitative research. Themes that emerged within each domain were the following: sexuality/fertility, fatigue, depression/poor coping/habits,adherence issues, use of technology, dependency issues, changes in roles/relationships, issues with school/education, financial issues, family problems/issues, miscellaneous, religion/spirituality, fear of future, uncertainty, life, death, more life appreciation. These data guide us for providing targeted interventions for the needs of this AYA population. This paper has presented literature and developmental theory, qualitative and qualitative data from an intervention study, and clinical cases in order to propose a developmental treatment model for AYA transplant patients. A coordinated and multidisciplinary approach is needed for the HCT patient who is an AYA.
    PMID: 21966725 [PubMed - in process]

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    Risks and benefits of soy isoflavones for breast cancer survivors.
    Oncol Nurs Forum. 2004 Mar-Apr;31(2):249-63
    Authors: Hu SA
    To present state-of-the-art information about the risks and benefits of soy isoflavones for breast cancer survivors.
    PMID: 15017441 [PubMed - indexed for MEDLINE]

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    [Clinical value of the comprehensive treatment in intermediate and advanced cervical cancer with uterine arterial interventional chemoembolization and radiotherapy].
    Zhonghua Fu Chan Ke Za Zhi. 2010 Jul;45(7):506-10
    Authors: Tian ZZ, Li S, Liu ML, Zhu XH, Zhao R, Yue YJ, Chen XH
    To investigate the long-term curative effect of the radiotherapy combined uterine arterial interventional chemoembolization for cervical cancer.
    PMID: 21029602 [PubMed - indexed for MEDLINE]

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    Due to the unique psychosocial issues that affect the adolescent and young adult (AYA) cancer population there exists a special subgroup of palliative care. Palliative care is used to provide pain and symptom control, so the ability to win the trust and respect of the AYA population is especially crucial yet extremely challenging. AYA treatment compliance is dependent on this confidence created between patient and provider as AYAs claim their independence while transitioning into adulthood. Cancer care goals may be objectively assessed through the use of a palliative medicine consultant particularly in progression from curative intent to symptom management.

    Source: Wein S, Pery S, Zer A. Role of Palliative Care in Adolescent and Young Adult Oncology. J Clin Oncol. 2010; 28:4819-4824.

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    Cardiovascular disease in the Asia Middle East region: global trends and local implications.
    Asia Pac J Public Health. 2010 Jul;22(3 Suppl):83S-89S
    Authors: Ramahi TM
    Cardiovascular disease (CVD) is the leading cause of death worldwide and in most countries outside sub-Saharan Africa. The root causes of this modern epidemic are sedentary stressful urban lifestyles and high-calorie diets rich in saturated fats, salt, and simple sugars. Although the mortality from CVD has long peaked in most developed countries, its prevalence continues to rise because of improved survival and aging of the populations, placing tremendous strains on health care financing in some of these countries. In most Asian and Middle Eastern countries, outside East Asia, prevalence of CVD and its risk factors are high and still rising, while the rising mortality is among the highest in the world. As the predominantly young populations of these countries age, they face inadequate health care systems without assured financial coverage. Effective measures are therefore urgently needed to combat the epidemic of CVD. Comprehensive preventive measures are essential to curb the spread of this epidemic, while health care systems should be structured on the basis of locally derived data to provide adequate affordable care to the ever increasing pools of patients with CVD.
    PMID: 20566538 [PubMed - indexed for MEDLINE]

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    The time has come to vote for the finalist videos of our Stop A Doc Contest!

    SeventyK's Stop A Doc campaign emphasizes the five important questions for an Adolescent or Young Adult (AYA) cancer patient to ask his or her healthcare provider before receiving treatment. With just these five simple questions, we can spread awareness about the AYA cancer segment and the unique needs that AYAs face. This is a big step for a great change in improving the survival rates of AYAs with cancer.

    To vote for your favorite videos in our two categories - videos made by patients and videos made by healthcare professionals - please go here. "LIKE" your favorite videos to vote for them. Winners will receive a cash prize.

    To learn more about our Stop A Doc campaign, please visit http://www.stopadoc.org. Feel free to spread the word!

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    Optimal therapy for acute lymphoblastic leukemia in adolescents and young adults.
    Nat Rev Clin Oncol. 2011;8(7):417-24
    Authors: Schafer ES, Hunger SP,
    Although the survival rate for adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) has steadily improved over the past several decades, it still lags behind that of younger children. This Review explores the reasons for this discrepancy and potential solutions, focusing on patients aged 15-22 years. Recent studies that compared the outcome of AYA patients with ALL treated on pediatric or adult clinical trials have shown substantially better outcomes for this patient population obtained with the pediatric trials. Excellent early results have been obtained for patients with ALL aged up to 40-60 years who were treated in adult study groups with pediatric-based regimens. Targeting biological and socio-political features unique to AYA ALL has reduced the 'AYA gap' and has provided the foundation for basic science and translational and clinical AYA initiatives that are charged with the task of discovering further methods to improve the outcome of AYA with ALL.
    PMID: 21629213 [PubMed - in process]

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    Universal human papillomavirus genotyping by the digene HPV Genotyping RH and LQ Tests.
    J Clin Virol. 2011 Apr;50(4):276-80
    Authors: Geraets DT, Lenselink CH, Bekkers RL, van Doorn LJ, Quint WG, Melchers WJ
    High-risk (hr)HPV testing plays an important role in primary cervical cancer screening. Subsequent hrHPV genotyping might contribute to better risk stratification. The majority of hrHPV tests do not include identification of individual hrHPV genotypes.
    PMID: 21296612 [PubMed - indexed for MEDLINE]

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    Registration and classification of adolescent and young adult cancer cases.
    Pediatr Blood Cancer. 2008 May;50(5 Suppl):1090-3
    Authors: Pollock BH, Birch JM
    Cancer registries are an important research resource that facilitate the study of etiology, tumor biology, patterns of delayed diagnosis and health planning needs. When outcome data are included, registries can track secular changes in survival related to improvements in early detection or treatment. The surveillance, epidemiology, and end results (SEER) registry has been used to identify major gaps in survival for older adolescent and young adult (AYA) patients compared with younger children and older adults. In order to determine the reasons for this gap, the complete registration and accurate classification of AYA malignancies is necessary. There are inconsistencies in defining the age limits for AYAs although the Adolescent and Young Adult Oncology Progress Review Group proposed a definition of ages 15 through 39 years. The central registration and classification issues for AYAs are case-finding, defining common data elements (CDE) collected across different registries and the diagnostic classification of these malignancies. Goals to achieve by 2010 include extending and validating current diagnostic classification schemes and expanding the CDE to support AYA oncology research, including the collection of tracking information to assess long-term outcomes. These efforts will advance preventive, etiologic, therapeutic, and health services-related research for this understudied age group.
    PMID: 18360832 [PubMed - indexed for MEDLINE]

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    HIV testing in colposcopy and termination of pregnancy services: a missed opportunity?
    J Fam Plann Reprod Health Care. 2011 Oct;37(4):201-3
    Authors: Briggs A, Partridge DG, Bates S
    Abstract
    INTRODUCTION: The 2008 National HIV testing guidelines produced jointly by the British Association of Sexual Health and HIV, British HIV Association and British Infection Society recommend HIV testing for patients attending termination of pregnancy (TOP) services and patients diagnosed with cervical intraepithelial neoplasia (CIN) Grade 2 or above. The aim is to reduce the time between acquisition and diagnosis of HIV by encouraging testing in settings where patients present with indicator diseases. Benefits of earlier HIV diagnosis include improved survival, prevention of onward transmission, and optimisation of maternal health when planning pregnancy. There is evidence that HIV reduces the effectiveness of standard treatment for CIN 2/3 and cervical cancer. The experience of antenatal screening indicates that the majority of women accept HIV screening if it is offered as part of a package of care.
    METHODS: This retrospective case notes review of 60 HIV-positive women, diagnosed between 1 January 2006 and 31 July 2009, collected data on age, ethnicity, length of time in the UK, timing of HIV diagnosis and possible timing of acquisition relative to attendance at colposcopy or TOP services, CD4 count and symptoms at diagnosis and cervical cytology history.
    RESULTS: The authors found that three (5%) women were diagnosed with CIN Grade 2 or above prior to HIV diagnosis; HIV testing at the time of TOP may have resulted in earlier diagnosis for three (5%) women. There was at least one missed opportunity for earlier diagnosis in five (8%) cases.
    CONCLUSIONS: The authors suggest further work should be undertaken to establish HIV prevalence in TOP and colposcopy services and that HIV testing should become standard practice in the management of CIN 2/3 and cervical cancer.
    PMID: 21835967 [PubMed - indexed for MEDLINE]

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    A tiger mouse and relatives. Variants caused by an activated transposable element?
    J Hered. 1984 Jan-Feb;75(1):2-7
    Authors: Wallace ME, Nash HR
    In a laboratory-bred population of wild Peruvian house mice, one male had an excessive rate of non-pairing of the X and Y chromosomes. After crossing him with laboratory stock mice, a mouse of very unusual phenotype appeared from a yellow (AyA) mother. He was yellow with black dorsal stripes; hence Tiger. He was mated to many females, and inbred F2 and F3 generations were raised. There were no more tiger phenotypes, but his F1 contained an excess of black-and-tans over yellows, showing him to be a gonosomic mosaic Ayat/atat; the homozygous cell line probably arose from the heterozygous one. The mitotic karyotype was normal. Some of Tiger's mates were of known allozyme types and their progeny were scored. The allozyme segregations were normal, except at the Es-3 locus (esterase-3), for which Tiger was typed as homozygous. Several unusual events among Tiger's close relatives included a mutation to an unstable pattern mutant, three probable translocations, and several cases of somatic defect. All unusual mice derived from Tiger's yellow mother, whose genome was one-quarter Peruvian. Yellow is associated with an ecotropic murine leukemia virus. The Peru genome is characterized by a high occurrence of mutation and aberrant karyotypes. It is suggested that something from the Peru genome in Tiger's mother caused instability of the DNA sequence associated with yellow, with related disturbance at different locations thereafter. The nature of this instability, and of the Peru genome, is discussed.
    PMID: 6323571 [PubMed - indexed for MEDLINE]

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    SeventyK offers video resources for news media.  In addition to providing patient and healthcare professional interviews, we provide Stop A Doc support materials and flyers; SeventyK Wellness Network buckslips; and press releases.  For more information and for broadcast quality video, contact Stacy Tsai at Stacy@seventyk.org.

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    Building the bridge between rhabdomyosarcoma in children, adolescents and young adults: The road ahead.
    Crit Rev Oncol Hematol. 2011 Jul 28;
    Authors: Van Gaal JC, De Bont ES, Kaal SE, Versleijen-Jonkers Y, van der Graaf WT
    Rhabdomyosarcoma (RMS) is a rare type of soft tissue sarcoma that mainly affects children, but also occurs in adolescents and (young) adults (AYA). Despite dramatic survival improvements reported by international study groups in children over the past decades, the awareness of a dismal outcome for older patients with RMS has grown. In contrast to the world-wide organization of care for children with RMS, standard care in adults lags behind. A step forward in RMS management for patients of all ages is urgently needed. Both paediatric oncologists and medical oncologists are essential players in development of a concept of RMS care, but bringing two worlds together seems not so easy. This review provides an overview which highlights the similarities and differences in children and adults with RMS. Furthermore, it comes up with a novel concept to overcome the virtual gap between the treatment approach of children and AYA with RMS.
    PMID: 21802959 [PubMed - as supplied by publisher]

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    The relationship between unmet needs and distress amongst young people with cancer.
    Support Care Cancer. 2011 Feb 11;
    Authors: Dyson GJ, Thompson K, Palmer S, Thomas DM, Schofield P
    PURPOSE: Most psychosocial research in cancer has been restricted to paediatric or older adult populations. This study aimed to explore psychological distress and unmet needs in adolescents and young adults (AYA) with cancer and identify predictors of distress among demographic and illness characteristics and supportive care needs. METHODS: Fifty-three patients between 16 and 30 years completed a cross-sectional survey, administered shortly after presentation to an AYA oncology service and within 4 months of diagnosis. Measures included the Beck Depression Inventory-Fast Screen (BDI-FS), State-Trait Anxiety Inventory-State Form (STAI-S) and the Supportive Care Needs Survey. Level of distress-related sypmtomatology in this population was based on previous work, whereby a cut-off score of 4 or greater was used for the BDI-FS, and one standard deviation above the sample population mean was used for the STAI-S. RESULTS: Prevalence of distress (25%) was lower than that found previously in AYA with cancer. Physical and daily living needs were the most frequently unmet needs overall, followed by psychological needs, health system and information needs and care and support needs. Lastly, being pre-treatment predicted increased depression and state anxiety, while having treatment post-surgery predicted reduced state anxiety. After controlling for treatment status, however, the main predictors of depression and state anxiety were physical and daily living needs and health system and information needs, respectively. CONCLUSIONS: Lower levels of distress and unmet psychological needs were related to the few participants (17%) in this study who were pre-treatment, when distress was most likely. However, physical needs and information needs, which are almost inevitable throughout treatment and beyond, were more important predictors of distress. Further exploration must consider the psychosocial difficulties underlying this association and the needs of AYA at transitions between critical periods in their cancer journey (i.e., upon diagnosis, during treatment, etc.).
    PMID: 21311915 [PubMed - as supplied by publisher]

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    TipText: 
    Invite other AYA cancer patients, caregivers, and healthcare professionals to join the SeventyK Wellness Network. Regardless of where anyone is in their cancer journey, they can feel supported here. http://www.mybridge4life.com/seventyk
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    A case of peripheral T-cell lymphoma unspecified involving subcutaneous tissue.
    Leuk Lymphoma. 2005 May;46(5):785-8
    Authors: Futagami A, Aoki M, Kawana S
    A 36-year-old man presented with a 3-year-old red-brown plaque with subcutaneous nodules on his left thigh. Although a similar lesion was observed on his right thigh 3 years earlier, it spontaneously disappeared 1 year later. However, the lesion on the left thigh was growing larger. Histologically, the lesion showed a diffuse and dense infiltration of atypical lymphocytes extending from the superficial dermis to the subcutaneous tissue. Severe lobular panniculitis, composed of small- and medium-sized atypical lymphocytes and large normal histiocytes, was observed in the subcutaneous adipose tissue. Immunohistochemical studies revealed a post-thymic T-cell phenotype. A genetic analysis demonstrated a rearrangement of the T-cell receptor chain gene. The left skin lesion also gradually disappeared after skin biopsy without therapy, and he continues to be in remission.
    PMID: 16019520 [PubMed - indexed for MEDLINE]

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    Contact Us

    We hope to empower others and to garner support for our mission to educate patients, supporters, caregivers, and healthcare professionals about the unique needs of adolescent and young adult cancer patients. Together, we can improve the survival rates of this underserved population. We look forward to hearing from you.

     

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    TipText: 
    For AYA patients (and many more) who feel like they may be the only one, Imerman's Angels is a resource that has an extensive database of cancer survivors that meets all demographics. http://www.imermanangels.org/
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    Adolescent and young adult (AYA) oncology: the first A.
    Pediatr Hematol Oncol. 2007 Jul-Aug;24(5):325-36
    Authors: Bleyer A
    Whereas adolescents with cancer as a group used to have a better prognosis than children with malignant disease, trends suggest that the overall survival of 15- to 19-year-olds is now worse than in younger patients. Also, the incidence of cancer is higher in 15- to 19-year age span than during the first 15 years of life. In 2006, the U.S. National Cancer Institute (NCI) and the Lance Armstrong Foundation conducted a Program Review Group (PRG) of the Adolescent and young Adult (AYA) problem. Recommendations covered awareness, prevention/cancer control/epidemiology/risk, biology, access, health insurance, clinical care models, clinical trials/research, special populations, psychosocial/behavioral factors, health-related quality of life, and long-term effects. This Commentary reviews each of the primary executive recommendations of the PRG report with respect to their adolescent oncology perspective and application. Primary implementation of the recommendations is responsibility of a new consortium of organizations devoted to assisting adolescents and young adults with cancer, the LiveStrong Young Adult Alliance, a program of the Lance Armstrong Foundation. Prior programs included the Children's Oncology Group AYA Committee and two disease-specific initiatives: the Intergroup Consortium Against Sarcoma and a clinical trial in young adults with acute lymphoblastic leukemia that will be conducted by Cancer and Leukemia Group B, the Southwest Oncology Group, and Eastern Cooperative Oncology Group. Preliminary evidence indicates that these efforts have already had measurable success.
    PMID: 17613877 [PubMed - indexed for MEDLINE]

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    Adolescents' awareness of HPV infections and attitudes towards HPV vaccination 3 years following the introduction of the HPV vaccine in Hungary.
    Vaccine. 2011 Nov 3;29(47):8591-8
    Authors: Marek E, Dergez T, Rebek-Nagy G, Kricskovics A, Kovacs K, Bozsa S, Kiss I, Ember I, Gocze P
    Abstract
    Hungary takes the fourth place regarding the incidence and the fifth regarding the mortality of cervical cancer among the member countries of the European Union, with 500 deaths due to this preventable illness and nearly 1200 new cases diagnosed every year. Although the vaccines have been available for 3 years, the estimated rate of the female population vaccinated against HPV is approximately 10% in the 12-26-year-age cohort. The aim of this study was to determine factors and motivations affecting the uptake of HPV vaccination among Hungarian adolescents. Examining the effects of some possible sociodemographic predictors (age and gender) and the exposure to health information on HPV vaccine acceptability were also focused on, as well as assessing the most trusted sources of information about sexually transmitted diseases (STDs). A nationwide anonymous questionnaire survey with a sample of 1769 students attending public primary or secondary schools was organised by the authors in 16 Hungarian cities and towns. Data were analysed using the Statistical Package for the Social Sciences (SPSS). Adolescents' awareness of HPV was relatively low. Only 35% of the participants reported they had heard about HPV prior to the survey. Almost 70% of the potentially affected study population had not heard about the vaccine previously. Every fourth student did not believe that vaccination against HPV can prevent cervical cancer. If the vaccination was available free of charge, almost 80% of respondents would request it, but in case they had to pay for it, this number would significantly decrease. Significantly better knowledge and also more positive attitudes towards HPV vaccination was found in relation to the number of information sources. The majority of respondents (62-83%) were open for further information about STDs. The main trusted mediators were school-health services (61.3%), education on health at school (49.2%), health professionals (42.2%) and electronic media (24.6%). Since Hungarian adolescent students expect guidance about STDs principally from school health education, an urgent need for well-designed, HPV-focused educational programmes emerges. Launching such programmes would be especially important for the adolescent population to increase their awareness of the risks associated with HPV infection thus reducing the high incidence of cervical cancer in Hungary in the future.
    PMID: 21939711 [PubMed - indexed for MEDLINE]

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    Sex- and age-related chemotherapy toxicity in patients with non-metastatic osteosarcoma.
    J Chemother. 2009 Apr;21(2):205-10
    Authors: Ferrari S, Palmerini E, Staals E, Abate ME, Longhi A, Cesari M, Balladelli A, Pratelli L, Bacci G
    The influence of age and sex on chemotherapy-related toxicity was evaluated in children and adults with non metastatic osteosarcoma. treatment consisted of methotrexate (MTX, 12 g/m(2)), cisplatin (CDP 120 mg/m(2)) and doxorubicin (ADM 75-90 mg/m(2)) and high-dose ifosfamide (HDIFO). toxicity data from 1,051 courses (295 with MTX, 756 based on doxorubicin, cisplatin and high-dose ifosfamide) were analyzed. Children (4-14 yrs) and females showed a higher incidence of grade 4 neutropenia and thrombocytopenia and were more frequently hospitalized for neutropenic fever compared to adolescents and young adults (AYA, 15-19 yrs) and adults (>20-40 yrs). Delayed MTX excretion was higher in adults than AYA and children. Adults (up to 40 years) can be treated with pediatric protocols for osteosarcoma and they experience lower hematologic toxicity compared to pediatric population. further investigations on sex-related susceptibility to chemotherapy in osteosarcoma patients are recommended.
    PMID: 19423475 [PubMed - indexed for MEDLINE]

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    Journal of Adolescent and Young Adult Oncology Jan 2011, Vol. 1, No. 1: 49-52.

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    [The accuracy of FDG-PET/CT in early-stage cervical and vaginal cancers].
    Gynecol Obstet Fertil. 2011 Apr;39(4):193-7
    Authors: Bentivegna E, Uzan C, Gouy S, Leboulleux S, Duvillard P, Lumbroso J, Haie-Meder C, Morice P
    [(18)F]fluoro-deoxy-glucose positron-emission tomography combined with integrated computed tomography (FDG-PET/CT) is commonly used for advanced stage cervical cancer but its efficiency is discussed in early stage. The aim of this study was to evaluate false negative rate of FDG-PET/CT in early-stage cervical and vaginal cancer.
    PMID: 21429783 [PubMed - indexed for MEDLINE]

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    Management of Early Invasive Breast Cancer in Very Young Women (<35 years).
    Clin Breast Cancer. 2011 Jul 11;
    Authors: Hartmann S, Reimer T, Gerber B
    BACKGROUND: To give an overview about current treatment recommendations and special problems concerning the management of women <35 years with early breast cancer. METHODS: We performed a selective systematic literature review. We discussed with reference to key studies and meta-analyses, current standards of care, and controversies regarding patient management. RESULTS: Breast cancer in patients younger than 35 years is rare but associated with an unsatisfactory prognosis. Local treatment should not differ from general guidelines, but awareness of the high risk of local recurrence must be maintained. Adjuvant polychemotherapy is almost always indicated, standard endocrine therapy is tamoxifen. Before the start of systemic therapy, the patient must be offered different types of fertility preservation. Pregnancy related breast cancer is not associated with a worse prognosis, but with delayed diagnosis. Therefore, every suspicious lesion in the breast or axilla must be imaged and biopsied. The optimal time to delay pregnancy following the diagnosis is unknown. Hormonal contraceptives are contraindicated after breast cancer. Every woman <35 years diagnosed with breast cancer should be offered genetic counseling. CONCLUSION: The management of breast cancer in very young women requires a multidisciplinary team to find the optimal treatment and to solve their specific problems.
    PMID: 21752723 [PubMed - as supplied by publisher]

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    [Application of the Bethesda system in cervical cancer screening].
    Zhonghua Bing Li Xue Za Zhi. 2011 Mar;40(3):189-90
    Authors: QU YQ, ZHOU XR, WANG L, NING Y, XU T, ZHU Q, WANG C, WANG XY, CHE Q, Zhang LH, Wang YQ
    PMID: 21575392 [PubMed - indexed for MEDLINE]

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    [Chromosome and DNA analyses of peripheral blood lymphocyte from the quadruple cancer patient].
    Gan To Kagaku Ryoho. 1992 Jul;19(7):1055-7
    Authors: Yamaguchi H, Kaneda K, Aya T, Imai S, Yamawaki S, Moriuchi T
    The patient with quadruple cancer was a 32 year-old female who had osteosarcoma, bilateral breast cancer and adenocarcinoma of the lung. When chromosomal analysis of peripheral blood lymphocyte was performed, two abnormal cells were detected among 42 cells examined. The first cell showed a translocation involving chromosome 1 and 20 and trisomic for chromosome 19. The second cell was trisomic for chromosome x. Southern blot analysis of DNA from peripheral blood lymphocyte revealed that there was no difference in the expression of Rb gene between the patient and healthy adult.
    PMID: 1626941 [PubMed - indexed for MEDLINE]

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    [Survey on menopausal age and menstruation span in women in Pudong district of Shanghai].
    Zhonghua Fu Chan Ke Za Zhi. 2010 Jun;45(6):415-9
    Authors: Chen H, Feng YJ, Shu HM, Lu TM, Zhu HM, Yang BL, Xiong M
    To investigate natural spontaneous menopausal age, menstruation span and their relationship with menarche age and parity in Pudong district of Shanghai.
    PMID: 21029590 [PubMed - indexed for MEDLINE]

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    Events

    Stay in Touch. This calendar contains events, conferences and seminars, as well as general information to help you keep informed.

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    Recruitment of adolescents and young adults to cancer clinical trials--international comparisons, barriers, and implications.
    Semin Oncol. 2010 Apr;37(2):e1-8
    Authors: Fern LA, Whelan JS
    The last 30 years have seen significant improvements in survival rates for children and older adults. In contrast, the 5-year survival rate among 20 to 39 year olds has been static at around 70% since 1986. Data from the United States, Australia, Italy, and the United Kingdom suggest that this age group also has the lowest rate of clinical trial participation. In the United States, just 2% of patients aged 20 to 29 years enter trials, in contrast with an estimated 60% of patients under 15 years of age. In the United Kingdom, the nadir in accrual is for patients aged 35 to 39 years, of whom only 7.5% are recruited, compared to 52.7% of patients below 15 years of age. This level of trial activity may be associated with the lack of improvement in survival for the older age group. Strategies to increase the numbers of adolescents and young adults (AYA) recruited to cancer clinical trials have become a focus of research activity in several countries. This article explores possible barriers to recruitment of AYA and summarizes current policies in the United States and the United Kingdom to increase accrual of young adults with cancer to clinical trials.
    PMID: 20494693 [PubMed - indexed for MEDLINE]

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    Javed Khan, M.D. is a molecular biologist at the National Cancer Institute (NCI) working on the Pediatric Cancer Genome Project. A focus has been placed on pediatric cancer because the number of mutations leading to cancers in children is much less than in the cancers occuring in adults. The project attempts to sequence the genome of tumors from hundreds of children with cancer to identify the genetic changes from children without cancer. With these genetic changes identified and characterized, clinicians may be able to prescribe appropriate treatments to combat specific cancers.

     

    Watch the video: //www.youtube.com/watch?v=Oe-wIa5fRkY

    For NCI's information on Cancer Biology: http://www.cancer.gov/aboutnci/budget_planning_leg/plan-2012/cancerbiolo...

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    Leukemia mortality trends among children, adolescents, and young adults in Latin America.
    Rev Panam Salud Publica. 2011 Feb;29(2):96-102
    Authors: Curado MP, Pontes T, Guerra-Yi ME, Cancela Mde C
    To describe and compare trends in leukemia mortality among children (0-14 years of age) and adolescents and young adults (AYA, 15-24 years of age) in 12 countries in Latin America during 1980-2004.
    PMID: 21437366 [PubMed - in process]

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    Current issues in adolescent and young adult cancer survivorship.
    Cancer Control. 2008 Jan;15(1):55-62
    Authors: Soliman H, Agresta SV
    Overall, the survival rate for cancer patients has continued to improve over the past several decades. However, those aged 15 to 29 years have not experienced the same improvements in survival. This review explores some of the challenges faced by adolescent and young adult (AYA) cancer patients and their survivorship needs.
    PMID: 18094661 [PubMed - indexed for MEDLINE]

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    Prevalence of human papillomavirus among women with normal cervical cytology in Kuwait.
    J Med Virol. 2011 Mar;83(3):453-60
    Authors: Al-Awadhi R, Chehadeh W, Kapila K
    Abstract
    This study was undertaken to determine the prevalence and type specific distribution of human papillomavirus (HPV) in women with normal cervical cytology in Kuwait. The study is the first of its type in Kuwait and one of few in the Middle East. The age specific distribution of HPV types was determined in 3,011 ThinPrep samples taken from women seeking routine gynaecological care. ThinPrep samples were screened for HPV DNA by real-time PCR. The type specific distribution of the viruses was determined by PCR-based sequencing. The results showed that HPV DNA was detected in 71 women (2.4%), and 21 different HPV genotypes were detected, comprising eight high-risk (HR) (16, 31, 33, 53, 56, 58, 66, and 73), seven low-risk (LR) (6, 11, 54, 61, 70, 81, and 90), four intermediate-risk (IR) (67, 82, 83, and 84) and HPV 102 and HPV 106. LR HPV types were found in 71.8% of infected samples, HR types in 32.3%, and IR types in 7%. With regard to age, 40.8% of all HPVs were found in women 30-39 years of age, 29.6% in women 40-49 years of age, 19.7% in women over 50 years and 9.9% in women less than 34 years old. The study shows that the prevalence of HPV infection in Kuwait is among the lowest in the world and suggests that HPV vaccine could prevent the development of HPV associated cervical cancer in 1.39% of young females living in Kuwait. However, more extensive population-based studies should be undertaken before implementing HPV vaccination.
    PMID: 21264866 [PubMed - indexed for MEDLINE]

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    Interaction between Epstein-Barr virus and type-C virus in human cells.
    IARC Sci Publ. 1978;(20):413-20
    Authors: Osato T, Yamamoto K, Matsuo T, Aya T, Mizuno F, Nonoyama M
    The interaction between EBV and type-C viruses was studied in our FVNC experimental system, in which EBV and type-C viral genomes are contained in each cell. The data indicate that the human lymphoid FVNC cells are sensitive to both EBV and type-C virus exposure, showing high frequencies of induction of both repressed viral genomes. The two different viral genomes may be associated with different chromosomes in individual cells.
    PMID: 215524 [PubMed - indexed for MEDLINE]

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    THE STOP A DOC VIDEO CONTEST LAUNCHES TODAY!

    Patients and Healthcare Professionals Get Rewarded for Creativity That Can Increase Cancer Survivorship for Adolescents and Young Adults

    Orange, California - August 29, 2011
    The Stop A Doc campaign features a video contest to educate the public and healthcare providers the five things crucial to treating AYA cancer patients and improving their survival.  Enter a video to win a cash prize and have your video become a featured SeventyK Stop A Doc public service announcement. It's time to get creative! Read more of the press release at: http://www.prweb.com/releases/2011/8/prweb8680506.htm

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    Self-collected human papillomavirus testing acceptability: comparison of two self-sampling modalities.
    J Womens Health (Larchmt). 2011 Mar;20(3):397-402
    Authors: Igidbashian S, Boveri S, Spolti N, Radice D, Sandri MT, Sideri M
    Human papillomavirus (HPV) testing can be used as a primary test for cervical cancer screening. HPV self-sampling has the potential to replace physician/nurse sampling. Our objective was to compare the acceptability of two self-sampling methods among 205 women undergoing an excisional procedure for cervical intraepithelial neoplasia (CIN) at the European Institute of Oncology (IEO).
    PMID: 21351869 [PubMed - indexed for MEDLINE]

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    Quality cancer care for adolescents and young adults: a position statement.
    J Clin Oncol. 2010 Nov 10;28(32):4862-7
    Authors: Zebrack B, Mathews-Bradshaw B, Siegel S,
    This consensus-based position statement on behalf of the LIVESTRONG Young Adult Alliance (Alliance) offers recommendations to enhance oncologic care of adolescent and young adult (AYA) patients with cancer.
    PMID: 20855821 [PubMed - indexed for MEDLINE]

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    TipText: 
    Journal of Adolescent and Young Adult Oncology (JAYAO) breaks new ground as the first cancer journal dedicated to the adolescent and young adult-aged oncology population. You can keep updated with AYA cancer here: http://seventyk.org/get-educated/jayao
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    The value of ultrasound-guided fine-needle aspiration cytology for thyroid nodules: an assessment of its diagnostic potential and pitfalls.
    Surg Today. 2001;31(2):97-101
    Authors: Ogawa Y, Kato Y, Ikeda K, Aya M, Ogisawa K, Kitani K, Onoda N, Ishikawa T, Haba T, Wakasa K, Hirakawa K
    This study was conducted to assess the diagnostic potential and pitfalls of performing fine-needle aspiration cytology (FNAC) for thyroid nodules. We retrospectively analyzed 1,012 aspirated samples obtained from 806 thyroid nodules by the ultrasound (US)-guided method. Of these 806 nodules, 226 (31%) had been surgically treated, 152 (67%) of which were histologically diagnosed as malignant. The rate of sufficient aspirate was 82%, being lower in nodules with a diameter of less than 5mm (73%, P = 0.10); either calcified (77%, P = 0.043) or benign (72%, P = 0.0002). The accuracy of FNAC was 75%, the rate of indeterminate diagnosis was 16%, the false negative rate was 13%, and the positive malignancy rate was 99%. The rate of indeterminate diagnosis was higher in adenomatous goiter, follicular carcinoma, and malignant lymphoma, at P = 0.015, P = 0.0008, and P = 0.035, respectively. The accuracy was lower in follicular carcinoma and malignant lymphoma (both at P = 0.013). Sufficient aspirate was finally obtained from 701 (87%) of the 806 nodules by repeated aspiration. Of 152 malignant nodules, 28 (18%) were diagnosed after two or more aspirations, and the accuracy was improved to 81% by repeating the procedure. These findings indicated that repeated aspiration may be a simple and effective method of improving the diagnostic potential of FNAC.
    PMID: 11291721 [PubMed - indexed for MEDLINE]

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    TipText: 
    Look for support for AYA cancer patients! SeventyK's website is a great starting point for AYA cancer patients, supporters, caregivers, and survivors to find the resources they need. http://seventyk.org
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    Tomando Control: a culturally appropriate diabetes education program for Spanish-speaking individuals with type 2 diabetes mellitus--evaluation of a pilot project.
    Diabetes Educ. 2006 Sep-Oct;32(5):751-60
    Authors: Mauldon M, Melkus GD, Cagganello M
    The purpose of this study was to pilot test the feasibility, acceptability, and efficacy of a culturally appropriate and culturally relevant Spanish-language cognitive-behavioral diabetes self-care educational intervention for Hispanic Americans with type 2 diabetes mellitus.
    PMID: 16971708 [PubMed - indexed for MEDLINE]

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    A qualitative analysis of South African women's knowledge, attitudes, and beliefs about HPV and cervical cancer prevention, vaccine awareness and acceptance, and maternal-child communication about sexual health.
    Vaccine. 2011 Nov 3;29(47):8760-5
    Authors: Francis SA, Battle-Fisher M, Liverpool J, Hipple L, Mosavel M, Soogun S, Mofammere N
    Abstract
    In South Africa, cervical cancer is the second leading cause of death among women. Black South Africa women are disproportionately affected by cervical cancer and have one of the highest mortality rates from this disease. Although the body of literature that examines HPV and cervical cancer prevention is growing in the developing world; there is still a need for a better understanding of women's knowledge and beliefs around HPV and cervical cancer prevention. Therefore, this formative study sought to examine women's attitudes, beliefs and knowledge of HPV and cervical cancer, HPV vaccine acceptance, maternal-child communication about sexuality, and healthcare decision-making and gender roles within an urban community in South Africa. Women ages 18-44 were recruited from an antenatal clinic in a Black township outside of Johannesburg during the fall of 2008. Twenty-four women participated in three focus groups. Findings indicated that the women talked to their children about a variety of sexual health issues; had limited knowledge about HPV, cervical cancer, and the HPV vaccine. Women were interested in learning more about the vaccine although they had reservations about the long-term affect; they reinforced that grandmothers played a key role in a mother's decisions' about her child's health, and supported the idea that government should provide the HPV vaccine as part of the country's immunization program. Our findings indicate the need to develop primary prevention strategies and materials that will provide women with basic cervical cancer prevention messages, including information about HPV, cervical cancer, the HPV vaccine, screening, and how to talk to their children about these topics. Prevention strategies should also consider the cultural context and the role that grandmothers play in the family unit.
    PMID: 21855591 [PubMed - indexed for MEDLINE]

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    Current issues in adolescent and young adult cancer survivorship.
    Cancer Control. 2008 Jan;15(1):55-62
    Authors: Soliman H, Agresta SV
    Overall, the survival rate for cancer patients has continued to improve over the past several decades. However, those aged 15 to 29 years have not experienced the same improvements in survival. This review explores some of the challenges faced by adolescent and young adult (AYA) cancer patients and their survivorship needs.
    PMID: 18094661 [PubMed - indexed for MEDLINE]

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    Journal of Adolescent and Young Adult Oncology Jan 2011, Vol. 1, No. 1: 53-59.

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    Oncogenic HPV among HIV infected female population in West Bengal, India.
    BMC Infect Dis. 2011;11:72
    Authors: Sarkar K, Pal R, Bal B, Saha B, Bhattacharya S, Sengupta S, Mazumdar PP, Chakraborti S
    Prevalence of both cervical cancer and Human Immunodeficiency Virus (HIV) infection are very high in India. Natural history of Human Papilloma Virus (HPV) infection is known to be altered in HIV positive women and there is an increased possibility of persistence of HPV infections in this population. Therefore, this study was conducted to understand the epidemiology and circulating genotypes of oncogenic HPV among HIV positive and negative female population in West Bengal, India.
    PMID: 21418663 [PubMed - indexed for MEDLINE]

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    Discussing fertility preservation options with patients with cancer.
    JAMA. 2011 Jul 13;306(2):202-3
    Authors: Snyder KA, Pearse W

    PMID: 21750299 [PubMed - indexed for MEDLINE]

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    [Histological evaluation of cervical carcinomas in FIGO stage Ib2/IIa after neoadjuvant chemotherapy].
    Zhonghua Bing Li Xue Za Zhi. 2011 Mar;40(3):173-6
    Authors: CHEN XD, SHI HY, LÜ WG, QIN JL
    Abstract
    OBJECTIVE: To investigate the histological changes of cervical cancer after neoadjuvant chemotherapy (NACT) and to establish histological criteria for interpretation of chemotherapeutical effects.
    METHODS: Fifty-six patients with FIGO stage Ib2-IIa cervical cancers treated by NACT and subsequent radical surgery were retrospectively analyzed, in which the pre- and post-chemotherapeutic histopathological changes were assessed.
    RESULTS: The post-chemotherapeutic histopathological changes of 56 cases included grade 3 effects in 11 cases (19.6%), grade 2 in 24 cases (42.9%), grade 1 in 13 cases (23.2%) and no response in only 8 cases (14.3%). The histologic response rate was 62.5% (35/56) and the overall clinical response rate was 67.9% (38/56). The overall coincidence by both criteria was 78.6% (44/56). Four cases (7.1%, 4/56) had only histological response and 8 cases (14.3%, 8/56) had response by imaging. In comparison with the pre-chemotherapy specimens, the chemotherapy-associated histological changes included shrinkage and scattering of tumor nests,decrease of tumor cellularity,tumor cell degeneration and necrosis.
    CONCLUSIONS: The histological changes in locally advanced cervical cancers induced by NACT are significant, which may challenge the diagnosis in the final specimens. There are some discreqancies between the histological criteria and imaging/gynecological ones for the therapeutic evaluation of cervical cancers,and it is thus recommended to use the pathological criteria for clinic practice.
    PMID: 21575388 [PubMed - indexed for MEDLINE]

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    Trichomonas vaginalis infection among women in a low prevalence setting.
    Sex Health. 2011 Mar;8(1):65-8
    Authors: Uddin RN, Ryder N, McNulty AM, Wray L, Donovan B
    Trichomonas vaginalis has become rare in Australian cities but remains endemic in some remote regions. We describe the prevalence and associations of infection among women attending an urban Australian sexual health clinic.
    PMID: 21371384 [PubMed - indexed for MEDLINE]

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    Fertility-preserving measures for girls and young women with cancer.
    Tidsskr Nor Laegeforen. 2011 Aug 9;131(15):1429-1432
    Authors: Stensvold E, Magelssen H, Oskam IC
    Background. Children and young adults with cancer may be rendered infertile as a result of their treatment. The purpose of this article is to provide an overview of fertility-preserving measures for girls and young women. Material and methods. The article is based on literature searches in the medical databases Medline, Pubmed and Scopus and the experience of a Nordic cooperative group on gonadal preservation in connection with cancer treatment. Results. There are several methods for preserving the fertility of girls and young women with cancer. These should form a part of the actual cancer treatment. Cryopreservation of embryos is a well established method for adult cancer patients, also in Norway. Cryopreservation of eggs and ovarian tissue is to be regarded as still at the experimental stage. Research and new methods will improve the options for prepubertal children and young adults with disseminated cancer. Interpretation. Multidisciplinary cooperation is necessary to ensure that children and young cancer patients receive thorough information about the risk of infertility after cancer treatment, and about potential fertility-preserving measures.
    PMID: 21844944 [PubMed - as supplied by publisher]

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    Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls.
    J Clin Oncol. 2010 Apr 20;28(12):2002-7
    Authors: Kazak AE, Derosa BW, Schwartz LA, Hobbie W, Carlson C, Ittenbach RF, Mao JJ, Ginsberg JP
    PURPOSE The purpose of this study was to compare adolescent and young adult (AYA) pediatric cancer survivors and peers without a history of serious illness on psychological distress, health-related quality of life (HRQOL), health beliefs; examine age at diagnosis and cancer treatment intensity on these outcomes; and examine relationships between number of health problems and the outcomes. PATIENTS AND METHODS AYA cancer survivors (n = 167) and controls (n = 170), recruited during visits to a cancer survivorship clinic and primary care, completed self-report questionnaires of distress, health problems, and health beliefs. For survivors, providers rated treatment intensity and health problems. Results There were no statistically significant differences between survivors and controls in psychological distress or HRQOL. Cancer survivors had less positive health beliefs. Survivors diagnosed as adolescents had significantly greater psychological distress and fewer positive health beliefs than those diagnosed earlier. Survivors with the highest level of treatment intensity had greater anxiety and fewer positive health beliefs than those with less intense treatments. Provider report of current health problems related to survivors' beliefs and mental HRQOL only, whereas patient report of health problems correlated significantly with most psychosocial outcomes and beliefs. CONCLUSION AYA cancer survivors did not differ from peers in psychological adjustment but did endorse less adaptive health beliefs. Survivors diagnosed during adolescence and who had more intensive cancer treatments evidenced poorer psychosocial outcomes. Beliefs about health may be identified and targeted for intervention to improve quality of life, particularly when patient perceptions of current health problems are considered.
    PMID: 20231679 [PubMed - indexed for MEDLINE]

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    TipText: 
    According to the Huffington Post, men have a greater risk of developing aggressive prostate cancer if consuming large quantities of red meat, particularly if grilled or well-done. Limit intake of red and processed meats and opt for lean protein like chicken, fish, beans, and legumes. This is a good guideline for many AYA cancers.
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    Unique characteristics of adolescent and young adult acute lymphoblastic leukemia, breast cancer, and colon cancer.
    J Natl Cancer Inst. 2011 Apr 20;103(8):628-35
    Authors: Tricoli JV, Seibel NL, Blair DG, Albritton K, Hayes-Lattin B
    Each year in the United States, nearly 70 000 individuals between the ages of 15 and 40 years are diagnosed with cancer. Although overall cancer survival rates among pediatric and older adult patients have increased in recent decades, there has been little improvement in survival of adolescent and young adult (AYA) cancer patients since 1975 when collected data became adequate to evaluate this issue. In 2006, the AYA Oncology Progress Review Group made recommendations for addressing the needs of this population that were later implemented by the LIVESTRONG Young Adult Alliance. One of their overriding questions was whether the cancers seen in AYA patients were biologically different than the same cancers in adult and/or pediatric patients. On June 9-10, 2009, the National Cancer Institute (NCI) and the Lance Armstrong Foundation (LAF) convened a workshop in Bethesda, MD, entitled "Unique Characteristics of AYA Cancers: Focus on Acute Lymphocytic Leukemia (ALL), Breast Cancer and Colon Cancer" that aimed to examine the current state of basic and translational research on these cancers and to discuss the next steps to improve their prognosis and treatment.
    PMID: 21436065 [PubMed - indexed for MEDLINE]

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    Challenges in the recruitment of adolescents and young adults to cancer clinical trials.
    Cancer. 2007 Dec 1;110(11):2385-93
    Authors: Burke ME, Albritton K, Marina N
    The adolescent and young adult (AYA) oncology population has seen inferior progress in cancer survival compared with younger children and older adults over the past 25 years. Previously, AYAs had the best survival rates due to the prevalence of highly curable diseases including Hodgkin lymphoma and germ cell tumors, yet today AYAs have inferior survival rates to children and some adult cohorts. Survival rates are particularly poor for AYA-specific diseases such as sarcomas. Research involving children and adults diagnosed with common malignancies such as acute lymphoblastic leukemia has resulted in improved survival rates. However, AYAs have not directly benefited from such research due to low rates of access to and accrual on clinical trials. AYAs are less likely to have insurance or access to healthcare, are more likely to see providers who are not part of research institutions, and are less likely to be referred to or to join clinical trials, all of which may contribute to worse outcomes. Few clinical trials target AYA-specific diseases, leading to little information regarding how these diseases behave and what role the host plays. Tumor samples for this population are underrepresented in national tumor banks. Coupled with the need for more clinical trials that focus on AYA-specific cancers, better collaboration between adult and pediatric cooperative groups as well as increased education among community oncologists and primary care providers will be needed to enhance participation in clinical trials with the goal to increase survival and improve quality of that survival.
    PMID: 17918260 [PubMed - indexed for MEDLINE]

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    Tito Dudley is a student at the Natural Gourmet Institute. Born and raised in New York City, he is a chef, nutrition consultant, personal trainer, natural bodybuilder, actor, and filmmaker. He was diagnosed with Hodgkins Disease/Cancer at the age of 15. Dudley says that after his recovery, he made a promise to himself to live a healthier lifestyle. His goal is to help others do the same.

     

    During the holiday season it can be very hard for many of us, including myself, to stay on our fitness and nutrition journey. We are bombarded with all these wonderful parties and events that continuously tempt us to eat holiday treats and carb loaded foods (acidic/expansive foods) until we're stuffed. Also, many of these events don't even serve large portions of vegetables (alkaline/contractive foods). The holidays are usually a time to spend with family, friends and loved ones. Even amongst all the enjoyment and fun of this time, we should keep a side note on how we can balance our bodies.

    Most people during the holidays would try to eat less by skipping a few meals because they're waiting for that big exciting cheat meal. Skipping meals is like driving a vehicle on very little gas or oil. Eventually it will have an effect on other parts of the car - your body will hold on to more body fat than needed (to preserve energy), you can become nutritionally depleted and extract nutrients from other parts of the body such as organ and bones leading to other issues over time all because of skipping meals. Obviously, all these symptoms can happen over time of continuous misguided behavior. We also are so caught up in squeezing time in for all these events that we end up jeopardizing our sleep as well as being dehydrated from all the liquor, soda, and any unnatural drink we've consumed over the last few days. Eating high consumption of carb loaded foods can be a form of stress to the body, which can create inflammation.

    Stress is the number one cause of many of our chronic diseases. It is very important to have fun, but also make healthy choices to keep our bodies balanced. Eating more greens (Ex: leafy greens, salads, root vegetable, & sea vegetables), drinking lots of water, making sure to get your quality fats in your eating regimen (Ex: olive oil, avocados and nuts), get enough sleep, and continue to exercise. All of these choices will help promote a well-balanced body during the holidays and even long after its over. Have fun and stay healthy!

    Here is a recipe for a Ginger Tonic. This recipe is great because it helps stimulate your digestive system to make it easier for your body to break down food.

     

     

    Ginger Tonic Recipe (Simple and Easy)

     

    Ingredients:

    2 Stalks Ginger

    ¼ Cup of Maple Syrup

    Pinch of Cayenne Pepper (optional)

    Procedures:

    1.     Juice Ginger in a juicer

    2.     Add the maple syrup and cayenne pepper until fully combined.

    3.     Have a small amount before about 10 minutes before eating.   

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    Dual persistence of Epstein-Barr viral and type-C viral genomes in nonproducer human lymphoblastoid cells.
    Bibl Haematol. 1975;(40):585-8
    Authors: Osato T, Yamamoto K, Mizuno F, Sugawara K, Aya T

    PMID: 169826 [PubMed - indexed for MEDLINE]

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    TipText: 
    As an AYA or pediatric cancer patient, consider fertility preservation at the time of diagnosis, and make it a part of your treatment conversations with your doctors. Here is a comprehensive overview of options and considerations http://www.cancer.gov/ncicancerbulletin/011111/page5
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    Awareness of oral cancer in the Mersey region.
    Br J Oral Maxillofac Surg. 2011 Apr;49(3):176-81
    Authors: Rogers SN, Hunter R, Lowe D
    The purpose of this study was to assess the levels of awareness and knowledge about oral cancer in the Liverpool area. This included the awareness of oral cancer compared to other cancers, risk factors, symptoms and where people would go to seek advice in the event of experiencing oral cancer symptoms. Five hundred and thirty-five people agreed to take part in a street survey that was done in four locations (Liverpool city centre, Bootle, Crosby, and Southport). A quota sampling approach was used to achieve a reasonable balance by sex, age, and locality. When asked without prompting to name all the cancers they had heard of, oral cancer was stated first by only 1%; it was given within the first three responses by 4%, and by 11% overall. Cervical cancer was mentioned without prompting by 22%, and two-thirds thought that it was more common than oral cancer. When asked without prompting 74% were aware that smoking could be a likely cause, but only 21% mentioned alcohol. Without prompting, 35% said that a non-healing mouth ulcer was a symptom of oral cancer. When asked without prompting what they would do if a painful mouth ulcer had lasted for more than three weeks, 61% said they would see their doctor and 27% their dentist, which is encouraging.
    PMID: 20471730 [PubMed - indexed for MEDLINE]

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    Adolescent and young adult oncology training for health professionals: a position statement.
    J Clin Oncol. 2010 Nov 10;28(32):4858-61
    Authors: Hayes-Lattin B, Mathews-Bradshaw B, Siegel S
    We outline here the essential elements of training for health care professionals who work with adolescent and young adult (AYA) patients with cancer. Research is emerging that a number of cancers manifest themselves differently in the AYA population, both in terms of biology and treatment response. In addition, there are a number of issues uniquely experienced by the AYA population that are critical for health care professionals working within AYA oncology (AYAO) to understand. The LIVESTRONG Young Adult Alliance, a Lance Armstrong Foundation program and a result of the Adolescent and Young Adult Oncology Progress Review Group cosponsored by the Lance Armstrong Foundation and the National Cancer Institute, assembled a group of experts representing relevant medical, psychosocial, and advocacy disciplines to create a blueprint for the training and development of health care professionals caring for AYA patients with cancer. The Alliance recommends that all health care professionals working in AYAO receive training that provides expertise in the following three critical areas: AYA-specific medical knowledge; care delivery specific to AYAs relative to pediatric and older adult populations; and competency in application and delivery of AYA-specific practical knowledge. These three areas should form the foundation for curricula and programs designed to train health care professionals caring for AYAO patients.
    PMID: 20823410 [PubMed - indexed for MEDLINE]

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    Nursing experts have come up with tips for cancer survivors to receive quality follow-up care post-treatment. As an AYA cancer patient, follow-up care is crucial to see improved survival rates.
     
    Nursing Times's 10 top tips for getting the best post-cancer treatment support:
     
    1. Discussing your needs with a healthcare professional at the end of treatment
    2. Seeing a copy of your end-of-treatment assessment and care plan
    3. Finding out who is your ongoing "main contact" in the hospital team
    4. Being aware of any post-treatment symptoms
    5. Getting support with day-to-day concerns like money, work and family issues
    6. Talking with your general practitioner or main contact about how you feel
    7. Taking steps toward healthier living
    8. Finding out more about what to look out for if you are worried about treatment side effects or the cancer coming back
    9. Monitoring your own health and keeping up to date with ongoing check-ups
    10. Making suggestions based on your experiences of treatment and care
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    High Epstein-Barr virus (EBV) susceptibility of both lymphoblastoid and lymphoma cell lines derived from a Japanese patient with EBV genome-positive Burkitt's lymphoma.
    Tohoku J Exp Med. 1993 Jun;170(2):71-9
    Authors: Okano M, Aya T, Mizuno F, Takada K, Osato T
    A Lymphoma cell line from the tumor tissue was established spontaneously from a Japanese patient with Epstein-Barr virus (EBV) genome-positive Burkitt's lymphoma (BL). Additionally lymphoblastoid cell lines from peripheral blood of this patient were established either spontaneously or by in vitro infection with B95-8 EBV. Lymphoma cells showed monoclonal surface immunoglobulins (kappa and gamma) with specific chromosomal translocations, t (8; 14). In contrast, lymphoblastoid cells expressed polyclonal surface immunoglobulins without specific chromosomal abnormalities. Lymphoma cells made colonies in soft agarose approximately 10 times more than those of the lymphoblastoid cells. When each cell line was cultured at lower temperature of 33 degrees C, treated with 12-O-tetradecanoyl- phorbol-13-acetate (TPA), and superinfected with P3HR-1 EBV, all cell lines expressed 5 to 10 times higher levels of EBV early antigens (EA) and viral capsid antigen (VCA) than lymphoblastoid cell lines from healthy controls. Furthermore, lymphoblastoid cell lines obtained from peripheral blood of this patient during the period of remission also exhibited high EA and VCA inducibility and superinfectibility. These findings suggested that the lymphoid cells in this patient were genetically highly susceptible to EBV infection, and this evidence possibly linked to the lymphomagenesis of EBV genome-positive BL.
    PMID: 8266328 [PubMed - indexed for MEDLINE]

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    The adolescent/young adult experience.
    J Pediatr Oncol Nurs. 2004 May-Jun;21(3):145-9
    Authors: Haase JE, Phillips CR
    Adolescents and young adults with cancer (AYA) have strikingly poorer outcomes when compared to younger or older patients. Contributing reasons include low rates of enrollment in clinical trials and the "invisibility" of the AYA perspectives in research reports. We recommend a shift in research perspectives away from function-based studies that focus on morbidity and mortality outcomes to meaning-based models that will very likely rely upon qualitative methods and findings as the basis for developing psychosocial interventions that are sensitive to the AYA cancer experience. In addition, research on positive health concepts such as hope, spirituality, and positive coping are recommended as a way to learn about the effective strategies used by AYA to adjust to the cancer experience.
    PMID: 15296043 [PubMed - indexed for MEDLINE]

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    Class III nerve-sparing radical hysterectomy versus standard class III radical hysterectomy: an observational study.
    Ann Surg Oncol. 2011 Nov;18(12):3469-78
    Authors: Ditto A, Martinelli F, Mattana F, Reato C, Solima E, Carcangiu M, Haeusler E, Mariani L, Raspagliesi F
    Abstract
    BACKGROUND: The purpose of this observational study was to evaluate disease-free survival, overall survival, local recurrence rate, and morbidities in patients submitted to class III nerve-sparing radical hysterectomy (NSRH) compared with standard radical hysterectomy (RH) in cervical cancer (CC). This was a comparative study in the context of multimodal therapies.
    MATERIALS AND METHODS: We investigated patients with CC admitted to the National Cancer Institute of Milan between January 4, 2001, and September 29, 2009, treated with NSRH. We compared patients operated with RH between March 20, 1980, and December 28, 1995. A total of 496 patients were enrolled. The median follow-up was 93 months (42 and 159 months for the NSRH and RH groups, respectively).
    RESULTS: The overall number of relapses was 30 out of 185 and 60 out of 311 for NSRH and RH, respectively. Five-year disease-free survival estimate was 78.9% (95% confidence interval [CI] 72.0-85.7) in NSRH and 79.8% (95% CI 75.3-84.3) in RH (P=0.519). Five-year overall survival estimate was 90.8% (95% CI 85.9-95.6) in NSRH and 84.1% (95% CI 8.0-88.3) in RH (P=0.192). Rates of postoperative serious complications were 9.7% and 19.6% for NSRH and RH, respectively (P=0.004). Positive pelvic lymph node and vagina status were significant (P<0.01) independent predictors by multivariable analyses.
    CONCLUSIONS: The oncologic results were comparable between NSRH and conventional class III RH in the context of two multimodal treatments. Bladder function and postoperative complications rate are improved by nerve-sparing technique. The nerve-sparing technique should be considered in all CC patients addressed to surgery because it improves functional outcome and preserves radicality without compromising overall survival.
    PMID: 21556949 [PubMed - indexed for MEDLINE]

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    Adolescent and young adult (AYA) oncology: the first A.
    Pediatr Hematol Oncol. 2007 Jul-Aug;24(5):325-36
    Authors: Bleyer A
    Whereas adolescents with cancer as a group used to have a better prognosis than children with malignant disease, trends suggest that the overall survival of 15- to 19-year-olds is now worse than in younger patients. Also, the incidence of cancer is higher in 15- to 19-year age span than during the first 15 years of life. In 2006, the U.S. National Cancer Institute (NCI) and the Lance Armstrong Foundation conducted a Program Review Group (PRG) of the Adolescent and young Adult (AYA) problem. Recommendations covered awareness, prevention/cancer control/epidemiology/risk, biology, access, health insurance, clinical care models, clinical trials/research, special populations, psychosocial/behavioral factors, health-related quality of life, and long-term effects. This Commentary reviews each of the primary executive recommendations of the PRG report with respect to their adolescent oncology perspective and application. Primary implementation of the recommendations is responsibility of a new consortium of organizations devoted to assisting adolescents and young adults with cancer, the LiveStrong Young Adult Alliance, a program of the Lance Armstrong Foundation. Prior programs included the Children's Oncology Group AYA Committee and two disease-specific initiatives: the Intergroup Consortium Against Sarcoma and a clinical trial in young adults with acute lymphoblastic leukemia that will be conducted by Cancer and Leukemia Group B, the Southwest Oncology Group, and Eastern Cooperative Oncology Group. Preliminary evidence indicates that these efforts have already had measurable success.
    PMID: 17613877 [PubMed - indexed for MEDLINE]

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    TipText: 
    As an AYA cancer patient, it is crucial to understand and to utilize your health insurance. The National Coalition for Cancer Survivorship is a great resource. http://www.canceradvocacy.org/resources/insurance/
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    Journal of Adolescent and Young Adult Oncology Jan 2011, Vol. 1, No. 1: 61-63.

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    Nonmalignant Diseases and Treatments Associated with Primary Ovarian Failure: An Expanded Role for Fertility Preservation.
    J Womens Health (Larchmt). 2011 Aug 9;
    Authors: Hirshfeld-Cytron J, Gracia C, Woodruff TK
    Abstract Cancer treatments can be detrimental to fertility; recent literature has focused on the efforts of fertility preservation for this patient population. It should be recognized, however, that several nonmalignant medical conditions and therapeutic interventions could be similarly hazardous to fertility. Some of these nonmalignant diseases and their treatments that can adversely impact the reproductive axis are gastrointestinal diseases, rheumatologic disorders, nonmalignant hematologic conditions, neurologic disorders, renal disorders, gynecologic conditions, and metabolic diseases. Their negative effects on reproductive function are only now being appreciated and include impaired ovarian function, endocrine function, or sexual function and inability to carry a pregnancy to term. Complications and comorbidities associated with certain diseases may limit the success of established fertility preservation options. Recent advances in fertility preservation techniques may provide these patients with new options for childbearing. Here, we review several fertility-threatening conditions and treatments, describe current established and experimental fertility preservation options, and present three initiatives that may help minimize the adverse reproductive effects of these medical conditions and treatments by raising awareness of the issues and options: (1) increase awareness among practitioners about the reproductive consequences of specific diseases and treatments, (2) facilitate referral of patients to fertility-sparing or restorative programs, and (3) provide patient education about the risk of infertility at the time of diagnosis before initiation of treatment.
    PMID: 21827325 [PubMed - as supplied by publisher]

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    Oscar

    Cancer category: Leukemias

    Cancer type: Acute Lymphocytic Leukemia

     

    Oscar was diagnosed with Acute Lymphocytic Leukemia at the age of 25. He is an engineer who wants to pursue his Masters Degree in Structural Engineering, something he wanted to do before his cancer diagnosis.

     

    Oscar’s Story

    “I was 25 years old, working in an Engineering firm and applying to get my masters in Structural Engineering at the University of Michigan.  I was focused on my dream of working for a well known Engineering firm and opening my own business.  It was then that I was diagnosed with Acute Lymphocytic Leukemia (ALL) and my plans had to change a bit…

    One of the biggest challenges of having cancer at 25 was losing my freedom. I felt that my life was fading away, that the world was spinning and everyone around me was enjoying the ride, enjoying life, enjoying health, but me. Cancer not only took my freedom, but made my family suffer as well; my mom, dad, sister and brother joined me on my journey of physical pain and sometimes emotional pain as well.  I was at the hospital for days, sometimes weeks, depending on my condition; it made the agony of the first three months of my chemo even worse. Seeing myself getting weaker and weaker as time went by, losing my hair, my eyebrows and my strength made me feel useless and scared for the first time in my life.

    Cancer took my freedom, but not my life. At some point during chemotherapy, something happened; it is hard to explain, but suddenly I was not scared anymore.  I felt that I was on a vacation, a long vacation.   Every journey to the hospital transformed into a way to relax and get treated and of course get attended to by angels (nurses).  After I completed my treatment, this experience made me mentally and emotionally stronger. When it was all over I went back to work and after 3 years I opened my own business as an Engineer.

    My future goal is to pick up where I left off before my diagnosis and get my Masters Degree in Structural Engineering in the next year or so.  My aspirations are to see my company grow someday and travel around the world with my beautiful wife.  I would like to pay tribute to my mom, dad, sister, and brother for sticking by me through those tough days in the hospital, through treatment and beyond…and to my wife for giving me so much to look forward to!”

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    Fertility determinants after conservative surgery for mucinous borderline tumours of the ovary (excluding peritoneal pseudomyxoma).
    Hum Reprod. 2011 Apr;26(4):808-14
    Authors: Koskas M, Uzan C, Gouy S, Pautier P, Lhommé C, Haie-Meder C, Duvillard P, Morice P
    BACKGROUND The aim of this study was to define determinants of fertility in patients treated conservatively for mucinous borderline ovarian tumours (MBOTs), and to compare outcomes after salpingo-oophorectomy or cystectomy. METHODS This was a retrospective cohort study of fertility results in a series of patients treated conservatively for MBOTs and desiring pregnancy. Conservative surgery was defined as preservation of the uterus and ovarian tissue in one or both adnexa(e). Fertility results were compared with patients who had undergone a cystectomy or a (salpingo-)oophorectomy. Only patients with a minimum of 1 year of follow-up were included. Epidemiological, surgical, histological parameters and other prognostic factors for fertility results were investigated. RESULTS A group of 31 patients who had been treated conservatively between 1997 and 2004 and who desired pregnancy were investigated. Patients were treated by unilateral salpingo-oophorectomy (USO) (n = 19) or cystectomy (n = 12). The 5-year recurrence-free survival rate was higher in the USO group compared with the cystectomy group (94.7 versus 49.1%, P = 0.041). Among the 31 women, 12 had become pregnant. The 5-year probabilities of pregnancy were comparable between the cystectomy and salpingo-oophorectomy groups (41.8 and 45.9%, respectively, P= 0.66). None of the other factors studied (epidemiological, surgical and histological parameters) were associated with fertility results. CONCLUSIONS The use of salpingo-oophorectomy rather than cystectomy should be preferred during conservative surgery for patients with MBOTs because it decreases the risk of recurrence and does not impair fertility.
    PMID: 21262776 [PubMed - indexed for MEDLINE]

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    Association between circulating interleukin-1 beta (IL-1β) levels and IL-1β C-511T polymorphism with cervical cancer risk in Egyptian women.
    Mol Cell Biochem. 2011 Jul;353(1-2):159-65
    Authors: Al-Tahhan MA, Etewa RL, El Behery MM
    Abstract
    Cancer cervix is one of the leading causes of cancer-related mortality among women worldwide. It is believed that the host genetic factors such as inflammation-induced cytokines may play a role in cervical carcinogenesis. The interleukin-1β (IL-1β) gene contains several single nucleotide polymorphisms. One of them, C-511T, which in the promoter region has been associated with increased IL-1β production and with increased risk of developing cancers. We assessed the association between the IL-1β C-511T polymorphism and cervical cancer risk in a case-control study among 100 histopathologically confirmed Egyptian women with cervical cancer and 50 age-matched, cervical cytology negative, healthy controls by polymerase chain reaction-restriction fragment length polymorphism. Plasma levels of IL-1β were assayed by enzyme-linked immunosorbent assay. There was significant increase in the mean plasma IL-1β level in cervical cancer cases (43.40 ± 25.95 pg/ml) when compared with controls (30.51 ± 18.28 pg/ml, P = 0.002). The plasma levels above the 75th percentile of controls (IL-1β ≥ 45.74 pg/ml) were significantly associated with a 2.49-fold increased risk of cervical cancer. The significant increase in IL-1β concentration in cervical cancer cases was observed only among cervical cancer cases carrying C-511T variant genotypes. T/T genotype of IL-1β polymorphism was significantly higher in cervical cancer cases compared with controls (57 vs. 38%; OR = 2.16; P = 0.028) and the T allele carriage was significantly associated with cervical cancer risk (OR = 2.00, 95% CI = 1.19-3.38, and P = 0.008). In conclusion, plasma IL-1β level and IL-1β C-511T polymorphism may be considered as candidate biomarkers for cervical cancer in Egyptian women.
    PMID: 21424904 [PubMed - indexed for MEDLINE]

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    Unique characteristics of adolescent and young adult acute lymphoblastic leukemia, breast cancer, and colon cancer.
    J Natl Cancer Inst. 2011 Apr 20;103(8):628-35
    Authors: Tricoli JV, Seibel NL, Blair DG, Albritton K, Hayes-Lattin B
    Each year in the United States, nearly 70 000 individuals between the ages of 15 and 40 years are diagnosed with cancer. Although overall cancer survival rates among pediatric and older adult patients have increased in recent decades, there has been little improvement in survival of adolescent and young adult (AYA) cancer patients since 1975 when collected data became adequate to evaluate this issue. In 2006, the AYA Oncology Progress Review Group made recommendations for addressing the needs of this population that were later implemented by the LIVESTRONG Young Adult Alliance. One of their overriding questions was whether the cancers seen in AYA patients were biologically different than the same cancers in adult and/or pediatric patients. On June 9-10, 2009, the National Cancer Institute (NCI) and the Lance Armstrong Foundation (LAF) convened a workshop in Bethesda, MD, entitled "Unique Characteristics of AYA Cancers: Focus on Acute Lymphocytic Leukemia (ALL), Breast Cancer and Colon Cancer" that aimed to examine the current state of basic and translational research on these cancers and to discuss the next steps to improve their prognosis and treatment.
    PMID: 21436065 [PubMed - indexed for MEDLINE]

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    Genetic diversity of HPV-16 E6, E7, and L1 genes in women with cervical lesions in Liaoning Province, China.
    Int J Gynecol Cancer. 2011 Apr;21(3):551-8
    Authors: Sun Z, Ren G, Cui X, Zhou W, Liu C, Ruan Q
    High-risk human papillomaviruses (HPVs) play a cardinal role in the etiology of cervical cancer. The most prevalent type, HPV-16, shows intratypic sequence variants that are known to differ in oncogenic potential and geographic distribution. Intratype variations in oncogenic E6/E7 and capsid L1 proteins of HPV-16 are associated with risk of viral persistence and progression.
    PMID: 21436703 [PubMed - indexed for MEDLINE]

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    Evaluation of a survivorship educational program for adolescent and young adult survivors of childhood cancer.
    J Cancer Educ. 2010 Dec;25(4):530-7
    Authors: Bingen K, Kupst MJ
    Educational programs to address specific needs of adolescent and young adult (AYA) childhood cancer survivors are scarce. A quarterly speaker series and 1-day conference involved presentations by oncology experts to increase knowledge of AYA cancer survivorship issues and awareness of community programs and resources. Pre- and post-evaluations were administered to determine the program's efficacy. Most rated program satisfaction as "moderately high" to "high" and having met expectations. Self-report ratings indicated a significant increase in perceived knowledge of survivorship topics and resource awareness for AYA childhood cancer survivors and caregivers. Nearly one third attended more than one presentation, indicating that the educational program was beneficial to them. This program was effective in increasing self-reported survivorship education for AYA survivors of childhood cancer, families, and health care providers.
    PMID: 20229076 [PubMed - indexed for MEDLINE]

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    TipText: 
    Moderate exercise for just 30 to 45 minutes a day, 5 days a week, can help prevent cancer. Staying active is just as important for AYA cancer patients who want to prevent the recurrence of cancer. http://www.fhcrc.org/research/profiles/mctiernan.html
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    Malignant hematologic diseases in adolescents and young adults.
    Blood. 2011 Jun 2;117(22):5803-15
    Authors: Wood WA, Lee SJ
    Adolescents and young adults (AYA) with cancer have been designated as a vulnerable population by the National Cancer Institute. This group, defined by the ages of 16-39 years, has not enjoyed the same survival improvements over the past several decades as older and younger cohorts. Several barriers prevent the optimal delivery of oncologic care in this subpopulation. This review will describe these challenges in the context of the major hematologic malignancies affecting this population (acute lymphoblastic leukemia [ALL], acute myeloid leukemia [AML], Hodgkin lymphoma [HL], and non-Hodgkin lymphoma [NHL]). For example, historical differences in care delivery between pediatric and adult health care systems have created confusion about optimal treatment planning for AYAs, a population that spans the pediatric-adult divide. In the case of ALL, retrospective studies have demonstrated significantly better outcomes when AYAs are treated according to pediatric and not adult protocols. Additional challenges more specific to AYAs include increased treatment-related toxicity relative to younger patients; less access to care and, specifically, access to clinical trials; lower adherence to medications and treatment plans; and psychosocial stressors relevant to individuals at this stage of life. Recognizing and responding to these challenges in AYAs may create opportunities to improve the cancer outcomes of this group.
    PMID: 21398581 [PubMed - in process]

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    Utility scores and treatment preferences for clinical early-stage cervical cancer.
    Value Health. 2011 Jun;14(4):582-6
    Authors: Jewell EL, Smrtka M, Broadwater G, Valea F, Davis DM, Nolte KC, Valea R, Myers ER, Samsa G, Havrilesky LJ
    Abstract
    OBJECTIVES: To determine utility scores for health states relevant to the treatment of early-stage, high-risk cervical cancer.
    METHODS: Seven descriptive health states incorporating the physical and emotional aspects of medical treatment, recovery, and prognosis were developed. Forty-five female volunteers valuated each health state using the visual analogue score (VAS) and time trade off (TTO) methods. Treatment options were ranked by mean and median TTO scores. The 95% confidence intervals were calculated to determine the statistical significance of ranking preferences. The Wilcoxon rank-sum test was used to compare central tendencies related to age, race, parity, and subject history of abnormal cervical cytology.
    RESULTS: VAS and TTO scores were highly correlated. Volunteers ranked minimally invasive radical hysterectomy with low-risk features as most preferred (mean TTO = 0.96; median TTO = 1.00) and aborted radical hysterectomy followed by chemoradiation as least preferred (mean TTO = 0.69; median TTO = 0.83). Health states that included radical surgery were ranked higher than those that included chemoradiation, either in the adjuvant or primary setting. When survival was comparable, volunteers rated radical hysterectomy with high-risk pathology followed by adjuvant chemoradiation (mean TTO = 0.78; median TTO = 0.92; 95% CI: 0.69-0.87) similarly to chemoradiation alone (mean TTO = 0.76; median TTO 0.90; 95% CI: 0.66-0.86; p = NS). Utility scores for the majority of health states were not significantly associated with age, race, parity, or subject history of abnormal cervical cytology.
    CONCLUSION: Subjects consistently preferred surgical excision to treat early-stage, high-risk cervical cancer and chose a minimally invasive approach. Such utility scores can be used to incorporate quality-of-life effects into comparative-effectiveness models for cervical cancer.
    PMID: 21669383 [PubMed - indexed for MEDLINE]

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    The effect of community nurses and health volunteers on child mortality: the Navrongo Community Health and Family Planning Project.
    Scand J Public Health. 2007;35(6):599-608
    Authors: Pence BW, Nyarko P, Phillips JF, Debpuur C
    Despite effective treatments and preventive measures for the major causes of child illness and death in less wealthy nations, child mortality remains high in resource-poor settings due in part to ineffective health service delivery models.
    PMID: 17852975 [PubMed - indexed for MEDLINE]

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    For young women with cancer, ob/gyns are the best advocates for patients when it comes to future fertility. Below is a blog post from the Oncofertility Consortium at Northwestern University.

     

    The Role of OB/GYN in Comprehensive Cancer Care

    POSTED BY ANGELA KRAUSFELDT

    DECEMBER 22, 2011

    What is the role of an obstetrician/gynecologist in cancer care for young women? When you think about cancer and cancer treatment, most likely you’re thinking of oncology and what line of defense will be taken against the cancer. A new article in Clinical Obstetrics and Gynecology from Oncofertility Consortium members, Betty Kong, BA, Robin Skory, BS, and Teresa K Woodruff, PhD, entitled “Creating a Continuum of Care: Integrating Obstetricians and Gynecologists in the Care of Young Cancer Patients,” argues that in some cases, the OB/GYN is the key component in this game.

    Kong and Skory are both Woodruff Lab members pursuing dual MD/PhDs at Northwestern University, meaning they want to be involved in both the clinical and research aspects of oncofertility. Clearly they are invested in the scientific pathways oncofertility has to offer, but from a clinical perspective, they assert that obstetriciangynecologists are the best advocates for their patients to help them make informed decisions about their future fertility. According to the authors, “obstetricians and gynecologists [are] the primary physicians to many women during their reproductive years [thus] are in a unique position to be at the forefront of the oncofertility initiative by ensuring [they receive] the proper counseling, referrals, and continuity of care for their patients before, during, and after cancer treatment.”

    For many young women, once they’ve reached the pinnacle of pediatric care (18yrs old), they are no longer regularly immersed in follow-up medical care as parents, schools, etc, require. Often the physician they see the most is their OB/GYN, whether it be for birth control options, pre natal care or their yearly exams. Many young women build long-standing patient/physician relationships with their OB/GYN as they did with their pediatricians. It is with this understanding that the authors claim the responsibility for the continuum of care falls upon the OB/GYN in many cases. Thus, the more informed they are in the field of oncofertility, the less patients will encounter a gap in their comprehensive cancer care, specifically in fertility preservation.

    An OB/GYN is also in a key role should a cancer diagnosis present itself during a woman’s pregnancy. More studies need to be done on the long term affects of chemotherapy regimes on fetus development and future fertility, but there are treatments that women can undergo in their second and third trimester of pregnancy to try and eradicate the disease. According to the authors, “although it is an uncommon diagnosis, cancer during pregnancy presents a critical scenario that must be carefully treated by a multidisciplinary team of obstetrician gynecologists, medical oncologists, radiation oncologists, surgeons, pediatricians, genetic counselors, and patient navigators.” Again, as the multidisciplinary field of oncofertility develops, it is imperative that clinicians and scientists from diverse fields collaborate to provide patients with the best care possible and the most options for their future fertility.

     

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    A 32-year-old man with copious, watery diarrhea.
    N C Med J. 2001 May-Jun;62(3):134-9
    Authors: Smith CS, Houston M, Jensen B, Mlinar K, Toulson C, Tillotson LG

    PMID: 11370315 [PubMed - indexed for MEDLINE]

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    State Medicaid coverage and access to care for low-income adults.
    J Health Care Poor Underserved. 2008 Feb;19(1):307-19
    Authors: Weissman JS, Zaslavsky AM, Wolf RE, Ayanian JZ
    Budgetary pressures have led some states to limit Medicaid eligibility. We evaluated access to care for all low-income adults by the extent of state Medicaid coverage.
    PMID: 18264004 [PubMed - indexed for MEDLINE]

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    Determining research priorities for young people with haematological cancer: a value-weighting approach.
    Eur J Cancer. 2010 Dec;46(18):3263-70
    Authors: Clinton-McHarg T, Paul C, Sanson-Fisher R, D'Este C, Williamson A
    Haematological malignancies account for a third of all cancers affecting adolescents and young adults (AYAs). Funding agencies are regularly faced with the dilemma of how to deploy resources in order to provide the greatest possible benefit to this patient group. This study used a value-weighting approach to quantify the stakeholders' perceptions about how resources should be allocated to best improve outcomes for AYA patients and their families.
    PMID: 20634057 [PubMed - indexed for MEDLINE]

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    Binh

    Cancer category: Breast cancers

    Cancer type: None

     

    Binh was 22 years old when she found out she had breast cancer. Her future goals and aspirations are to go back to college, to open her own business one day, and to start a family.

     

    Binh's Story

    “I was 22 years old, working as a bar tender and going to school. Having cancer was something that never crossed my mind until the day that I was told to go get an ultrasound for the lump on my right breast. Even after the ultrasound, the breasts exam, and the biopsy, my brain didn't process the fact that it could be cancer because in my mind, I just didn't think it was possible. I was naive and thought that I was too young and with no family history, the news hit me like a brick wall.

    A big challenge for me as a young adult with cancer was the effect it had on my self-image. Soon after my lumpectomy, I started having doubts about myself. The scars were a constant reminder of my cancer. The chemotherapy took its toll on my body, I was pale and feeling nauseous and sick all the time. The first time my hair fell out was a huge blow to my self esteem but when my hair started to fall out the second time, I knew what to expect and it lessened the blow. The weight gain was ridiculous but soon after my chemotherapy and radiation, I have shed most of it off. Questions about my fertility have also left me blue but I have decided that I will cross that bridge when it comes.

    Cancer did not stop me from living my life, it was a roadblock but it wasn't a dead end. I have managed to carry on; I married my husband and we started our lives together. We're happy as ever and this experience has definitely made us who we are today.  I'm very fortunate and thankful to have a husband that has stuck with me and was very supportive during those tough times. With time, love, and support from my family and friends, I have overcome all the confusion and anger and am dedicated to staying in remission.

    My future goals and aspirations are to re-enroll in college and getting started in business management and hopefully open my own business one day. I would also love to start a family of my own years down the line.  I would like to pay tribute to my husband Dean and our families for supporting me through this journey.”

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    Frequent association of Epstein-Barr virus in Japanese patients with Burkitt's lymphoma.
    Jpn J Clin Oncol. 1992 Oct;22(5):320-4
    Authors: Okano M, Kikuta H, Abo W, Koizumi S, Aya T, Yano S, Takada K, Mizuno F, Osato T
    Seven Japanese patients with Burkitt's lymphoma (BL), residing in Hokkaido, were studied during the period, 1979-1991. Immunological analyses of their lymphoma cells showed all to express surface and/or cytoplasmic immunoglobulins. Chromosomal analysis was performed in five cases. Four of the five lymphomas had the chromosomal translocation, t(8;14), and one had t(2;8). Three patients had extremely high IgG antibody titers to Epstein-Barr virus (EBV) viral capsid antigen (VCA) and to EBV early antigens (EA). Two patients had positive antibodies to EA, and two others had normal antibody patterns comparable to those of EBV-seropositive age- and sex-matched healthy controls. Four of the seven lymphomas (57.1%) were positive for EBV-determined nuclear antigen (EBNA) by anticomplement immunofluorescence and/or EBV DNA using DNA-DNA reassociation kinetics, and/or Southern blot analysis. The frequency of EBV positivity in BL patients residing in Hokkaido was higher than that of cases previously reported in Japan. Three of the four EBV genome-positive BL patients responded well to chemotherapy, radiotherapy and/or surgical treatment, with no significant relapse being observed during the study period. In contrast, EBV genome-negative patients had poor prognoses despite having similar levels of clinical staging at the time of diagnosis.
    PMID: 1281896 [PubMed - indexed for MEDLINE]

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    Psychosocial aspects of women's lives: work, family, and life cycle issues.
    Psychiatr Clin North Am. 2003 Sep;26(3):741-57, viii
    Authors: Shrier DK
    Over the past century and continuing to evolve into the twenty-first century, there have been dramatic changes in work and personal/family lives within the United States. These changes, though strongly affecting men and children, have impacted most dramatically on women's lives, particularly white, middle-class women. Psychiatrists and other mental health clinicians need to be aware of the scope and nature of these changes and to recognize that their own personal experiences and values might differ from those of women of different generations as well as different socioeconomic and cultural backgrounds.
    PMID: 14563107 [PubMed - indexed for MEDLINE]

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    TipText: 
    A good place to begin to learn about AYA cancer or cancer in general, is here: http://health.nytimes.com/health/guides/disease/cancer/overview.html?scp... The New York Times has a health guide with information on the causes, symptoms, exams, treatment, and prevention for cancer. Scroll down for cancer-specific information.
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    Overview of sarcomas in the adolescent and young adult population.
    J Pediatr Hematol Oncol. 2005 Apr;27(4):215-8
    Authors: Herzog CE
    Based on the data of the Surveillance, Epidemiology and End Results Section of the Nation