Attending the Inaugural International Adolescent and Young Adult Oncology Congress in Sydney late last year was a fascinating and valuable experience for BCAC committee member, Greer Davis (pictured right).
The congress was titled “Crossing Boundaries and bringing it all together” and really focused on the complex nature of treating and supporting young people with cancer.
The three-day event supported by Canteen (the cancer organisation supporting young people living with cancer both here and in Australia) featured many fascinating and informative talks from international professionals and provided the opportunity to meet and make connections with advocates from both New Zealand and Australia.
Greer attended many sessions, ranging from the latest medical updates on a wide array of cancers impacting young people, to psychosocial care, health literacy and communication and long term survivorship. However, the most interesting sessions for Greer were those that dealt with the repercussions of breast cancer in young people on sexuality and fertility.
“Having the opportunity to meet advocates from both Australia and New Zealand was definitely a highlight,” Greer says, “and I particularly enjoyed meeting the team from Canteen NZ.
“But also hearing about the latest research in relation to oncofertility and discussing what more can be done to support cancer patients to be well-informed in making long-term decisions about their treatments in light of their effects.”
Some session highlights were:
Current Practices in Female Fertility Preservation
There is increasing awareness of the importance of early oncofertility discussion and the prompt consideration of fertility preservation options. Given the potentially toxic effects of chemotherapy to the ovary, with the risk of temporary or more permanent ovarian failure or early menopause, the availability of options to preserve and protect fertility is vitally important to young women and their families. Any young woman at risk of compromised fertility should be given the opportunity to talk with fertility specialists as soon as possible after diagnosis. Prompt referral and discussion of options is vital as there are various options currently available that need to be delivered before chemotherapy.
Fertility related Psychological Distress, and the Construction and Experience of Fertility for Adolescent and Young Adult (AYA) Cancer Patients
Fertility is an important aspect of quality of life, as well as identity, and there is growing evidence that changes to fertility can be the most difficult long term effect of cancer diagnosis and treatment. But, fertility is rarely addressed by health professionals and remains largely invisible within cancer policy and practice guidelines, especially among adolescents and young adults where focus on survival takes a front seat. Sadly, lack of knowledge on the part of the patient means that consequences of treatment on long term fertility are often not truly considered and understood at the time.
Breast Cancer in AYA populations
Breast cancer is uncommon in the AYA age groups (0.7/100,000 in 20-24yo, and 3.9/100,000 in 25-29yo), and it is a disease most typically associated with increasing age. Screening is not common and often diagnosis is delayed. Occurrence in very young women may be more highly associated with BRCA 1 and 2 mutations, or prior cancer treatment e.g. for Hodgkins Disease. Various challenges to treatment include psychosocial and body image considerations, preservation of fertility and early menopause, or diagnosis during pregnancy. Recent trials have identified that ovarian suppression enhances the efficacy of tamoxifen in young women with hormonal breast cancer. Also, in the international POEMS study, in non-hormonal cancer, ovarian suppression during chemotherapy reduced the incidence of premature menopause and increased pregnancy success.
For more information about the fertility issues associated with a breast cancer diagnosis please visit our website: http://www.breastcancer.org.nz/content/Support/Young-Women/Fertility
More information about the congress can be viewed at http://www.youthcancerevent.com.au/ayacongress/program
A global AYA cancer conference will take place later this year in Edinburgh: https://www.teenagecancertrust.org/about-us/what-we-do/professional-leadership/international-conference
4 April 2016
