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Pathways to Discovery: Fall 2012

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New Program Delivers Specialized Care for Adolescents, Young Adults

The University of Chicago (UChicago) Medicine Adolescent and Young Adult (AYA) Oncology Program, which officially opened in August, is the first of its kind in the Midwest.

The program was created based on research* led by professors of medicine Wendy Stock, MD, Richard Larson, MD, and the late James Nachman, MD, professor of pediatrics. In a retrospective comparison study, they found that adolescents and young adults with newly diagnosed acute lymphoblastic leukemia (ALL) were more successfully treated using pediatric treatment protocols rather than adult treatment regimens for ALL. Dr. Stock is now leading a national clinical trial to determine if a pediatric regimen will improve survival rates in adults with ALL.

Individuals between ages 16 and 30 have been identified as a group that often lacks the support necessary to cope with cancer diagnosis, treatment, and survivorship. “They don’t have the stability in their lives yet,” said Dr. Stock. “It’s a very challenging age to be confronted with a life-threatening illness.”

The most common cancers to strike adolescents and young adults are lymphoma, leukemia, germ cell tumors, melanoma, central nervous system tumors, sarcomas, and breast, cervical, liver, thyroid, and colorectal cancers, according to the National Cancer Institute.

“Successful treatment of these diseases requires significant support from family and friends, and young adults may not have as much support as children,” said Dr. Stock. The focused input from medical oncologists, nursing, psychiatry, nutrition, and social work is typically more readily available to the relatively smaller number of pediatric cancer patients when compared to busy clinical practices with large numbers of adult cancer patients.

Improving Patient Care
Staffed by doctors and nurse practitioners from both pediatric and adult programs, the program will start by offering personalized care to AYA patients with hematological malignancies, or cancers of the blood, bone marrow, and lymph nodes. As the program develops, the group plans to expand services to young adults with other common malignancies that affect this age group.

Dr. Stock is joined by lymphoma expert Sonali Smith, MD, associate professor of medicine, and pediatric specialists Jennifer McNeer, MD, MS, assistant professor of pediatrics, Navin Pinto, MD, instructor of pediatrics, and Tara Henderson, MD, MPH, assistant professor of pediatrics. The multidisciplinary team gathers weekly to discuss cases before seeing patients on the second floor of the Comer Children’s Hospital.

Dr. McNeer said, “This exciting collaboration between medical and pediatric oncologists allows us to optimize our care of this unique population, not only in terms of their medical therapy, but also by offering important psychosocial support both during and after their diagnosis and treatment.”

Research Opportunities
The program presents opportunities to conduct research in many areas, while continuing to focus on the patient. One unique aspect of AYA is that it offers investigational therapies through early phase (I and II) clinical trials to its patients. Dr. Stock said that research can help to identify the challenges that patients and their healthcare providers face with the goal of improving treatments and developing interventions to mitigate these difficulties.

John Cunningham, MD, professor of pediatrics and chief of the Section of Pediatric Hematology/Oncology, said, “The development of the AYA Oncology Program is a natural consequence of our commitment to translating our research into clinical care that alters cancer outcomes.”

*This research study was supported by grant numbers CA31946 and CA98543 from the National Institutes of Health. 

Ernst Lengyel