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TEENAGE AND
YOUNG ADULT
CANCER
Dr. Novak Gupta
Q1 : WHAT IS TYA?
 World Health Organization : adolescent as someone between 10–19
years of age, and youth as someone aged 15–24 years of age.
 The National Cancer Institute (U.S.) : identifies 15- to 39-year age group,
now referred by NCI as adolescents and young adults (AYA).
 The National service delivery framework, Australia : defines
‘adolescents and young adults’ as young people between 15 and 25
years of age.
 Indian context : age group of 15-30, is taken as Teenage and young
adults
Q2: WHY FOCUS ON TYA’S?
 PATIENT FACTORS :
 DISEASE FACTORS
 TREATMENT FACTORS
 Age
 Embryonal tumos early on
 can tolerate intensive
 Developmental issues
 Epithelial tumors later on
 Psychological issues
 No screening methods
 Fertility
 may result from late effects of
 Dependence
 Co -morbidities.
paediatric cancers
treatment
 long term side effects
OUR STUDY
 We collected the data of Sri Aurobindo Medical College and P.G Institute for
the year 2013.
 A proforma was created and filled.
 Education, economic status, duration of symptoms, contact with primary
doctor and oncologist, treatment, abandonment, alive/ dead.
 Tele- conversation with either the patient or the relative.
 Period of study – May 2016 till date
 Plan to collect data for patients till 2016
 Telephonic conversation tried with – 85
 Not responding/wrong numbers – 29
 Total data for – 56
Adult
Peadiatric
TYA - Male
TYA - Female
 SAIMS cancer patients (2013) - 1562
 TYA patients 01 Jan to 31 Dec 2013 – 186
7%
 Male – 104
 Female – 82
1%
87%
12%
5%
 TYA : total ratio - 186/1562 = 11.2%
 Paediatric cancers ( y2013) - 24
 Pead : TYA ratio - 24/186 = 1:8
AGE DISTRIBUTION ( N = 186 )
 AGE
Number of cases
 15 -19 years -
17 (9%)
 20- 24 years -
27 (14%)
15-19
20-24
25-29
30-35
9%
 25-29 years -
35 (19%)
14%
 30-35 years -
107 (58%)
58%
19%
TYPE OF MALIGNANCY ( N = 186 )
 Head and neck – 56
 Genito urinay – 23
 Hematological – 22
 GIT – 10
 Tongue – 21
 Ovary – 9
 HD – 5
 Anorectal – 5
 Buccal mucosa – 16
 Cervix – 7
 ALL – 4
 Stomach – 2
 Lip – 3
 RCC – 2
 NHL – 5
 Esophagus – 2
 Tonsil – 2
 Prostate – 1
 CML – 3
 Colon - 1
 Vagina – 1
 Others – 5
 Others – 14
 Testicular – 2
 Uterus – 1
 Breast – 28
 Thyroid – 2
 Sarcomas – 20
 Bone sarcoma – 16
 CNS - 22
 Soft tissue – 4
 Melanoma – 2
 Lung - 1
Thyroid
1%
Melanoma
1%
Sarcoma
11%
Lung
1%
( N = 186 )
Hematological
12%
CNS
12%
GUT
12%
GIT
5%
Breast
15%
Hematological
CNS
Head and neck
Head and neck
30%
Breast
GIT
GUT
Sarcoma
Thyroid
Melanoma
Abandonment
ABANDONMENT
Unkown
 Definition : Failure to start treatment
or to complete treatment
0%
( N = 56 )
 12 (21.4%)
21%
52%
27%
 Unknown :
 15 (26.7%)
 Completed treatment:
 29 (51.7%)
SURVIVAL ( AS OF MAY 2016 ) N = 56
 Alive : 27 (48.2%)
 Unknown : 4 (7.4%)
Dead
Alive
 Dead : 25 (44.6%)
Unknown
Alive
Unknown
Dead
2016
 Total number of TYA patients (till Sept.
2016) : 102
 Head and neck – 14
 Sarcoma – 12
 Breast -9
 Haematological : 40
 Colorectal -8
 ALL-18
 Gynaecological – 8
 NHL- 12
 CNS -7
 AML- 6
 Renal -2
 HD -4
 Thymoma -1
 HCC – 1
2013 VS 2016
2016
2013
Thyroid
Melanoma
Lung…
1% 1%
Sarcoma
11%
Hepatocellular
Thymoma
Renal
CNS 2%1%1%
6%
Hematological
12%
Gynaecological
8%
CNS
12%
GUT
12%
GIT
5%
Hematological
39%
Colorectal
8%
Breast
9%
Breast
15%
Head and neck
30%
Sarcoma
12%
Head and neck 14
14%
COMPARISON BETWEEN 2013 AND 2016
2013 (N=56)
2016 ( N =102)
 Abandonment - 12 (21.4%)
 Abandonment – 7 (6.8%)
 Dead - 25 (44.6%)
 Dead – 13 (12.7%)