There are also differences by gender (acute leukemias, malignant non-Hodgkin Lymphoma, osteosarcoma and gonadal germ cell tumours occur more in boys and malignant melanomas and carcinomas of the thyroid more present among girls).
If the overall survival rate of 74.5% at 5 years, it varies strongly according to the tumor: survival at 5 years of a youth of a Rhabdomyosarcoma is estimated at 41.7%, while it reached 100% for cancers thyroid1.
Often likened to cancers of the child, the adolescent cancers have not benefited from the same therapeutic advances that children2. From 1975 to 1997, French and American evidence that the 5-year survival has increased an average of more than 1.5% per year among children aged 0 to 14 years old at the time of diagnosis, against 0.9% per year only in adolescents (and 0.6% per year for young adults aged 20-24). A difference explained in part by a lower inclusion in clinical trials, but also by a less good follow-up of treatments at a discount period in question authority.
Adolescent cancer: special support
During this transitional phase from childhood to adulthood, the taking of independence through significant physical and emotional upheavals by a questioning of the authority and of the risk taken. The onset of the disease at this time of life is so difficult to manage. In 1998, the first Estates General of the cancer patients, organized by the National League against cancer, had helped to express the need of a specific charge on the therapeutic and psychological plan for young patients.
Changing the image induced by cancer and treatments (pallor, anorexia, alopecia…) can have an impact important social relationships with other adolescents, the beginning of love and sexual life… The disease and its consequences can also obstruct the project of life of the teenager: how one day have children in the event of impairment of fertility? How to call into question his choice of study or career as a result of the treatment?…
All of these settings, some of which are specific to adolescents, are not always properly perceived by health professionals, focused on only healing. Patients can have the impression of not being understood, and do not properly follow its treatments.
A priority of the Plan Cancer 2009 – 2013
Meeting on January 29, 2010 at the national Institute of cancer (INCa), institutional, community and health professionals emphasized the importance of a specific support of adolescence3. Present at this meeting, Health Minister Roselyne Bachelot has thus stressed: “A age where we build, the test of cancer can be a real break. “Should be singling out the accompaniment of adolescents: make them clinical trials more accessible, developing collaboration between pediatric and adult medicine, deliver a customized information throughout the support and in particular on the impacts of cancer – fertility, sexual and affective life, schooling, professional life – at the announcement of the disease, it must be in the clear in order to anticipate difficulties in processing”.
A partnership agreement between the INCa and the AP – HM (Assistance Publique – Hôpitaux de Marseille), was signed on this occasion, in order to support the project EMA (Adolescent Mediterranean area), which incorporates a space dedicated to young people facing cancer. This innovative project, which will be based in Marseille, will propose including to adolescents with cancer (excluding acute phase) psychosocial support. It is for Marcel Rufo, through this project, accompany the teenager to “heal his healing to embark on life”. Roselyne Bachelot wished that the cancer Plan would allow many other Marseille-like structures to see the day.