Cancers in adolescents and young adults

There are 2,300 new cases of cancer among 15-25 year-old every year in France. These adolescents and young adults (AYA) require very specific care at a pivotal period in their lives. 

Institut Curie takes care of them within a dedicated AYA unit, which brings together, in a transversal manner, a multidisciplinary team formed to offer them complete medical, psychological and socio-educational care.

Management of AYA cancers

Different types of tumors can occur in adolescents and young adults. These include:

• pediatric-type tumors: leukemias, brain tumors, etc.
• more frequent tumors in AYA: osteosarcomas, Ewing's sarcoma, lymphomas (especially Hodgkin's lymphoma), testicular, and ovarian germ cell tumors, etc.
• adult-type tumors, more common with advancing age: thyroid cancers, breast, melanomas, etc.

At Institut Curie, the course of care for AYA benefits from the joint expertise of pediatric oncologists and "adult" oncologists-hematologists.

The treatment plan is determined at a multidisciplinary consultation meeting, which brings together medical oncologists and pediatricians, surgeons, radiotherapists, and pathologists (who analyze the characteristics of the tumor).

This essential collaboration makes it possible to decide on the optimal combination, depending on each case, and choose between surgery, chemotherapy, targeted therapies or radiotherapy, in particular protontherapy.

Preservation of fertility 

Treatments sometimes have an impact on future fertility and require young people to project themselves prematurely into the future. Treatments sometimes have an impact on future fertility and force young people to plan prematurely for the future.

Psychological and social support for AYA

The period between the ages of 15 and 24 is the moment of identity construction, acquisition of autonomy, educational orientation, sexual maturation, making choices with regard to academic and professional orientations, entering the world of work: it is essential to support AYA and help them continue with their training and life plans, as well as maintain social and family connections, despite the illness.

This comprehensive support is provided, in particular, by psychologists, child psychiatrists, psychomotor therapists, physiotherapists, dietitians, facilitators and social workers of the AYA unit of Institut Curie, alongside oncologists.

Educational/Professional life

The school at the hospital helps patients with their school projects. Institut Curie offers their patients the opportunity to take the certificate, baccalaureate, and faculty exams at the hospital in conjunction with National Education. Dedicated associations can help support orientation and professional reintegration.

Leisure

A youth room, equipped with a console, sofa, and games, is reserved for teenagers and young adults, to allow them to meet up and encourage get-togethers. Cooking, visual arts, photo and video workshops, as well as cultural, fun outings with family or other patients, are also offered.

AYA cancer research

A major player in cancer research at the national and international level, Institut Curie carries out numerous research projects, in particular, within its SIREDO center (Care, Innovation, Research Oncology of Children, Adolescents and Young Adults).

Some lines of research focus on rare cancers particularly represented in AYA, such as Ewing's sarcoma:

• Identify the molecular abnormalities of tumors to better classify various types of sarcomas
• Use these biomarkers to improve diagnosis
• Understand the mechanisms of cancer development, dissemination, and resistance to treatments. For example, teams at Institut Curie have recently discovered mechanisms at work in the formation of metastases in Ewing's sarcoma
• Refine the prognosis: some identified subtypes respond differently to treatments
• Develop new treatments by targeting the mechanisms involved. Advances have been made in medulloblastoma or Ewing's sarcoma.
• The Immuno-Ewing project, coordinated at Institut Curie, seeks to develop an immunotherapy based on the recognition of the particular proteins present in Ewing's sarcoma.

Institut Curie promotes and opens clinical trials open to AYAs in order to allow them to access innovative therapies.