Cancer in the adolescent and young adult phase poses additional challenges to this period of development that is crucial to the transition to independence. This report provides a brief review of normal developmental milestones in this age range while highlighting the disruptive effects of cancer. We focus on the psychological burden of cancer in patients aged 15–39 years and explore the application of the total pain model to highlight the psychological/emotional, social, and spiritual aspects of non-physical pain. We also briefly review posttraumatic growth and resilience. Lastly, we provide a review of areas for possible development and future research.

Assessment and management of pain for pediatric patients receiving stem cell transplants can be challenging for a health care team. Diagnostic evaluation and interventions vary between institutions and individual provider practices. In this review, we investigate and describe approaches to pain management for the most common sources of pain in pediatric patients undergoing stem cell transplants. Mucositis pain, abdominal pain, and hemorrhagic cystitis emerged as the most frequent sources of acute pain in children during conditioning and transplantation periods. Furthermore, psychosocial distress and psychological pain or distress constitute significant components of the total pain experienced by children undergoing stem cell transplantation. We will expand upon appropriate usage and escalation of opioids, as well as complementary interventions and timely initiation of interventions, in order to help control pain in these clinical syndromes.

Adolescents and young adults (AYAs) with advanced cancer represent a unique and vulnerable population. Little is known about the optimal approach to support their medical decision-making needs. The objective of this cross-sectional survey study was to elucidate the perspectives of AYAs with advanced cancer regarding their emotional experience of having cancer and their decision-making needs. Between April 2020 and December 2023, AYAs with advanced cancer were surveyed using the Herth Hope Index (HHI), the Peace, Equanimity, and Acceptance of Cancer Experience scale (PEACE), The Human Connection scale (THC), and the Child and Adolescent Participation in Decision Making Questionnaire (CAPDMQ). Descriptive analyses, t-tests, and Wilcoxon rank-sum tests were used to assess associations between demographic and clinic variables with patient responses. Fifty-seven AYAs participated. The median age was 22 years (range: 15-29); 51% were female. Majority of participants were White (68%), non-Hispanic (61%), single (96%), and Christian (67%). The most common diagnosis was sarcoma (39%). Most participants reported acceptance and peace with their illness, yet many struggled with changes in physical appearance, the unfairness of getting cancer, and angry feelings related to their illness. Participants also reported high levels of therapeutic alliance with their doctors. These AYAs reported remaining hopeful and future oriented despite their prognosis. They also reported a strong belief that AYAs should be involved in decision-making. Most AYAs accepted their illness and found peace, yet many still felt the burden of disease and fear about the future. Despite this, they felt hopeful and remained future oriented. AYAs value being involved in decision-making; further work is needed to develop clinical guidelines to facilitate shared decision-making for this population.

The US opioid crisis has affected many patients across the age spectrum. Yet little has been reported on the effects of this crisis on cancer patients. Prescription drug monitoring programs have emerged as potential tools to mitigate risks of opioid prescribing, but they are not without limitations. We present a case of missing opioid prescriptions on EMR integrated PDMP versus the web based PDMP. A full review of PDMP integration is needed to identify gaps as these pose a significant patient safety issue.