New tailored supports for adolescent and young adult cancer patients

A graphic showing the backs and heads of six diverse young adults. They wear bright tops in various colours of the rainbow.

Monash Health is looking at new ways to support our adolescent and young adult (AYA) patients with cancer, recognising that their needs differ from those of paediatric and adult patients. 

Each year, our health service treats around 100 people aged 15 to 25 years with a new diagnosis of cancer. 

“A cancer diagnosis not only brings a significant threat to a young person’s physical health but can also have a profound impact on their psychological and social development, and trajectory in life,” said adult haematologist and AYA clinical lead at Monash Health, Dr Pasquale Fedele. 

“This project is an important step in the development of an AYA cancer service at Monash Health to better support young people during this difficult time.”

An AYA cancer working group, consisting of passionate medical, nursing, and allied health clinicians, has been established to meet this goal. 

Dr Pasquale Fedele in a navy jacket and blue shirt leaning against a red and orange wall with his arms crossed.

The concerns of adolescent and young adult patients with cancer vary, but may include: 

  • preserving fertility  
  • juggling treatment with high school/university and entering the workforce 
  • navigating the health system alone for the first time 
  • changing family dynamics, friendships, and romantic relationships 
  • missing momentous events, such as exams, milestone birthdays and graduations 

Our inaugural Adolescent and Young Adult Cancer Nurse Consultant, Tegan Dunmall, is dedicated to improving the cancer care journey of people aged 15 to 30. 

“Our aim is to provide a tailored service that can support these young people from diagnosis through treatment and beyond,” she said.  

Having both paediatric and adult multidisciplinary cancer expertise, Pasquale says Monash Health is in an “ideal and unique position to provide excellence in care.” 

The director of the Children’s Cancer Centre at Monash Children’s Hospital, Professor John Heath, also sees the great potential for collaboration and cross-specialty communication. 

In recent months, Tegan has been identifying and evaluating the support services available to the cohort within Monash Health and in the community.

Tegan Dunmall, wearing a cream shirt and red and cream chequered jacket, smiles for a photo in a hospital walkway with bright green curved decor in the background. “Access to services is one of the biggest issues impacting the ways in which we care for our young people,” she said. 

“At Monash Children’s Hospital, we have a larger number of services available to make referrals to. Such as occupational therapy, physiotherapy, psychology, social work, teachers, art therapy and music therapy. We do not have many of those services in the adult sector, and capacity is more limited.” 

“We want to get to the point where there is a clear pathway for referral,” said Tegan. 

A collaboration with Latrobe Regional Hospital has been established to extend the project’s benefits to AYAs living in the Gippsland region.  

Tegan is leading a pilot study, screening adolescent and young adult cancer patients to identify their specific support needs. 

“In conversation with adolescent and young adult cancer patients, we unpack their main concerns and what their needs are, rather than make assumptions.” 

It is envisaged this screening will become a permanent feature of care for 15 to 30-year-olds at Monash Health. It would be carried out at moments of upheaval, such as at diagnosis, during treatment and when care changes. 

The information gathered at each stage will be discussed by a multidisciplinary team of allied health professionals, to best support the evolving care needs of adolescent and young adult patients. 

“Their needs are distinct and need to be honored,” said Tegan. 

Monash Health would like to acknowledge the important support for this work from the Southern Melbourne Integrated Cancer Service, Gippsland Regional Integrated Cancer Service and Paediatric Integrated Cancer Service, as well as the Miranda Foundation.