13a barriers to the care of adolescents and young
Upcoming SlideShare
Loading in...5
×
 

13a barriers to the care of adolescents and young

on

  • 386 views

 

Statistics

Views

Total Views
386
Views on SlideShare
386
Embed Views
0

Actions

Likes
0
Downloads
0
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    13a barriers to the care of adolescents and young 13a barriers to the care of adolescents and young Presentation Transcript

    • Barriers to the Care of Adolescents and Young Adults with Cancer in the Medical Oncologist’s Office
      AnuDham MD
      Cancer Care Centers of South Texas
    • One in every 168 Americans develops invasive cancer betweenage 15 to 30 years
      No specialized centers of care, transition between adult and pediatric
      Medically underserved population, “special population
    • What Makes a Person Part of a “Special Population”?
      Age
      Race and ethnicity
      Gender
      Income
      Insurance status
    • Health Disparities
      Unequal access to health care for segments of a population
      Inferior health outcomes
      Unequal burden
      morbidity
      quality of life
      survival
    • What ELSE?
      Rural environment
      Abilities/disabilities
      Physical
      Cognitive
      Educational
      Sexual orientation
      Demographic and social characteristics that are different from the majority
    • Diagnostic Delays
      Ignoring symptoms (patients), sense of invincibility
      Insurance and access to healthcare, usually no “well” visits
      Not thinking about cancer (physicians)
      “Empirical treatment”, antibiotics etc
      Impact cancer stage and hence survival
    • Treatment Barriers
      Dosing intensity in cancer treatment
      Adherence to schedules and regimens (practical and psychological issues)
      Resistance to disfiguring surgery, mastectomy, colostomy, amputation, orchiectomy
      Higher use of alternative medicine, specially female
    • The Self
      Practical problems in social life
      Alopecia
      Weight gain or loss
      Mucositisand dermatitis
      Bleeding, infection and contagiousness
      Susceptibility to infectionand need for isolation
      Impaired sexuality
      Pressure to stay “normal”
      Suspicion if partner staying in relationship due to guilt
    • Survivorship
      More risk taking behavior
      Oligospermiaand ovarian damage
      Fertility
      Persistent anxiety, Damocles syndrome
      School, work, wages
      Family relationships
    • Survivorship
      Lifelong cognitive deficit
      Disorganization
      IQ
      Poor emotional control
      Osteoporosis
      Heart disease
      Premature menopause
      Chronic pain
    • Adult Oncology Office
      “ New Doctor”
      Surrounded by older adults, no peer group
      Chronological vs developmental age
      Dependency on parents
      Higher expectation of independence
      Insurance access
    • Independence
      Appt making
      Med refills
      Medical history
      Healthy life style choices
      Life goals
      Stress management
      Bill paying
    • Interventions
      Honesty in communicating
      Peer groups
      Encourage independence in schedules and treatment
      Foster control
      Plan transition early if pediatric cancer survivor