Breaking Down Barriers to Diagnosis in AYA Patients With Lymphoma

Adolescent and young adult patients (AYA) with cancer, particularly lymphoma, are presented with challenges that other patients with the disease do not face, sometimes even before their initial diagnosis, according to Dr. Kara Kelly, a pediatric oncologist, who cites delays in diagnosis as one of the biggest challenges for this patient subgroup.

To further discuss the topic, Kelly sat down for an interview with CURE to discuss some of the most common challenges faced by AYA patients with lymphoma, highlighting some initiatives and strategies that may help address these challenges.

Kelly is the chair of the Department of Pediatric Oncology, as well as the Waldemar J. Kaminski Endowed Chair of Pediatrics, at the Roswell Park Comprehensive Cancer Center, located in Buffalo, New York.

Transcript:

I think one of the biggest challenges for patients who develop lymphoma in that age group is that there are often delays in diagnosis. AYA’s tend to be healthy in general, and they are also in a transitional period in their lives, moving out from their parents' homes to study or take their first jobs. Many of them don't have a primary care doctor or health insurance.

Unfortunately, this leads to a lot of misdiagnosis or delays in diagnosis of lymphoma because either physicians are not considering lymphoma as the cause of their symptoms, or patients may not have health insurance or know where to seek help and may postpone seeing a doctor until the lymphoma is in a much more advanced stage. This delay or misdiagnosis is a major concern in this population. The second challenge is that these patients are somewhat in the gray zone between pediatric and adult oncology.

For some subtypes of lymphoma, there have historically been quite different approaches to managing these patients. My area of expertise is Hodgkin lymphoma, and one of the things that has really struck me is that an 18-year-old patient who comes in with Hodgkin lymphoma might receive a totally different treatment recommendation compared to if they were seen by one of my adult oncology colleagues down the hall.

There has been a real need for us to come together — the pediatric and adult oncology disciplines — and try to harmonize our processes. Fortunately, this is one area where we are really beginning to see the results of these collaborative efforts. Now, we don't have a separate pediatric or adult recommendation but a recommendation that is truly the best for adolescents and young adults with lymphoma.

Transcript has been edited for clarity and conciseness.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.