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New psychological model-of-care for younger cancer patients

 Psycho oncology launch


“Being diagnosed with cancer as a child or adolescent can be a potentially traumatic experience,” according to Dr Chiara Besani, psycho-oncology clinical lead of the national paediatric psycho-oncology service, Children’s Health Ireland (CHI) at Crumlin, speaking as a new approach – a model-of-care – was launched in recent weeks.

There has been increasing recognition of the psychological impact of a cancer diagnosis not just on the patient, but on the entire family and the wider community in Ireland over the past decade. This is especially true when the diagnosis occurs in children, adolescents and young adults (CAYA).  Each year in Ireland, around 200 children up to the age of 16, a further 69 adolescents between the ages of 16 and 19, and 111 young adults between the ages of 20 and 24 are diagnosed with cancer.

Support each family

Dr Besani, who is co-chair of the CAYA (Children, Adolescents and Young Adults) psycho-oncology model-of-care, stressed that for those involved in delivering care, their role is to “ensure that we support each family in coping and adjusting to the incredibly unfair and difficult journey they face. In clinical practice, we are delighted to see many developing post-traumatic growth and we aim for all of our patients to achieve their goals.”

The new model-of-care will mean psycho-oncology services for all 0-15 year olds will be delivered within the national paediatric psycho-oncology (NPPO) service in the CHI at Crumlin, while AYA (Adolescents and Young Adults) psycho-oncology services (for 16-24 year olds) will be delivered within the recently developed AYA cancer service network, which incorporates CHI at Crumlin, Cork University Hospital, Galway University Hospital, and St James’s Hospital, Dublin.

Welcoming the new approach, Prof Risteárd Ó Laoide, Director, National Cancer Control Programme (NCCP), noted that the “national cancer strategy highlighted the important role of psycho-oncology services for people living with cancer and their families. This model-of-care is an important step in highlighting the supports needed for children, adolescents and young adults and their families. I want to thank the broad range of stakeholders who were involved.”

Eilísh Hardiman, Chief Executive, Children’s Health Ireland, (CHI), described the new approach as an “important milestone for the national paediatric psycho-oncology service within the national children's cancer service, CHI, in our commitment to developing services that encompass the holistic needs of the young person. I’m also pleased for the inclusive engagement on this model-of-care, as it reflects our networked approach to paediatric services in collaboration with other cancer centres.”

Dr Helen Greally, national clinical programme lead for psycho-oncology, NCCP, added that it was a great development “for children and adolescents diagnosed with cancer, who, along with their families, can now have growing confidence in the availability of a professionally-led, patient-centred service whose primary aim is to deliver psychosocial and psychological support services in line with international and national best practice. The NCCP is delighted to be part of this development through policy and funding initiatives.”

Dr Besani added that the new approach brought to fruition the work that has been developing in paediatric psycho-oncology over the past decade by hospitals and charities: “While cancer is recognised as a potentially traumatic life event for children and young adults, we aim to minimise the psychological, neurocognitive and psycho-social aspects and contribute to improved long-term quality-of-life for our patients.

“Crucial is the recognition that every child, adolescent and young adult in Ireland should receive CAYA-centric, developmentally appropriate, and systemic care. We are looking forward, with the appropriate resources, to be able to provide equal access to the best evidence-based care.”