Psychological referral and consultation for adolescents and young adults with cancer treated at pediatric oncology unit.

Purpose: Managing older adolescents and young adults with cancer is a challenge, both medically and psychosocially: it is important to assess these patients' psychological issues and the type of services they need when deciding who should treat these patients, and where.

Methods: This study describes the pattern of psychological referral and consultation for older adolescents and young adults with cancer being treated at a pediatric oncology unit, as compared with the case of younger patients.

Results: Between 1999 and 2006, 318 patients <15 (32% of the patients in this age group) and 117 >/= 15 years old (30%) were referred for psychological consultation. The number of interviews per patient was 2.8 for patients under fifteen and 7.8 for older patients. Younger patients were referred by all members of staff, while most older patients were referred by doctors, mainly because they had trouble adapting to the cancer's diagnosis and treatment. An ongoing, weekly, long-term psychotherapy was needed for 1% of patients <15 and 10% of those >/=15 years old.

Conclusions: Adolescents and young adults with cancer have specific psychological needs. While awaiting the full development of programs dedicated to these patients, they would seem to benefit from being treated in a multidisciplinary setting of the kind usually developed at pediatric units, fully integrating the psychological operators with the other staff members.