Teenagers battling cancer are stuck between wards

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Teenagers battling cancer are stuck between wards

They are left feeling displaced because there are no guidelines on when they are ready for oncology adult care, say experts

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Too old to be in the paediatric ward and too young to be in the adult ward, SA teenagers battling cancer “don’t fit in”.
The lack of adolescent-specific wards is one of the issues the Cancer Association of South Africa (CANSA) is focusing on as the country observes Childhood Cancer Awareness month.   
CANSA national relationship manager for service delivery Cara Noble told Times Select there are no clear guidelines on when to transition children to oncology adult care, and that it seemed to vary from 12 to 18 years depending on the facility.
“Adolescents with cancer are stuck in the middle, as many are not adult enough to feel comfortable in an adult oncology ward, sometimes being as young as 12 or 13 or even 17 years of age.
“When you are sick, away from home and cannot relate to those around you when you are in hospital for a long period of time, this can be overwhelming,” she explained.
In the paediatric oncology ward there was more attention given to the children, and a more childlike and compassionate approach, compared with an adult ward.
“It is almost as if teenagers are too old for the paediatric oncology ward and too young for the adult one. This can leave them feeling displaced and some find it more difficult to cope.
“With most hospitals having their own protocol this is not a standardised practice but a guideline, which leaves the choice to the discretion of the ward,” Noble said.
She said CANSA would support the introduction of specialised adolescent wings that cater for the needs of teens to allow them to feel safe, secure and understood.
National Health Department spokesperson Popo Maja said his understanding was that children older than 15 were treated by non-paediatric oncologists.
“It is not an international standard or norm to have adolescent wards separate from adults wards.”
According to CANSA, the true incidence rate of cancer among teens is unknown as they believe adolescents are under-represented on the National Cancer Registry and the South African Children's Cancer Registry.
However, based on available statistics, Hodgkin and Non-Hodgkin lymphoma remain the leading causes of cancer among male and female adolescents, accounting for 24.19% of the overall cancers.
Children and adolescents with Hodgkin lymphoma have a five-year overall survival rate of 79% in SA.
CANSA researcher Dr Jennifer Geel said teens diagnosed with cancer experience anxiety, fear of death, loss of purpose and difficulty with schoolwork and socialising.
“A diagnosis of cancer is devastating for anyone, but teens are also coming to terms with rapidly changing life circumstances – puberty, high school, post-school education, entry into the workplace, relationships, individuating from their parents, becoming adult members of society – and a diagnosis of cancer puts everything on hold.”
She said teens struggle to manage themselves while their lives are threatened.
“There are high rates of depression among teen patients, but it’s often undiagnosed.”

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