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Introduction . Daniel Kelly and Faith Gibson. A Young Person'sExperience : Life Before Treatment . Becky Lofts. 1. Cancer in Adolescence:Incidence and Policy Issues . Jeremy Whelan and Lorna Fern. Introduction.Incidence of cancer in young people. Types of cancer affecting TYAs.Adolescent cancer incidence in England. Adolescent cancer incidence inEurope. Changes in incidence in Europe. Gender differences. Outcomes oftreatment. Delivery of care. Influence of protocols. Long-term issues.National health policy in the UK. Development of specialist services. Youngpeople and the national cancer policy. Current level of implementation.Summary. 2. The Physical and Emotional Impact of Cancer in. Adolescents andYoung Adults . Daniel Kelly. Introduction. A unique time of life. A period oftransition and change. A life interrupted. Confronting a diagnosis of cancer.The 'problem' of adolescence. The 'reality' of adolescence. The culture ofcare. The context of care. The importance of coping. Emotional support.Support needs of young people. The importance of the body in adolescentcancer. Recurrence of disease and the body in adolescent cancer. Body work incancer care. Looking forward. 3. The Impact of Cancer on Parents and Families. Anne Grinyer. Introduction. Making this research possible. The researchapproach. Renegotiating relationships within the family. Fluctuatingdependence and independence. Taking control of their body. Sharing intimatemoments. Financial dependence. Relationships within the family. Parentingroles. Place of death. Negotiating relationships outside the family.Consultations with professionals. Family social networks. The implicationsfor policy. Final thoughts. 4. The Impact of Adolescent Cancer on HealthcareProfessionals . Susie Pearce. Introduction. Cultural meanings of care,cancer, and adolescent cancer care. Theories of stress, burnout, and coping.Emotions and care work. The 'emotional self'. Unconscious feelings inadolescent cancer work. Mastering intense feelings. Maintaining boundaries.Multidisciplinary team working. Care and support. Concluding thoughts. AYoung Person's Experience : Life During Treatment . Kelly Denver. 5.Supportive Care for Adolescents and Young Adults. During Cancer Treatment . JNeale Hanvey and Alison Finch. Introduction. Supportive care: how is itdefined?. Defining supportive care. The young person and cancer. Adolescenceand transitions. Beyond adolescence. Supporting the tasks of adolescence:forming a clear identity. Accommodating a changing or new body image. Thesignificance of symptom management on body image. and self-concept.Negotiating a new relationship with parents. The emerging independent self.Trying to reconcile the situation. The ethics of supportive care. Developinga personal value system. Consent. Ethical theories. Achieving financial andsocial independence. Developing relationships. Peer relationships. Romanticrelationships. Fertility. Developing cognitive skills and the ability tothink abstractly. Controlling their future. Developing the ability to controlbehaviour according to. social norms and taking responsibility. Meeting thechallenges of supportive care in reality. Team working. The importance of aworking philosophy and physical. environment. Summary. Concluding thoughts.6. Getting on With Life During Treatment . Roberta Woodgate. Introduction.Challenges facing adolescents with cancer. Body image and sense of selfchallenges. Peer relation challenges. Family relation challenges. Sexualhealth challenges. Education and employment challenges. Getting on with life.Hoping for the best. Having the right attitude. Knowing what to expect.Making some sense out of a bad situation. Taking one day at a time. Takingtime for yourself. Staying connected. Implications for health professionals.Conclusion. 7. End of Treatment Issues: Looking to the Future . NeliaLangeveld and Julia Arbuckle. Introduction. The ongoing support needs ofyoung people finishing. cancer treatment. Trajectory of need. Re-establishingan individual, social, and sexual identity. Establishing a new identity.Sexual identity. Renegotiating relationships with family and friends. Family.Friends. Illustration of negotiating relationships. Re-engaging with lifeafter treatment by occupying time. with meaningful activity. Coping with theafter-effects of treatment. Facing mortality. Being a cancer survivor. Theneed for aftercare. Models of follow-up care. The transition process.Conclusion. A Young Person's Experience : Life After Treatment. orChemotherapy Saves the Lost Boy . Alan Pitcairn. 8. Long-term Effects ofCancer Treatment . Gill Levitt and Debra Eshelman. Introduction. Long-termsurvival. Long-term sequelae. Physical late effects. Pubertal development andfertility. Cardiac effects. SMNs. Radiation and SMNs. Chemotherapy and SMNs.Genetic factors and SMNs. Osteopenia/Osteoporosis. Obesity. Neurocognitiveeffects. Psychosocial late effects. Body image. Sexuality. Fatigue.Post-traumatic stress. Health behaviours. Smoking. Alcohol use. Illicit druguse. Occupational and insurance status. Delivery of care. Patient education.Conclusion. 9. Palliation and End of Life Care Issues . Maggie Bisset, SueHutton, and Daniel Kelly. Introduction. The importance of experience.Constructions of palliative care. Defining palliative care. Palliative carefor whom?. What we mean by palliative care. The search for meaning. Workingwith the search for meaning. Practice and challenges in palliative care. 'Whyme man?'. 'Don't tell him he's dying'. 'My pain's no better ... you'rerubbish you are!'. Near the end of life. Recognising when death is likely.Place of death. Decision making. Fundamental aspects of care. Is theremeaning in bereavement?. Common occurrences in bereavement. Having a hidingplace. Completing the construction of palliative care. Summary. 10. Buildinga Culture of Participation: Young People's Involvement. in Research . FaithGibson. Setting the scene. Drivers towards increased participation of youngpeople. Why participation is important. Levels of participation. Young peopleas partners in research. Consulting with young people. Young people ascollaborators in research. User-controlled research. Methodologies used tofacilitate participation in research. Evaluating participation. Conclusion.11. Developing an Integrated Approach to the Care of Adolescents. and YoungAdults with Cancer . Daniel Kelly and Faith Gibson. Introduction. Puttingservice developments into context. Contributing to the evidence base. Issuesaround diagnosis. Delay in diagnosis. Impact of a cancer diagnosis. Impact onthe family. Supporting young people at diagnosis. Delivering appropriatecare. The treatment phase. Where should care be delivered?. Helpful andunhelpful ways of communicating. Creating the right environment for care.Supporting young people during treatment. Role and significance of familymembers. Beyond treatment. The need for continuing care. Supporting youngpeople after treatment. Towards an integrated approach to TYA cancer care.Useful Contacts . Index