Nurturing a Smooth Transition to Cancer Survivorship for Adolescents

The Role of Oncology Nurses

Cancer comes with many unknowns, and survivorship is no different. When working with adolescents after their treatment has ended, validation, acknowledgement, and feedback and information about what to expect is helpful. Supportive conversations with the family or encouraging family therapy can also help adolescents navigate these challenges. Families are a significant part of a young person’s life, and everyone copes with survivorship differently.

Oncology nurses are vital sources of support for adolescents in their transition to survivorship. They provide psychoeducation, emotional support, survivorship care planning, health promotion, advocacy, and connection to support resources.

A survivorship care plan is a tailored plan that outlines recommendations for ongoing monitoring, follow-up appointments, and screenings for potential late effects.⁴ Oncology nurses can explain the purpose of these recommendations and help adolescents understand their role in maintaining their health and well-being.

Coping Strategies

Referrals to individual, group, or peer support groups can help reduce feelings of isolation. During survivorship, adolescents are focused on the “what ifs” or the unknowns the next couple of months may bring.

Journaling, breathing techniques, mindfulness, and meditative practices can assist with grounding and focusing on the present moment. Although mindfulness and meditation can be hard to engage in, they can also be an excellent outlet for adolescents. Here are 2 mindfulness exercises that are easy to teach.

5-4-3-2-1 technique This mindfulness technique is designed to interrupt the cycle of anxious thinking. It requires the patient to take a few slow breaths then acknowledge

• 5 things you can see (colors, picture)
• 4 things you can hear (birds, wind, cars)
• 3 things you can feel (your feet on the ground, a ball, your friend’s hand)
• 2 things you can smell (candles, coffee, perfume)
• 1 thing you can taste (a mint, gum).⁵

Box breathing This is a 4-step breathing exercise to help patients with stress management.

• Step 1 Breathe in while counting to 4 slowly. Feel the air enter your lungs.
• Step 2 Hold your breath for 4 seconds. Try to avoid inhaling or exhaling during this time.
• Step 3 Slowly exhale through your mouth for 4 seconds.
• Step 4 Repeat steps 1 to 3 until you feel recentered.⁶

Extending the support network

CancerCare can also help find local resources for adolescents. Patients or family members that need additional support can also reach out to the CancerCare HOPELINE (800-813-4673) to speak with an oncology social worker.

Nikki Molfetas is an oncology social worker with CancerCare.

References

1. American Cancer Society. Special section: cancer in adolescents and young adults. In Cancer Facts & Figures 2020. Atlanta; American Cancer Society; 2020:29-43.

2. Zebrack B, Bleyer A, Albritton K, Medearis S, Tang J. Assessing the health care needs of adolescent and young adult cancer patients and survivors. Cancer. 2006;107(12):2915-2923. doi:10.1002/cncr.22338

3. Fidler MM, Frobisher C, Hawkins MM, Nathan PC. Challenges and opportunities in the care of survivors of adolescent and young adult cancers. Pediatr Blood Cancer. 2019;66(6):e27668. doi:10.1002/pbc.27668

4. Sadak KT, Connor C, DeLuca H. (2013). Innovative educational approaches to engage and empower the adolescent and young adult childhood cancer survivor. Pediatr Blood Cancer. 2013;60(12):1919-1921. doi:10.1002/pbc.24635

5. Office of Wellness. 5-4-3-2-1 Grounding technique for anxiety. UAB Medicine. Accessed July 27, 2023. https://www.uab.edu/medicine/home/images/directory/5-4-3-2-1-technique-jan-2023.pdf

6. Norelli SK, Long A, Krepps JM. Relaxation techniques. StatPearls [Internet]. Last updated August 29, 2022. Accessed July 27, 2023. https://www.ncbi.nlm.nih.gov/books/NBK513238/