A study authored by two students and a faculty member from the UC Irvine School of Pharmacy & Pharmaceutical Sciences assessed the presence of neuropsychiatric complications in adolescent and young adult cancer (AYAC) survivors, emphasizing the need for the effective management of such conditions and continued care for this population following cancer treatment.
Dr. Alexandre Chan, professor and founding chair of the Department of Clinical Pharmacy Practice, along with Ivann Agapito, a third-year Doctor of Pharmacy (PharmD) student, and Quinton Ng, a fourth-year PhD in Pharmacological Sciences student, authored the study, which was published in Cancer Medicine. Additional contributors to the study include Joel Milam, Argyrios Ziogas, and Hoda Anton-Culver.
The study focuses on health issues experienced by people who received their first cancer diagnosis between the ages of 15 and 39. In particular, the research centers on neuropathy, memory loss, epilepsy, chronic fatigue, and psychiatric conditions. The high prevalence of such issues, unique care needs (school and career development), and limited research on helping this population has led the National Cancer Institute (NCI) to declare AYAC survivors as a vulnerable population.
The team utilized the All of Us Research Program in their study, which was featured in the All of Us Research Highlights series in both English and Spanish.
All of Us, a National Institutes of Health (NIH) initiative, aims to collect health information, volunteered by 1,000,000+ people, to build an expansive health database. Currently, there are over 300,000 participants in the program. With this number of available participants, researchers have access to a diverse set of health data.
In this study, Dr. Chan, Agapito, Ng, and their team evaluated two distinct populations: AYAC survivors and non-cancer matched controls (NCMC).
By evaluating the health data of these groups, the researchers identified a higher prevalence of complications such as neuropathy, memory loss, epilepsy, and psychiatric conditions among AYAC survivors as compared to NCMC.
“Our findings showcase how AYAC survivors, who average nine years post-cancer diagnosis, are up to four times more likely to receive a diagnosis of neuropathy, memory loss, epilepsy, and chronic fatigue and have a higher rate of follow-up care for these complications compared to NCMC,” Agapito shared. “Among psychiatric conditions, a high prevalence of approximately one out of three AYAC survivors reported depression and anxiety. AYAC survivors were more likely to be diagnosed with depression, bipolar disorder, and epilepsy than NCMC between 18 to 64 years old.”
The results of this study emphasize the importance of not only identifying these issues among AYAC survivors, but also of developing effective therapies for treating neuropsychiatric complications among this group.
“These long-standing complications can create physical and emotional burdens to AYAC survivors who are eager to return to normal life and seek to return to normalcy (i.e., completing higher education, family building, and work progression) post-cancer treatment,” said Ng.
This study represents the beginning of efforts to establish effective solutions for managing neuropsychiatric complications in AYAC survivors and providing care well past cancer diagnosis and treatment.
The team hopes to further study neuropsychiatric complications among AYAC survivors and evaluate the issue in more detail: “The prevalent evidence of neuropsychiatric complications supports efforts to determine the contribution of genetic variations among AYAC survivors and its association with these complications, such as memory impairment after cancer treatment,” stated Dr. Chan. “By grasping a better understanding of the genetic associations with memory impairment, specific variations can be used clinically as predictive biomarkers for memory impairment and efforts can be made to prevent and mitigate these complications among AYAC survivors.”
