title: Adolescent urologic oncology: current issues and future directions.
abstract: Recent Surveillance Epidemiology and End Results (SEER) data indicate that the annual cancer incidence in adolescents is higher than in children, and is on the rise. However, the amount of attention, research funding, and therapeutic progress made in the adolescent oncology population pales in comparison with that of pediatric oncology. Issues of adolescent oncology have only recently been acknowledged by leaders in the field, and current efforts now focus on raising awareness of this unique patient group. In urology, there have been many gains made in pediatric urologic oncology, most notably in Wilms tumor and genitourinary rhabdomyosarcoma (genitourinary [GU] rhabdomyosarcoma [RMS]); however, there has been little to no progress in the adolescent population. In general, adolescent cancer represents the interface between pediatric and adult oncology. Similarly, adolescent urologic oncology must be approached as a distinct entity because of the unique disease processes, treatment-related comorbidities, and psychosocial issues. This article will serve to review the most pertinent adolescent urologic oncologic diagnoses (testicular germ call malignancy, the second peak of the bimodal age distribution of GU-RMS, and adolescent renal malignancies). Also, we focus on such issues as the therapeutic impact on fertility, radiation exposure during therapy, and surveillance, risk of secondary malignancy, the long-term impact of chemotherapy, and the psychosocial burden of cancer in this population. Lastly, we highlight future directions and the foreseeable obstacles towards achieving the same research and therapeutic success enjoyed in pediatric urologic oncology.
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: nicholas.cost@sbcglobal.net.
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Cost
authors.affiliation: Division of Hematology/Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Carrye R
authors.initials: CR
authors.lastname: Cost
authors.affiliation: Division of Hematology/Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: James I
authors.initials: JI
authors.lastname: Geller
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: W Robert
authors.initials: WR
authors.lastname: Defoor
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D015994:Incidence; D008495:Medical Oncology / Q000706:statistics & numerical data* / Q000639:trends; D018426:SEER Program / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*
keywords: Adolescent and young adult (AYA) oncology; Adolescent oncology; Cancer; Genitourinary oncology; Urologic oncology