title: Intimacy, Substance Use, and Communication Needs During Cancer Therapy: A Report From the "Resilience in Adolescents and Young Adults" Study.
abstract: The prevalence of intimacy and substance use among adolescents and young adults during cancer therapy has not been well described.
  
  
  
  The "Resilience in Adolescents and Young Adults with Cancer" study was a prospective, multicenter, mixed-methods cohort study. English-speaking patients 14-25 years old with newly diagnosed cancer were invited to complete a comprehensive survey at the time of enrollment (T1) and 3-6 months later (T2). Intimate relationships and health behaviors were assessed with questions adapted from the Guidelines for Adolescent Preventative Services assessment. Descriptive statistics characterized the prevalence of sexual and substance-related behaviors at each time point.
  
  
  
  Of 42 eligible and enrolled participants, 35 (83%) and 25 (59%) completed T1 and T2 surveys, respectively. Their mean age was 17.6 years (standard deviation 2.3), 57% were male, and the most common diagnoses were sarcoma and acute leukemia. Over a third of participants reported dating at each time point; 26% were sexually active at T1, and 32% at T2. Of those endorsing sexual activity, fewer than half reported consistent birth control or condom use and 4 reported their first sexual intercourse during our observation. In addition, 46% (T1) and 44% (T2) reported alcohol use and 23% (T1) and 26% (T2) reported illicit drug use. Despite these activities, fewer than 10% endorsed a worry or need to discuss these behaviors with oncology providers.
  
  
  
  Intimacy and substance use among adolescents and young adults are common during cancer therapy. Clinical and research implications include the identification of optimal communication and patient-centered supports.
authors: Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington. Electronic address: abby.rosenberg@seattlechildrens.org.
authors: Abby R
authors: AR
authors: Rosenberg
authors: Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Pediatric Hematology/Oncology, Harvard Medical School, Boston, Massachusetts.
authors: Kira
authors: K
authors: Bona
authors: Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.
authors: Tyler
authors: T
authors: Ketterl
authors: Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Claire M
authors: CM
authors: Wharton
authors: Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatric Hematology/Oncology, Harvard Medical School, Boston, Massachusetts; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors: Joanne
authors: J
authors: Wolfe
authors: Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.
authors: K Scott
authors: KS
authors: Baker
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D003142:Communication; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011446:Prospective Studies; D055500:Resilience, Psychological; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology; D055815:Young Adult
chemical_list: D013287:Illicit Drugs
keywords: Mixed-methods research; Quality of life; Risky health behaviors; Sexual behaviors; Substance use