Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Overlooked minorities: the intersection of cancer in lesbian, gay, bisexual, transgender and/or intersex (LGBTI) adolescents and young adults (#85)

Mairghread Clarke 1 , Jeremy Lewin 1 2 3 , Smaro Lazarakis 4 , Kate Thompson 1 5
  1. ONTrac at Peter Mac Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Service, Melbourne, Victoria, Australia
  2. Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  3. Department of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  4. Health Sciences Library, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  5. Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia

Cancer significantly contributes to the burden of disease in adolescents and young adults (AYA) and has notable implications in terms of their health care engagement and psychosocial wellbeing. Added to this, large numbers of AYA oncology patients in Australia are treated within adult hospitals, occupying an at-times uninviting landscape with the potential for unsatisfactory care experiences and poorer health outcomes. The emergence of AYA oncology as a specialised field seeks to redress this historical “no man’s land”, championing the cause for developmentally-informed and multidisciplinary clinical services within age-appropriate treatment environments.

Notwithstanding the progress of recent decades, for a number of AYA sub-populations cancer care is far from equitable. Over the past eighteen months, work undertaken by the Victorian Adolescent & Young Adult Cancer Service suggests that this is pertinent for the AYA with cancer who identifies as sexually and/or gender diverse.

This session will outline how the intersection of cancer (and its associated treatment and interventions) to an already complex period of evolving sexuality and gender diversity can result in unique challenges and risks for the young LGBTI cancer patient. It is relevant to all health care professionals involved in cancer care, from allied health clinician to consultant oncologist, and particularly those whose well-intentioned response may be “But I don’t have any LGBTI cancer patients.” Indeed, conscious or not, this patient cohort are accessing our oncology clinics, hospital wards, radiotherapy beds and surgical suites, and it is imperative that we understand and respond to their unique care needs appropriately.

Topics include:

  • Current knowledge of cancer in AYAs who identify as LGBTI: outcomes from literature and systematic reviews (updated to August 2019).
  • The case for LGBTI + AYA + Cancer = a medically underserved patient cohort. What we know from the care experiences of similar patient populations.
  • Moving toward an equitable and LGBTI-inclusive model of care: from clinical governance and physical space, to staff education and training needs.
  • Challenges in implementing LGBTI-inclusive principles: reflections informed from the outcomes and barriers experienced by the Victorian Adolescent & Young Adult Cancer Service
  • Development of the first resource for LGBTI young people with cancer: an exercise in meaningful consumer engagement and evidence-informed practice.
  • Call to Action: next steps in building the evidence base.