Nutrition in children, teenagers and young adults with cancer

Definitions

Cancer registration in the United Kingdom for children is from birth to 14 years (i.e. before 15th birthday) and for teenagers and young adults (TYA) is from 15 years to 24 years (i.e. before 25th birthday). The abbreviation CTYA applies to this entire age range.

Cancer in CTYA is considered a rare event but although this represents less than 2% of all cancer seen in developed/high income countries such as the UK, the risk of a cancer diagnosis occurring in a child is about 1:500 by the age of 15 years and, as the incidence of cancer continues to increase with age, about 1:200 between ages 15 -24 years. Furthermore, because of the young age at which they are diagnosed and the relatively high overall survival rates now seen, survivors of CTYA cancer account for a significant proportion of the total population who are living with and beyond a cancer diagnosis.

Cancer and Nutrition

Cancer occurs when control of cell behaviour is lost: cancer cells grow how, when and where they should not. Nutrition is the balanced provision of the energy and nutrients needed for cell life. Change to the nutritional environment may influence both the development of cancer and become altered as a result of its development and treatment. It may contribute to the complications and outcome of treatment and to long-term problems experienced by survivors. This may present particular challenges and consequences in children and young people in whom linear growth and the development and maturation of body organ systems is continuing.

Aims

Nutrition may have a role in all elements of CTYA cancer: prevention, diagnosis, treatment, and in living with and beyond cancer. Work in exploring the interface between nutrition and cancer could serve to contribute to three possible ambitions:

  1. A reduction in the risk of cancer.
  2. An improvement in care during, and outcome after treatment
  3. To enable the achievement of “healthier” function and body composition when living with and beyond cancer.

Whilst there are opportunities to explore nutritional issues implicated in the causes of CTYA cancer (ambition 1), it is currently less clear what possible interventions might follow. At present, it is believed that the greatest immediate benefit would derive from a focus on ambitions 2 & 3. It is to that end that the CTYA work stream will initially focus its activities. The purpose of its work will be to facilitate collaboration, advocate for progress, and to create clinical and scientific visibility for better nutrition care and research in CTYA living with and beyond cancer.

Led by: Professor Mike Stevens – Emeritus Professor in Paediatric Oncology, University of Bristol

Members:

Professor Faith Gibson – (Professor of Child Health and Cancer Care, University of Surrey and Great Ormond Street Hospital for Children NHS Foundation Trust)

Louise Henry – (Senior Specialist Dietician – Paediatric & TYA Cancer, Royal Marsden) 

Dr Martin McCabe – (Consultant in Paediatric & TYA Oncology, Christie Hospital)

Dr Gemma Pugh, Lecturer, Sports & Exercise Medicine, Queen Mary University London

Monika Siemicka, Senior Specialist Haematology and TYA Dietitian, Guy’s Hospital, London

Professor Rod Skinner – (Professor of Paediatric Oncology & BMT, Newcastle upon Tyne) 

Dr Dan Stark – (Consultant in Medical & TYA Oncology, Leeds)

Dr Sara Stoneham – (Consultant Paediatric Oncologist, UCL)

Active projects:

  • Metabolic dysregulation in skeletal muscle and adipose following allogeneic
    haematopoietic stem cell transplantation (HSCT) in children, teenagers and young adults – Programme Development Grant funded by the Wellcome Trust (see work stream strategy for further details)
  • Review article: The influence of nutrition on clinical outcomes in children with cancer

Documents:

CTYA work stream strategy
PROTOCOL Changes in body composition after allogeneic haematopoietic stem cell transplantation (HSCT) with total body irradiation (TBI) for treatment of leukaemia in children, teenagers and young adults (CTYA): a rapid review

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