Key words: adolescents, adolescents with cancer, young adults, pediatric oncology, psychosocial support, youth project, access to care. Acknowledgments: The authors would like to thank the Associazione Bianca Garavaglia and the Near/Magi- ca Cleme Foundation for supporting the Youth Project at the pediatric on- cology unit at the Istituto Nazionale Tumori in Milan. Chiara Secco is ac- knowledged for the figures. None of the authors have any conflicts of interest or competing financial in- terests to declare. Correspondence to: Andrea Ferrari, MD, Pediatric Oncology Unit, Fon- dazione IRCCS Istituto Nazionale Tu- mori, Via G Venezian 1, 20133 Milan, Italy. Tel +39-02-23902588; fax +39-02-23902648; email andrea.ferrari@istitutotumori.mi.it Received September 19, 2011; accepted October 19, 2011. The Youth Project at the Istituto Nazionale Tumori in Milan Andrea Ferrari 1 , Carlo Alfredo Clerici 1,2 , Michela Casanova 1 , Roberto Luksch 1 , Monica Terenziani 1 , Filippo Spreafico 1 , Daniela Polastri 1 , Cristina Meazza 1 , Laura Veneroni 1,2 , Serena Catania 1 , Elisabetta Schiavello 1 , Veronica Biassoni 1 , Marta Podda 1 , and Maura Massimino 1 1 Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan; 2 Faculty of School of Medicine, Department of Biomolecular Sciences and Biotechnology, Psychology Section, University of Milan, Milan, Italy ABSTRACT The paper describes the key issues of the Youth Project launched in 2011 at the pedi- atric oncology unit of the Istituto Nazionale Tumori in Milan dedicated to adolescents (over 15 years old) and young adults (up to 25 years old) with solid tumors. The Youth Project was developed within the pediatric oncology unit in the conviction that ado- lescent patients may benefit from the multidisciplinary team typical of the pediatric oncology setting, as well as the expertise in treating pediatric-type malignancies and enrolling patients in clinical trials. The project was an offshoot of existing activities, making no major changes to the hospital’s organization and posing no major de- mands on the institution’s administration and board. Patients are managed by the pe- diatric oncology staff, but they have access to particular services (e.g., regarding their psychosocial support, fertility preserving measures, access to care after completing therapy); dedicated, adequately equipped multifunctional rooms have been provid- ed. The location of the pediatric unit within a cancer referral center and the coopera- tion with divisions dedicated to adults have played an important role in the project’s creation. Introduction The pediatric oncology unit of the Istituto Nazionale Tumori (INT) in Milan con- ducts clinical and research projects on pediatric cancers. With 23 inpatient and 12 outpatient beds, the unit has always been tailored to the treatment of children with solid tumors (265 newly diagnosed patients treated in 2010), while it has been coop- erating closely with the pediatric hemato-oncology center at San Gerardo Hospital in Monza since the 1980s, where it refers children with leukemia. The INT pediatric on- cology unit includes a pediatric surgery subunit. The unit is part of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), the network of Italian pediatric oncology centers founded in the late 1970s to promote multicenter clinical trials and research. Unlike other Italian pediatric oncology centers at children’s hospitals or being part of pediatric departments in general hospitals, our unit is the only pediatric oncology unit in Italy within a large cancer hospital. As well as attracting large numbers of pa- tients over the years, this has facilitated close cooperation with the INT divisions ded- icated to adult cancers, enabling us to gain particular experience of certain tumor types (e.g., bone and soft tissue sarcomas) 1 across the pediatric and adult age groups, and of adult-type tumors occurring in children (melanoma, carcinomas) 2-5 . In addi- tion, special attention has been paid to patients with pediatric-type tumors (e.g., rhabdomyosarcoma, medulloblastoma) who are no longer of pediatric age: in partic- ular, 2 studies showed that young adult patients with rhabdomyosarcoma 6 and medulloblastoma 7 fared better when enrolled in pediatric trials, or at least treated ac- Tumori, 98: 399-407, 2012 © Il Pensiero Scientifico Editore downloaded by IP 89.96.77.209 Tue, 09 Oct 2012, 20:33:23