Breaking Down Barriers: Latvia Moves to Improve Cancer Care Transition for Young Adults
A coordinated effort is underway in Latvia to bridge the gap between pediatric and adult oncology care, ensuring a smoother and more effective treatment journey for young cancer patients as they transition into adulthood. The initiative, acknowledged by the Ministry of Health, aims to tailor treatment and monitoring plans to the unique needs of this vulnerable population, addressing a critical oversight in the current healthcare system.
The need for change was highlighted by the experiences of families like that of Mareta Bērzina-Meirāne, whose 21-year-old son, Niklāvas, was diagnosed with neuroblastoma at age seven. Despite the disease being in remission, ongoing specialist monitoring is crucial, and the shift from pediatric to adult care proved stressful for the entire family. “That transitional stage, if it had been prepared before, would be very, very important and would greatly ease stress, emotional experiences, and practical things,” Bērzina-Meirāne stated.
Discussions held on Wednesday at the Children’s Hospital underscored the industry’s recognition of the importance of a well-managed transition for successful patient recovery. Experts emphasize the need for comprehensive preparation and training for both patients and families, fostering open communication and reducing anxieties surrounding new medical environments.
However, the consensus extends beyond simply easing the transition. Specialists agree that, for some patients, continuing care with familiar doctors at the Children’s Clinical University Hospital (BKUS) is paramount. Pediatric hemato-oncologist Elizabete Cebura of BKUS explained that maintaining continuity of care can be vital for patients who benefit from established relationships with their medical team.
Riga Eastern Clinical University Hospital (RAKUS) supports this approach, with board member Vadims Beļuns noting the potential to continue care for patients beyond the age of 18. “We support this approach, that for those patients who need help after the age of 18, it would make sense to continue it here as well,” he said. The optimal age range for continued pediatric care – whether 18-24 or longer – remains under discussion.
While childhood cancer is considered rare, approximately 50-60 children receive a new diagnosis each year in Latvia. Crucially, 50 to 70 young people currently navigate this transition to adulthood annually, highlighting the scale of the need for improved systems.
Addressing the practical hurdles is a key priority. Valts Ābols, chairman of the board of BKUS, acknowledged the need to update existing protocols. “We have realized that it is no longer possible to act as we are old. There are a number of practical aspects that need to be completed, which are related to both certification matters, so that doctors who will continue treatment after the age of 18 can do so legally.”
Financial considerations also pose a challenge. Currently, certain medications and examinations are covered until a patient reaches the age of 18, but coverage often ceases upon reaching adulthood. A representative from the Ministry of Health expressed support for the changes but cautioned that a comprehensive solution will require careful study of international best practices. “It is difficult for me to name a term, because the experience of other countries should be studied, which is the best to adapt for Latvia, and then watch, put it together step by step,” stated Sanita Janka, director of the Health Care Department of the Ministry of Health.
The path forward requires regulatory changes and a commitment to patient-centered care, but the initial steps demonstrate a growing awareness of the critical need to support young adults as they navigate the complexities of cancer treatment and beyond.
