Transition from paediatric to adult survivor care — what the AYA shift means for your family

There is no single fixed age — the timing depends on the treating institution, your child's maturity, and their ongoing medical needs. In most programmes, the transition happens somewhere between the ages of 16 and 25. What matters more than the age is that the move is planned rather than abrupt. A good transition includes a handover meeting, a written survivorship care plan, and a named adult oncology contact before paediatric follow-up formally ends. At CION we plan this process with families well in advance, so nothing falls through the gap.

AYA stands for Adolescent and Young Adult — the age group roughly spanning 15 to 39 years. An AYA cancer survivor is someone who was diagnosed with cancer during this life stage or who is moving into it after a childhood cancer diagnosis. AYA survivors face a distinct mix of medical, psychological, social, and practical challenges that neither a purely paediatric nor a standard adult oncology service is always set up to address. Dedicated AYA survivor care recognises this gap and provides support that fits where a young person actually is in their life.

In paediatric care, you as the parent are usually at the centre of every conversation. In adult care, your child becomes the primary patient — appointments are addressed to them, consent is theirs to give, and the expectation is that they manage their own health information. This shift is healthy and important, but it can feel sudden if it is not prepared for. Beyond the relationship dynamic, the clinical content of follow-up stays similar: monitoring for late effects, managing any ongoing health issues from treatment, and supporting the young person's broader wellbeing. What changes is who leads the conversation.

A survivorship care plan is a written summary of your child's cancer history — the diagnosis, all treatments given, doses received, and any known late effects — combined with a personalised schedule of recommended follow-up tests and health checks going forward. Think of it as a medical passport. When your child eventually sees a GP, a new specialist, or an emergency doctor who has no knowledge of their cancer history, this document gives that clinician the information they need to make safe and informed decisions. It also helps the survivor themselves understand their own health story as they grow into adulthood.

This is one of the most common concerns parents and young survivors raise, and it is entirely understandable. The paediatric oncology team often becomes like an extended family over years of treatment and follow-up. Moving on can feel like losing a safety net. The most helpful approach is a gradual, well-planned transition — ideally including a joint appointment where both the outgoing paediatric team and the incoming adult team meet the young person together. Allowing the young person to tour the adult clinic beforehand, discussing what is changing and what is staying the same, and acknowledging the emotions involved all help. At CION we walk families through this process step by step.

Late effects are health changes that arise months or years after cancer treatment ends, caused by the treatment itself rather than the original cancer. Which effects are most relevant depends on the type of cancer, the treatment used, and the age at which treatment was given. Common areas to monitor include heart and lung function (after certain chemotherapy or chest radiation), bone density (after steroid use or pelvic radiation), hormone and thyroid levels, mental health and cognitive function, second cancers, and fertility. A personalised survivor care plan, based on your child's specific treatment history, sets out the monitoring schedule most relevant to them — rather than applying a one-size-fits-all approach.