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In the Netherlands, each year 2700 adolescents and young adults (AYA) aged 18 to 35 years are diagnosed with cancer. AYAs have age-specific problems in the areas of education, work, relationships and children that require specific attention. In 2013, we set up the Dutch national AYA 'Youth and Cancer' [Jong & Kanker] platform in co-creation between AYAs and healthcare professionals to address these problems. In this article we discuss the status and future perspectives of this platform.

Oral tyrosine kinase inhibitors and mammalian target of rapamycin (mTOR) inhibitors are indicated in several types of cancer. They are usually administered at a fixed dose. In recent years, observational studies have reported on the wide variability in exposure to these new drugs, and the relationship between clinical response (efficacy and toxicity) and target plasma concentrations. Additionally, we are gaining insight into different food and drug interactions with these new drugs. On the basis of current drug monitoring, advice can be given on individual dosing of pazopanib in metastatic renal cell cancer (mRCC), sunitinib in mRCC and gastrointestinal stromal tumor (GIST), and imatinib in GIST.

It has been suggested that clinical oncologists do not discontinue active treatment in the palliative setting in a timely manner, and only care about the extension rather than the quality of life. Moreover, patients may be not very well informed about their prognosis and the intention behind their treatment. To improve decision-making in the palliative phase, understanding of recent advances in cancer care should be shared, as well as any potential adverse effects. Decision aids may be useful to improve the chance of satisfactory treatment decisions. The desire to obtain information is high in the majority of patients; however, oncologists do not always provide enough key information, particularly in terms of survival. During consultations, the time available to discuss these aspects is limited; it is believed that allocating more time for outpatient consultations could improve the quality and satisfaction regarding the decision to treat or not to treat. Ideally, general practitioners and palliative teams should be involved early in the decision-making process.

We present two patients with colorectal carcinoma who were admitted with fever and diarrhoea during treatment with chemotherapy. Blood cultures taken from both patients revealed an infection with Listeria monocytogenes. A contaminated ice cream was probably the source of infection in one patient. The other patient died of the listeriosis. Patients with diminished cellular immunity are at risk of invasive listeriosis. Listeriosis has a high mortality rate in this group of patients. Intravenous penicillin or ampicillin for 4 to 6 weeks is the first choice of antibiotic treatment. These antibiotics can be combined with an aminoglycoside or trimethoprim-sulfamethoxazole for a synergistic effect. To prevent invasive listeriosis we recommend strict dietary advice to all patients with diminished cellular immunity.