Specialist cancer units for teenagers, complete with pool tables, widescreen satellite TVs, games consoles and internet access, are needed to help young people fight their disease, government advisers said yesterday.
Patients from their teens to their early 20s are too often being treated on wards alongside toddlers or people aged over 60, without regard for their physical and emotional "growing pains", they said.
The guidance issued yesterday to the NHS in England and Wales by the National Institute for Health and Clinical Excellence (Nice) was described by the Teenage Cancer Trust as "a monumental shift in health strategy".
The trust's chief executive, Simon Davies, said that the demand for age-appropriate services, along with properly trained health professionals at every stage of care, was "music to our ears". The trust had provided the capital costs for eight specialist units, two in London and one each in Manchester, Birmingham, Leeds, Sheffield, Newcastle and Liverpool. The largest had beds for 19 patients.
The guidance should at least double the number of units, encouraging more hospital trusts to provide the funds needed to run wards, which the trust remains happy to build.
The group developing the guidance also highlighted the delays some children faced in getting diagnostic tests and treatment because theatre and anaesthetic time was not specifically allocated to them. NHS trusts needed to factor in these services in their local planning, it said.
Mr Davies, who was on the development group that drew up the guidance, said: "Nice's endorsement of our philosophy, that teenagers and young adults are treated in appropriate surroundings, is an essential stamp of approval. We feel confident that these recommendations will take us a step nearer to ensuring that every young person with cancer has access to specialist facilities."
Six teenagers and young adults are diagnosed with cancer each day in the UK, and incidence of the disease has increased by 50% in the past 30 years, said the trust.
Patients have welcomed the youthful, friendly and relaxed atmosphere of the units already funded by the trust over the past 15 years, suggesting they are more akin to hotels, youth clubs or friends' houses. The units have included kitchens to allow young people to provide their own food.
Lucy Smith, 18, from Beccles, Suffolk, who was diagnosed with Hodgkin's lymphoma at the age of 16, said: "Being on an adult ward is very boring, and being isolated from other teenagers is very lonely and frightening. It is difficult being a 16-year-old girl who is bald and has a tube hanging out of her chest. My nurses were good but at the end of the day they were trained to deal with adults ... having friends on the ward would have helped when I was down."
Meriel Jenney, a paediatric oncologist in Cardiff, said of young people diagnosed with cancer: "Their physical and psychological needs are different. They are often not comfortable being cared for alongside a two-year-old or an elderly patient."
Sarah Ramsden, now 21, from Leeds, and her brother Tom were both treated for Hodgkin's disease on an adult ward in the city and they met no other teenagers with cancer while in hospital. "It is incredibly rare that siblings will have this disease and we both feel it is a good job we had each other ... I truly believe the experience of having cancer would not have been nearly so bad if I had had people to talk to who were going through a similar experience."
Joanne Rule, chief executive of the charity CancerBACUP, said services matching age groups would make a tremendous difference: "These guidelines need to be implemented urgently. The next step will be to improve access to teachers for young people with cancer, especially tuition for patients who are university students."
The guidelines also seek to ensure continuity of care for younger children staying at specialist centres, hospitals nearer home, or at home.