As I reflect on the theme of this issue of Connections—AYA Oncology—I keep coming back to how much of this work sits at the intersection of timing and disruption.

Adolescents and young adults (AYAs) with cancer are in a life stage defined by forward motion: becoming independent, building identity, forming relationships, starting school or careers, and imagining what comes next. A cancer diagnosis interrupts that trajectory in ways that are not only medically complex but deeply developmental. It is a disruption that lands differently because of when it happens.

Most of us in oncology social work already understand the framework of AYA care—the psychosocial needs, the structural gaps, the growing body of research and programming. And yet, even with that awareness, I find myself returning to a harder truth: we still have not fully translated what we know into consistent, developmentally attuned care in practice. Too many AYA patients continue to move through systems that were not built with their reality in mind.

This is where oncology social work is especially critical. We are often the professionals closest to the lived experience—holding the emotional weight, translating systems, supporting decision-making, and advocating for care that actually reflects where the patient is in their life. Just as importantly, we are positioned to lead: in shaping programs, informing research, strengthening interdisciplinary care, and pushing our institutions toward more intentional AYA-focused approaches.

In reflecting on AYA oncology here in Connections, and in anticipation of our conference next month, I would be remiss not to mention the excellent AYA-focused presentations planned, including the Blood Cancer United-sponsored luncheon: Supporting Mental Health in Young Adults with Cancer: Strategies for Oncology Social Workers, along with a number of additional sessions focused on this population.

I hope those of you planning to attend will make space for these conversations. If you haven’t registered yet, there is still time—we’ll be in Portland, June 10–12.

I also want to underscore something I believe deeply: the most important direction for this work comes from those closest to it. If you see gaps in AYA care or have ideas for initiatives we should prioritize, I encourage you to bring them forward. That is how we move from awareness to action.

AYA oncology is not a completed area of practice—it is an evolving responsibility. And it is one that oncology social workers are uniquely positioned to lead.