Young Adults Get Cancer, Too

We think of young adulthood as a time of freedom, opportunity, growth, and change. The transition into adulthood is often one of new and transformative experiences full of possibility – college, travel, first jobs, romantic relationships, and gaining independence and responsibility. A cancer diagnosis is never a good thing, but a cancer diagnosis in young adulthood (roughly defined as the period between ages 18-25) adds layers of complication to an already difficult situation. 

People in this age range are straddling two very distinct life stages – childhood and adulthood. Many may find themselves in that in-between phase of being not quite a child or an adult. That confusion, too, complicates both diagnosis and treatment for young adults with cancer. The needs of young adult cancer patients must be addressed holistically and strategically for them to get optimal care.  

Three areas that greatly impact young cancer patients uniquely are financial concerns, social/emotional concerns, and obstacles to treatment that are specific to this stage of life. Oncologists for this age group must be trained in identifying and addressing these unique needs.  

Financial Concerns

Younger adults aged 18-25 are as likely to be on their parent’s insurance coverage, have their own insurance coverage, or have no insurance coverage. It is a tricky time of life where insurance lapses are common and potentially devastating for a young cancer patient. Employment at this time of life may also be in flux. A young adult could be a college student, be in an entry level position, or working in a job that does not provide employer provided insurance coverage. Both factors can greatly impact a young patient’s treatment.

Social/Emotional Concerns

Just as a young adult is working to establish independence and autonomy from their family, receiving a cancer diagnosis can throw that newfound independence into question. Managing treatment, medication and side effects can be overwhelming for someone newly independent. This is a time of life, as well, when many young adults are forging identities and bonds outside their families. Friendships, romantic relationships and maintaining a social life can be complicated alongside cancer treatment.  

Moving forward and then taking several steps backwards with a cancer diagnosis can feel as if you are losing footing with newly claimed autonomy. A young adult may once again become dependent on parents, friendships can disappear or suffer, or romantic partners who signed up to date and socialize may not stick around for treatment. 

Obstacles to Treatment

Because a cancer diagnosis during young adulthood is rare, it is not uncommon for a proper diagnosis to be delayed for young adults. No one leaps to the idea of cancer with aches and pains in this stage of life. Patients may put off a nagging concern, thinking they will wait until they get a job with insurance or a steadier living situation. Those delays can enable the cancer to spread before it is detected.

Fertility preservation must be addressed for patients who may wish to one day have children, but who suddenly require high dose chemotherapy or radiation that make having children more difficult. These discussions and necessary procedures may delay treatment.

Isolation and a general sense of feeling out of place is common for young adult cancer patients. Young adults will feel old in a children’s hospital and younger than roughly 80% of patients if they choose an adult oncologist. That in-betweenness can act as a barrier to receiving timely care.  

The priorities of a young adult may be in direct opposition to the challenges of cancer treatment. Missing educational, career, or social opportunities gets old quickly for young adults. Having to prioritize treatment at the expense of those things can be difficult for a young adult to maintain.  

So many factors specific to young adulthood can act as obstacles to cancer treatment. Juggling the opposing needs of wanting independence while still needing to be cared for and nurtured is a delicate balancing act for everyone involved – the patient, their family, friends, romantic partner, and doctors. Choosing an oncologist aware of this is key to successful treatment for the young adult patient.

Srilata Gundala, MD, a hematologist/oncologist and founder of Hope & Healing Care in Hinsdale and Lombard, Illinois treats patients as young as 16* (depending on treatment needs and complexity of the case), and understands the challenges of providing cancer care to young adults, “It is so important to talk with your patients and understand those things in their lives that can help or hinder their care. Young adults want to be treated like the adults that they are, but also require support, encouragement and a gentle touch. As their doctor, I want to make certain they get the best medical treatment available, but also recognize those things that could get in the way of that treatment being provided.”    

If you are looking for more information for cancer treatments in young adults, resources can be found through the National Cancer Institute, the American Cancer Society or Stupid Cancer. Young adult patients may also benefit from learning about how to be an empowered cancer patient here. 

Written By: Sheila Quirke, MSW

Reviewed By: Srilata Gundala, MD

*Please note that even though Hope and Healing Cancer Services can take a patient as young as 16, it is heavily based on the treatment needs and complexity of the diagnosis. Some patients may be referred elsewhere.