By Eva Briggs, MD
I’m writing this in April, and learned that the first week of April is adolescent and young adult cancer awareness week. This encompasses patients aged 15 – 39.
Each year in the U.S. about 89,000 people in this age range are diagnosed with cancer.
Cancer in adolescents and young adults represents about 5% of all cancers.
Certain cancers occur most frequently in in adolescents and young adults: primary bone cancer, Hodgkin lymphoma and testicular cancer. Lymphomas and thyroid cancer are the most common cancers in 15 – 24-year-olds.
Each year the incidence of cancer in this age group has been rising by 0.3%. Survival rates are also improving, but lag behind the progress made in children. This is due to differences in tumor biology, enrolment in clinical trials, treatment protocols, treatment tolerance, and compliance with treatment.
The most common cancers by age range are as follows:
• 15-19 year olds: testicular cancer, Hodgkin lymphoma, thyroid cancer, and brain tumors.
• 20-29 year olds: testicular cancer, thyroid cancer, breast cancer, and melanoma.
• 30-39 year olds: breast, thyroid, testicular, and cervical cancer.
Adolescent and young adult cancer patients face a variety of challenges and frustrations. Their peers often don’t understand what treatment entails and how life is changed for cancer patients and survivors.
Relationships may suffer because many young cancer patients feel isolated from friends and family. Young people are beginning to be independent, perhaps starting a job, attending college, or staring a family. Cancer can cause a frustrating loss of that independence.
Body image can be altered by the disease itself, by medications that induce physical changes such as hair loss, weight gain or weight loss, and by surgery.
Mental health takes a hit with emotions ranging from shock, fear, anger, sadness, loneliness, to embarrassment. Fortunately, many hospitals offer support programs such as art therapy, music therapy, and support groups.
Cancer treatments can affect fertility. Reproductive endocrinologists can counsel patients about options to preserve fertility before starting treatment. Additional resources include the Oncofertility Consortium (https://oncofertility.msu.edu) and Livestrong Fertility (www.livestrong.org/what-we-do/program/fertility).
Cancer survivors face additional challenges. There may be worry that the cancer will return. Long-term side effects such as fatigue may take longer to resolve than anticipated. Late effects from treatment may develop months or years after treatment. For these reasons follow-up medical care is vital.
Unfortunately, not every cancer is curable.
Patients with terminal or end-stage cancer will need to have discussions with their family and medical team to navigate choices about their care and support.
The National Cancer Institute has a wealth of information geared toward adolescents and young adults with cancer at www.cancer.gov/types/aya.
If you want to hear some first-hand perspective about surviving cancer, check out the podcasts and videos by Will Flanary. He’s an ophthalmologist and comedian who survived cancer not once but twice in his 20s. And then had a cardiac arrest in his sleep, saved by his wife performing CPR. He goes by the social media handle Dr. Glaucomflecken. He has plenty of funny videos but also some serious talks and discussion. To get started, here’s an article about Flanary www.today.com/health/health/doctor-known-dr-glaucomflecken-testicular-cancer-twice-rcna6319
Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.