Life With Cancer as a Young Adult
By Nicholas Zuk
Receiving a cancer diagnosis at any age is a life-changing experience that comes with a variety of challenges. For young people, however, it presents difficulties that can make their situation even more complex. Unlike older adults who have likely been out of school for years or decades and have established careers, young cancer patients are more likely to experience personal setbacks beyond the physical toll of the disease. For young adults, a cancer diagnosis often occurs at a crucial time when a patient may be balancing academics, internships or early career paths, relationships, as well as beginning the early stages of living independently. This can force patients to delay plans and dreams they have been working to achieve. At a time when questions about job stability, financial independence, and future relationships are beginning to take shape, a diagnosis can be devastating. While these complications can feel overwhelming, resources and strategies are available to combat these setbacks and allow patients to continue their endeavors.
With so many life-defining events occurring between the ages of 18 and 25, a diagnosis can introduce a dynamic unique to young adults with cancer. One of the most significant issues for this age group is that there is often a delay in cancer diagnosis. The lack of routine cancer checkups for young adults usually results in cancer symptoms being mistaken for less severe conditions, leading to cancers being found later and have progressed further (American Cancer Society, 2024). For example, persistent fatigue or unexplained pain might be dismissed as stress, overexertion, or dietary issues, which can delay getting proper cancer screenings when they may be symptoms of cancer. Unlike older adults, younger patients are less likely to schedule routine colonoscopies, mammograms, lung cancer screenings, or other cancer checkups that older patients commonly receive (American Cancer Society, 2024). As a result, older adults are more likely to have their cancer diagnosed at earlier stages. While there are pediatric oncologists who specialize in treating young children, there are no oncologists who specialize in treating only young adults. Further, because cancer centers primarily cater either to children or older adults, young adults can feel out of place when choosing where to receive care from because their age places them in an age group between pediatric and adult oncology. This ambiguity about where to get treatment can cause delays in finding a place to receive routine care. An additional detriment of being diagnosed late is that more aggressive treatment options are generally required that can further exacerbate the physical and mental upheaval that cancer causes in a young adult’s life.
Financial challenges are another significant concern for young adults with cancer. 30%, or approximately one out of every five young adults ages 18-25 in the United States, are uninsured or underinsured (Centers for Medicare and Medicaid Services, 2024). Even with insurance, many patients may face high deductibles, copays, or non-covered services that can make cancer treatment prohibitively expensive. Given that a significant number of young adults have to pay all medical bills, with nearly a third of all young adults without sufficient healthcare, a large portion of them are left to deal with medical expenses that can be thousands or tens of thousands of dollars or more (Centers for Medicare and Medicaid Services, 2024). These are expenses that people in their mid-twenties usually can not afford on their own. Additionally, beyond direct medical costs, with frequent doctor visits, chemotherapy sessions, surgeries, as well as the recovery following them, cancer treatment often forces patients to work fewer hours, take a leave of absence, or even resign from their job or school, meaning the patient has less income to spend on their treatment and living costs.
A cancer diagnosis during young adulthood also has various negative impacts on the social aspects of a patient’s life. During these formative years, when a patient’s education, friendships, and romantic relationships are key milestones, cancer can seem like a concrete wall that stops everything in its tracks. Treatments not only take a physical and emotional toll, but they also make social aspects of a patient’s life challenging to maintain. Physically, changes like hair and weight loss from therapies or scars from surgery can notably cause self-esteem issues that affect social and dating lives (National Cancer Institute, 2023). Treatments can also cause complications with fertility, a possibility that can cause additional stress to both the patient and their partner if they have plans to start a family (Ogle, 2023). Emotionally, stress about how to disclose a diagnosis to family, friends, significant others, professors, coworkers, or peers and how they will react can further exacerbate insecurities a patient might have. Similarly, young adults might feel isolated when surrounded by peers who are healthy and focused on their academic or career endeavors. When it comes to careers and academics, cancer can be devastating and upend years of planning and hard work toward a degree or career. For young adults working to complete degrees, a diagnosis and the treatment schedules, medical consultations or appointments, and side effects of treatment that follow can make attending class, completing assignments, and taking exams extremely difficult. Oftentimes, if the workload becomes too overwhelming, a patient has no choice but to defer their coursework, take a medical leave of absence, or drop out of school entirely. For young professionals, the same medical obligations can cause career disruptions that put the patient’s prospects for promotions, better jobs, and networking opportunities on hold. In both scenarios, the patient’s long-term goals and aspirations are paused.
Despite the disruptions to education and careers, there are many ways young adults can adapt and receive help to allow them to keep moving forward, even during treatment. Learning about available resources can better prepare and aid young adults in their cancer journey. First, having a support system while battling cancer is essential for emotional well-being during treatment. While friends and family can be excellent sources of comfort, online and in-person peer groups can provide invaluable support too. Connecting with other young adults facing cancer allows patients to share similar experiences, ask questions, and gain advice from others with similar lived experiences. Organizations such as Elephants and Tea, Stupid Cancer, and Young Survivor Coalition (YSC) offer newsletters and host forums, webinars, and virtual hangouts specifically for young adults with cancer to participate in (McCoy, 2024). Common, helpful topics these groups address include balancing school or work life with treatments, managing social expectations from family and peers, and handling relationship stress. Additionally, professional mental health support can be a valuable tool to help young adults process emotions that arise during diagnosis and treatment. Having a confidential outlet to discuss fears, anxieties, and long-term concerns can help ease patients’ minds about their condition.
Second, while financial obstacles may be significant, financial assistance and legal protection programs are available. Some young adults may qualify for United States government initiatives that can alleviate some of the financial burden, such as the Family and Medical Leave Act (FMLA) or Americans with Disabilities Act (ADA) (American Cancer Society, 2019 & 2023). In addition to local nonprofits, large nonprofits such as Expect Miracles Foundation’s SAMfund also grant financial assistance specifically to young cancer survivors and help cover all costs from medical bills to housing rent. Other organizations, such as CancerCare, provide financial and copay assistance, counseling services, and support groups for cancer patients. For students, some colleges and universities offer financial support for those suffering from medical hardships. Current students should contact their schools’ financial aid office to determine if they offer such assistance. If this is not possible, many schools allow students to receive incomplete grades if cancer treatments interfere with coursework to the point that the student can not continue. Incomplete grades protect academic records and enable students to begin their courses where they left off once coursework is manageable again. For patients who decide to remain in school during treatment, discussing personal circumstances with professors can help them understand a student’s situation and can lead to altered deadlines and assignments if needed. Switching from in-person to online programs can also provide more flexibility during treatment.
Despite the formidable challenges posed by a cancer diagnosis in young adulthood, there are resources available to limit the disruptions it causes in a patient’s life. Building a strong support system, exploring financial and academic assistance, and addressing physical and emotional changes are vital for young adults to maintain a sense of normalcy and to continue living an everyday life. Through proactive communication with employers or professors, seeking age-appropriate medical expertise, joining specialized counseling services or online communities, and communicating with people in their personal and professional networks, young adults can continue to pursue their ambitions and dreams. While cancer can disrupt the momentum of early adulthood, a cancer diagnosis does not necessarily mean a patient has to put their life on pause indefinitely. Learning from their experience how to remain both determined and adaptable can make the remainder of a young adult’s treatment more manageable and prepare them to overcome obstacles they may face in the future.
References
American Cancer Society. (2019). Americans with Disabilities Act: Information for Cancer Patients. Retrieved from https://www.cancer.org/cancer/financial-insurance-matters/health-insurance-laws/americans-with-disabilities-act.html
American Cancer Society. (2023). Family and Medical Leave Act: FMLA Leave of Absence. Retrieved from https://www.cancer.org/cancer/financial-insurance-matters/health-insurance-laws/family-and-medical-leave-act.html
American Cancer Society. (2024a). Special Issues for Young Adults with Cancer. Retrieved from https://www.cancer.org/cancer/types/cancer-in-young-adults/special-issues.html
American Cancer Society. (2024b). Treating Cancers in Young Adults. Retrieved from https://www.cancer.org/cancer/types/cancer-in-young-adults/treating-cancers-in-young-adults.html
Centers for Medicare and Medicaid Services. (2024). Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses. Retrieved from https://www.cms.gov/cciio/resources/files/adult_child_fact_sheet#:~:text=Young%20adults%20have%20the%20highest,higher%20than%20older%20employed%20adults.
McCoy, A. (2024). 8 of the Best Support Organizations for Young Adults with Cancer. Retrieved from https://www.everydayhealth.com/cancer/the-best-support-organizations-for-young-adults-with-cancer/#:~:text=Elephants%20and%20Tea%20makes%20an%20effort%20to,and%20register%20for%20events%20on%20the%20website.
National Cancer Institute. (2023). Self-image, Sexuality, and Cancer. Retrieved from https://www.cancer.gov/about-cancer/coping/self-image
Ogle, A. (2023). Cancer Treatment and Fertility. Retrieved from https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/cancer-treatment-and-fertility
