Special Issues for Adolescents With Cancer

Teens with cancer and their families can face many challenges, from the first onset of symptoms through treatment and beyond.

Delays in diagnosis

Cancers in teens and young adults are often found later than they are in other age groups. (See Finding Cancer in Adolescents.) Sometimes this can complicate treatment if the cancer has grown large or spread by the time it’s found.

Treatment issues

Sometimes it’s not clear if teens with cancer are best treated by doctors who specialize in treating children with cancer (pediatric oncologists) or by doctors who mainly treat older adults (oncologists). Not all doctors are familiar with treating cancers in teens, which can often have unusual features.

Communication between patients and their doctors can also be an issue, as many cancer doctors are more comfortable dealing with other age groups.

Regardless of where they are being treated, teens and young adults can feel isolated and out of place. Most patients in doctor’s offices or cancer centers are either older adults or younger children, so teens aren’t likely to see many people their own age who are dealing with the same issues they are. It’s very important for people to be able to connect with others who understand what they’re going through and can relate to them on their level. Many support groups – both in person and online – now exist for teens with cancer who are looking to connect with others in similar situations.

Some teens themselves can be challenging as patients. They might place a higher priority on other things going on in their lives rather than treating the cancer, resulting in missed appointments for tests or treatments. This might be out of a misunderstanding of the seriousness of the cancer, resentment over having to deal with the cancer, or even fear of the unknown.

Social and emotional issues

Some of the greatest challenges faced by teens with cancer come from the fact that this tends to be a time of great change in a person’s life, which comes with many of its own stresses. Teens are often establishing their own identities at this time and developing social, emotional, and financial independence. A diagnosis of cancer can throw all of these things into disarray.

During treatment, patients and their families tend to focus on the daily aspects of getting through it and beating the cancer. But a number of emotional concerns can come up both during and after treatment. Some of these might last a long time. They can include things like:

• Dealing with physical changes (hair loss, weight gain, scars from surgery, etc.) that can result from the cancer or its treatment
• Worrying about the cancer returning or developing new health problems
• Resenting having cancer and having to go through treatment when others do not
• Having to become more reliant on parents at a time when a person is normally becoming more independent
• Having concerns about what to tell others or being treated differently or discriminated against (by friends, classmates, co-workers, employers, etc.)
• Having concerns about dating and someday marrying and having children

No one would choose to have cancer, but for many cancer survivors, the experience can be positive in the long term, allowing for clearer setting of priorities and helping to establish strong personal values. Still, some survivors may have a harder time recovering, adjusting to life after cancer, and moving on.

It’s normal to have some anxiety or other emotional reactions during and after treatment, but feeling overly worried, depressed, or angry can affect many aspects of a young person’s growth. It can get in the way of relationships, school, work, and other parts of life. With support from family, friends, mental health professionals, and others, many cancer survivors can thrive in spite of the challenges they’ve had to face.