Finding Cancer in Adolescents

Cancers are often found later (at a more advanced stage) in teens than they are in other age groups. There are a few reasons a cancer diagnosis might be delayed:

• Most teens tend to be fairly healthy and might not go to the doctor unless they feel they really need to. This is especially true for young men.
• These years are often a time of growing independence, when young people begin to establish their own identity and lifestyle. Concerns other than health, such as spending time with friends, dating, going to school, working, or getting ready for college are often higher priority than health at this time. Many teens might not even have a regular doctor.
• Even when a young person does go to the doctor with symptoms, cancer is not usually high on the list of probable causes because it’s not common in this age group. Doctors might be more likely to think symptoms like pain or feeling tired are due to causes other than cancer.

Still, some cancers in teens can be found early, when treatment is more likely to be successful.

Screening for cancers in teens

Screening is testing for a disease such as cancer in people who don’t have any symptoms. Cancers aren't common between ages 15 and 19, so there are no widely recommended screening tests to look for cancer in people in this age group who are not at increased risk.

Some people have a higher risk of developing certain types of cancer because they have a strong family history of cancer or because they've inherited a specific gene mutation from a parent. These might put them at a higher risk for cancers such as melanoma of the skin or colorectal, thyroid, or other cancers. People with these mutations may need careful, regular exams or tests starting at an early age to look for signs of cancer.

Possible signs and symptoms of cancer in teens

It’s important to be aware of the common signs and symptoms of cancer. These can include:

• An unusual lump or swelling in the neck, belly, testicle, or elsewhere
• Unexplained tiredness and loss of energy
• Easy bruising
• Abnormal bleeding
• Ongoing pain in one part of the body
• Unexplained fever or illness that doesn’t go away
• Frequent headaches, often with vomiting
• Sudden eye or vision changes
• Loss of appetite or unplanned weight loss
• A new mole or other spot on the skin, or one that changes in size, shape, or color

Other symptoms are also possible, depending on the type of cancer. See Types of Cancers that Develop in Adolescents for more information on common symptoms for specific cancers.

Many of these symptoms are much more likely to be caused by something other than cancer. Still, if a teen has any of these symptoms – especially if they don’t go away or they get worse – it's important to have them checked by a doctor.

Seeing a doctor

The doctor will ask about medical history and symptoms and will then do a physical exam. Depending on the symptoms, special types of exams or tests might be needed. The doctor might order blood tests, imaging tests (like x-rays or CT scans), or other tests to help figure out if the symptoms are caused by cancer or something else.

If the doctor thinks the symptoms might be caused by cancer, a teen will probably be referred to a specialist for more exams and tests. The type of doctor will depend on the teen's age and what type of cancer is suspected.

In some cases, if an abnormal lump or tumor is found, the doctor might need to remove some or all of it so that it can be checked for cancer cells with a microscope. This is known as a biopsy. For most types of cancer, a biopsy is needed to confirm the diagnosis. Biopsies can be done in many ways, ranging from removing a small sample of cells with a thin, hollow needle, to more extensive surgery. The type of biopsy used will depend on where the lump or tumor is and other factors.