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Adolescents and Young Adults with Cancer

Introduction to Adolescent and Young Adult Cancers

Cancer researchers, advocates, and a cancer survivor introduce the topic of adolescent and young adult cancers.

Types of Cancers in Young People

About 89,000 young people (ages 15 to 39) are diagnosed with cancer each year in the United States—accounting for about five percent of cancer diagnoses in the United States. This is about eight times the number of cancers diagnosed in children ages 0 to 14 and about one twentieth, or five percent, of the number of cancers diagnosed in adults 40 years and older, based on Cancer Facts and Figures 2020 by the American Cancer Society. 

Certain cancers, such as primary bone cancer, Hodgkin lymphoma and testicular cancer, are most frequently diagnosed among adolescents and young adults. However, the incidence of specific cancer types varies according to age. Lymphomas and thyroid cancer are the most common cancers among 15- to 24-year-olds. Among 25- to 39-year-olds, breast cancer and thyroid cancer are the most common, based on NCI’s Surveillance, Epidemiology, and End Results Program (SEER) Cancer Stat Facts.

Evidence suggests that some cancers in adolescents and young adults may have unique genetic and biological features. Researchers are working to learn more about the biology of cancers in young adults so that they can identity molecularly targeted therapies that may be effective in these cancers.

The most common cancers in adolescents and young adults (AYAs) are:

Finding a Doctor and Hospital

What Adolescents and Young Adults Need to Know after a Cancer Diagnosis

Experts in the field of adolescent and young adult (AYA) cancers and cancer survivors answer the question: What would you tell an adolescent or young adult with cancer?

Because cancer in young adults is rare, it is important to find an oncologist who specializes in treating the type of cancer you have. Research is finding that for some types of cancer, young adults may have better outcomes if treated with pediatric, rather than adult, treatment regimens.

Young adults who have a cancer that typically occurs in children and adolescents, such as brain tumors, leukemia, osteosarcoma, and Ewing sarcoma, may be treated by a pediatric oncologist. These doctors are often affiliated with a hospital that is a member of the Children’s Oncology Group . However, young adults who have cancers that are more common in adults are often treated by a medical oncologist through hospitals that are affiliated with an NCI-Designated Cancer Center or a clinical research network such as NCTN or NCORP.

Learn more about finding a doctor and how to get a second opinion in Finding Health Care Services. A second opinion may be especially helpful when there are complicated medical decisions that need to be made, there are different treatment options to choose from, you have a rare cancer, or the first opinion on the treatment plan comes from a doctor who doesn’t specialize in or treat many young adults with the type of cancer that you have.

Treatment Choices

The type of treatment you receive is based on the type of cancer you have and how advanced the cancer is (its stage or grade). Factors such as your age, overall health, and personal preference are also important.

Your treatment options may include a clinical trial or standard medical care.

  • Standard medical care (also called standard of care) is treatment that experts agree is appropriate and accepted for a specific disease. The A to Z List of Cancers has information about treatment for specific types of cancer. You can also learn about treatments such as chemotherapy, immunotherapy, radiation therapy, stem cell transplants, surgery, and targeted therapies in Types of Treatment.
  • Clinical trials, also called clinical studies, are carefully controlled research studies that test new ways to treat diseases, such as cancer. Clinical trials are conducted in a series of steps, called phases. Each phase aims to answer specific medical questions. Once a new treatment has been shown to be safe and effective in clinical trials, it may become the standard of care. You can get answers to commonly asked questions about clinical trials and search for clinical trials for the type of cancer you have.
Treatment decisions often come with questions and concerns, especially when considering participation in a clinical trial. We can help. Please contact our free, confidential Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) for information and for help finding clinical trials.

Fertility Preservation Options

Fertility Issues for Adolescents and Young Adults with Cancer

The effect of treatment on fertility is a special concern for young cancer patients.

It is important to talk with your doctor about how treatment may affect your fertility. Learn about all of your fertility preservation options and see a fertility specialist before starting treatment. Research has found that although discussions of fertility preservation between doctors and young adult cancer patients are becoming more common, improvements are still needed.

Organizations such as the Oncofertility Consortium and LIVESTRONG Fertility also provide fertility-related support and advice to young adults and health care professionals.

Coping and Support

Cancer can create a sense of isolation from friends and family, who may not understand what you are going through. As a young person, you may feel like you are losing your independence at a time when you were just starting to gain it. Perhaps you just began college, landed a job, or started a family. A desire for normalcy may keep you from sharing your experiences with friends. Learn about the unique ways that you can cope and find support: Emotional Support for Young People with Cancer.

After Treatment: Survivorship Care 

For many young people, the completion of treatment is something to celebrate. However, this time may also bring new challenges. You may worry that cancer will return or struggle to get used to new routines. Some young people enter this new phase feeling stronger, whereas others are more fragile. Most young people say the transition after treatment took longer and was more challenging than they anticipated. While most of the side effects that you had during treatment will go away, long-term side effects, such as fatigue, may take time to go away. Other side effects, called late effects, may not occur until months or even years after treatment.

Although follow-up care is important for all survivors, it is especially important for young adults. These check-ups can both reassure you and help to prevent and/or treat medical and psychological problems. Some young adults receive follow-up care at the hospital where they were treated, and others see specialists at late effect clinics. Talk with your health care team to learn what follow-up care you should receive and about possible places to receive it.

Two important documents to get written copies of, and to discuss with your doctor, include:

  • A treatment summary, with detailed records about your diagnosis and the type(s) of treatment you received.
  • A survivorship care plan or follow-up care plan, which addresses both physical and psychological follow-up care that you should receive after cancer treatment. The plan is usually different for each person, depending on the type of cancer and treatment received.

Studies have found that many young adult cancer survivors are often unaware of or underestimate their risk for late effects. Learn more about issues related to survivorship, and questions to ask your doctor, in our follow-up medical care section.

End-of-Life Care 

If the cancer you have cannot be cured, or continues to progress despite treatment, it may be called end-stage cancer or terminal cancer. Being told that treatment isn’t working and that you have end-stage cancer is exceptionally difficult to hear. Learn about issues that young people with end-stage cancer face. Get suggestions that can help you have conversations and make choices about end-of-life care and support: Young People Facing End-of-Life Care Decisions.

Organizations Serving AYAs

A growing number of organizations serve the needs of AYAs with cancer. Some organizations help young people cope or connect with peers who are going through the same things. Others address topics such as fertility and survivorship. You can also search a range of general emotional, practical, and financial support services in NCI’s list of Organizations That Offer Support Services. You are not alone.

Young Adults

Teens and Adolescents

Coping and Support

Fertility

Physical Activity and Outdoor Adventures

Survivorship

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