“When I was diagnosed with cancer at 27, I was completely overwhelmed. I was forced on to a journey I never expected to take. From the first week, I was bombarded with advice and information from experts, friends, and people I did not even know. I wish I had had a tool that organized the resources that were available to me. There are vast resources available to help you through whatever parts of your cancer journey in which you need help.

Below you will find a brief overview of many common concerns of young adult cancer patients. More in-depth information can be found in the Iris App and from an Iris peer mentor like me.” - Madison

Finding out that you have cancer is never easy to accept. It can be particularly challenging if you are a young adult (YA). As a YA, it’s likely that your needs and expectations may differ from those who are diagnosed later in life. Here are some common questions asked by YAs diagnosed with cancer:

• How do I navigate the health care system and understand my health insurance?

• What if I need to take time off from college or from my job?

• Will my friends be able to support me?

• How do I approach dating with a cancer diagnosis?

• Will my plans to have my own children change?

• How can I talk to my children about my cancer and treatment?

• How do I cope with physical changes and body image issues?

• How will my plans for the future change?

Adjusting to a cancer diagnosis can take time, and requires compassion towards yourself and flexibility in your assumptions about how life “should” be.

Making Sense of the Unacceptable

It is natural to question how or why you have cancer. As a YA who may not have a history of illness or interaction with medical systems, it can be even more challenging to make sense of a cancer diagnosis.

• Know that it is to be expected to ask yourself “How can this be?” and “Why me?”

• Cancer is not your fault. There isn’t anything you did or didn’t do to cause a cancer diagnosis.

• You are not alone. There are others your age going through a similar experience. You may find it helpful to connect with other YAs who can relate to what you are going through and to receive and offer support. For organizations that can connect you to other YAs with cancer, click on this link.

Isolation

When you are going through cancer treatment as a YA, it is common to feel as though few people in your personal life can truly understand your experience.

• There may be changes in the ways you interact with friends and family, and it can take time to feel well supported.

• Treatment for cancer can require many trips to oncology centers or hospitals. It may be rare to see other young people being treated for cancer in your setting and this can feel isolating.

• Friends and family may not know what to say to you and sometimes their attempts at support can make you feel like no one understands how you really feel.

Grief/Loss

Young adulthood is often a time of personal growth and achieving life milestones such as establishing a career, exploring intimate relationships, or having children. When your plans get interrupted, it can feel incredibly disappointing and even disorienting. A delay in pursuing plans or a change in plans can lead to feelings of grief and loss.

You may also experience a sense of loss due to changes in independence: physically, emotionally, financially, or practically. The ways you can be independent can change frequently during and after a cancer diagnosis. These changes can lead to feelings of sadness and grief. Learning to ask for and accept support from others is a skill that may take practice. While it can feel vulnerable to ask for help, and it can also strengthen relationships to allow others to support you.

Here are a few tips for navigating losses related to cancer:

• Be kind to yourself and know that these feelings are normal. Consider offering yourself the same compassion you would toward a close friend.

• Consider different strategies for processing these emotions such as talking through your situation with a friend, writing in a journal, seeing a mental health therapist, or joining a support group.

• Be open to new ways of feeling close to others. Often relationships grow in ways you don’t expect.

Coping with Physical Changes

Cancer is often accompanied by temporary and permanent physical changes. For example, chemotherapy can lead to temporary hair loss. The changes to one's physical appearance can be challenging, especially for YAs.

When dealing with physical changes and body image issues during and after cancer treatment, feelings will come and go, but there are ways to help yourself adjust.

• Allow yourself to feel. You might not understand your emotions fully, and something that seems small in the context cancer care can have a bigger meaning. For example, hair isn’t “just hair.” For many people, hair is part of your identity and the trauma of losing it goes far beyond your appearance.

• Focus on speaking more gently to yourself. Ask yourself, “Would I say what I just said to myself to my best friend in this situation?”

• Determine what you can control. The changes you face from your cancer treatment may be out of your control, but you can choose how you cope with these situations.

Taking Time Away from School/Work

Given the demands of treatment, you may need to adjust your approach to school and work. Some people find it helpful to take time off from their job or from school to focus on their health, while others find it important to work or attend school during treatment. Your treatment team can help you understand the demands of your treatment and possible side effects. This understanding can help you to make decisions about what is right for you regarding work/school. Give yourself the ability to make changes to any decisions you make as you or your treatment team cannot always predict how a treatment will impact you as an individual.

• If you are in school, reach out for support. Colleges and universities have offices that support students with disabilities. Reach out to determine what accommodations and services might be needed.

• If you are working, contact your employer’s human resource department or supervisor to understand your leave and disability benefits. Additional work-related information can be found at this link.

• Be kind to yourself and be aware that there are many different paths to getting to where you want to be academically and professionally.

Dating and Cancer

You may wonder about the impact your cancer diagnosis will have on dating and intimate relationships. This is different for everyone.

Questions to think about include:

• “Am I ready to put myself out there?”

• “When is the right time to bring up my cancer history?”

• “How do I explain the physical changes of my body in a new relationship?”

There is no right or wrong way to date or approach a new relationship following a cancer diagnosis. Honor your feelings, values, and beliefs about who you are and what you want right now.

Some considerations for dating include:

• How are you coping with your cancer, and are you “available” for a relationship?

• What are you hoping to get out of dating right now?

• What do you think you might be willing to reveal about the physical and emotional impact of your cancer diagnosis?

You may not be able to immediately answer these or other questions you might have. You may want to start slowly by taking the time to think about how you are coping with your cancer diagnosis and how dating might fit into your life right now.

Fertility

Some cancer treatments impact fertility, and it is natural for YAs to be concerned about the side effects of their treatment on fertility. Have an open and honest conversation with your care team about your fertility concerns. For more information about the impact of cancer treatment on your fertility, check out this link.

Some YAs will have to make decisions about fertility preservation before starting cancer treatment. These can be very difficult decisions to make about your future at a time when you were not planning to make such a decision, don’t have a partner to share in the decision, or when you are under stress to begin cancer treatment. Other YAs will have to consider choices about birth control during treatment. For some YAs, future pregnancies may require the assistance of a reproductive specialist after treatment, and some individuals will navigate family planning with alternatives like adoption.

Emotions surrounding fertility changes and loss can be challenging. Although you may be happy for friends and family members who are having children, you may also feel jealous that their road to creating a family is “easy” and yours may be more difficult.

Young Adults with Children

The idea of parenting while also going through a cancer treatment can feel overwhelming. Depending on the age and maturity level of your child, you may be asking yourself:

• How do I tell my child I have cancer?

• How will my cancer alter their life?

• How will my child be affected by the changes in our family's routine due to my treatment?

For more information about how to approach parenting with cancer, check out this link.

A Final Thought

“The one thing I want to say to any young adult going through cancer is that I wholeheartedly recommend finding someone to talk to, whether that be a peer mentor or one of our Iris mental health therapists. Having access to mental health support during my own cancer journey contributed greatly to saving my life. Cancer is hard, but you are not alone. Give yourself grace in this time and try to be kind to yourself. You probably never anticipated being here, and it is okay if you are struggling.” - Madison, Iris Peer Mentor