There has been a growing recognition in recent years that young adults with cancer are a distinct demographic group with unique needs, issues, and challenges related to their age and developmental stage of life. Cancer at this time of life is unexpected, and young adults are generally unprepared to manage the experience of a life-threatening illness. As the authors point out, it may take all of their attention and capacity to master this steep learning curve and get through treatment. Then, upon entering the post-treatment phase, the enormity of what they have endured can suddenly hit home, and must be acknowledged and dealt with as they try to reorient and reintegrate themselves into the world of work, school, friends, and family. Indeed, for a young adult, the impact of cancer does not stop and may even become more overwhelming following the end of treatment.
Odo and Potter do an excellent job of cataloguing the many ways that cancer survival impacts a young adult's life, organizing them into three primary categories: physiological, emotional, and practical. The multiple issues in each area are outlined, with the most significant ones explored in more depth and brought to life through poignant personal statements and descriptions given by young adult survivors.
In discussing the physiological impact of young adult cancer survivorship—including fatigue, scarring, cognitive changes, loss of fertility, and sudden onset menopause, among others—the authors summarize the many potential concerns of this group with the phrase, “loss of healthy self.” Indeed, the challenge of addressing the needs of young adult cancer survivors could be framed as a search to help them redefine and regain the “healthy self” in all three primary areas—physiological, emotional, and practical—through the successful integration of their cancer experience into their post-treatment lives.
The authors also relate the emotional impact of surviving cancer to the disruption of natural developmental tasks of the young adult, such as establishing independence or solidifying a not-quite-stable identity. The loss of innocence and control, along with the specter of uncertainty and existential questioning, may lead to a heightened sense of vulnerability and isolation from family and friends who do not understand the survivor's altered worldview.
In terms of practical concerns, in addition to relatively straightforward challenges such as education, career, finances, legal rights, and insurance, Odo and Potter point out how the interruption of normal development gives rise to more complex challenges for the young adult survivor, such as public vs private disclosure and goal-setting.
This article is commendable in its detailing of the many ways that a cancer diagnosis can impact the life of a young adult survivor. However, the number and breadth of issues included only magnifies the lack of programs and resources offered by healthcare professionals to help the young adult cancer survivor. In fact, young adult survivors themselves have been the primary initiators of programs and services for their age group, including online and face-to-face peer support communities; scholarship programs; camps; retreats; and other organizations addressing specific diseases, issues, or lifestyle challenges.
The authors end on a hopeful note, pointing out that despite the many challenges, young adult survivorship also presents opportunities for growth and hope. In order for this hope to be fulfilled, the current knowledge base must inform the development of appropriate interventions and additional resources that will help young adult cancer survivors to integrate their cancer experience into their lives and regain that ever-elusive “healthy self.”