Wednesday, April 1, 2009

Thirtysomething With Cancer

Remember the 90s television show Thirtysomething? If you do, you likely are thirtysomething yourself. It was a great show about a group of baby boomers who had lived through the counterculture 60s, and were trying to reconcile that past with their present as responsible adults and parents. I was in high school when it aired, and remember watching and thinking how old thirty seemed. Now, as I approach 40, my perspective has changed a bit.

I heard recently that most Millenials think that the term “grown-up” now applies to 30 and above. To them, it is not just high school and college that are reserved for being young and wild and making mistakes, but their early twenties as well. Adulthood keeps getting pushed further and further into the future by each succeeding generation. We are lucky to have the luxury to postpone adulthood according to our timeline. We haven’t had a great depression, world war or other calamity to force maturity upon us. That may be changing.

There is a challenge facing young adults today, though it isn’t visible and doesn’t get a lot of press. It is cancer. It is the leading cause of death among 15-39 year-olds, excluding homicide, suicide and non-intentional injury. Particularly women in this age group, have a higher likelihood to develop cancer as incidence rates for women are higher starting at age 20, and for those 35-39, cancer incidence among females is more than 80 percent higher than among males. Additionally, those 25-34 face an increased incidence rate of invasive cancer. (Albritton, Caliguiri & Anderson, 2006)

While five-year survival rates have improved significantly for both pediatric and geriatric cancer patients over the past 30 years, they have not for those in the AYA group (Adolescents and Young Adults). There are many factors that impact this, including: lack of regular health screenings and the highest uninsured rate of any age group, as well as delayed diagnosis because younger people feel invulnerable and ignore symptoms, and the fact that cancer is often not suspected for younger individuals by medical professionals.

Luckily, people are starting to pay attention. There are numerous groups now advocating for the AYA community (list at the end of this article), and even a National Young Adult Cancer Awareness Week (in it’s seventh year), April 5-11, 2009. “Consider Cancer” is this year’s call to action for Vital Options International and all the advocacy organization members of the LIVESTRONG™ Young Adult Alliance with an emphasis on encouraging young adults to talk to their doctors, know the warning signs of cancer, understand what types of cancer they may be at risk for, and learn about cancer screening and healthy life style choices.

I never thought it would happen to me, and while I thought I was young to be getting cancer at 36, I now know many, many others who were diagnosed at a much younger age, including one friend who had a complete hysterectomy for ovarian cancer at age 27.

Here are just a few things I recommend to insure a healthier future:

  • Don’t forego health insurance. That time between when you are no longer eligible for insurance under your parents (usually 23) and you finally begin to feel somewhat successful in your career can be a struggle financially. On their own for the first time, most young adults are busy navigating retirement contributions, leases, utilities, and new furniture. Health insurance can seem like a logical expense to cut out when you’re young and healthy. It’s not.
  • Listen to your body. That strange ache or swelling or weird dry patch of skin could be telling you something significant. Don’t ignore it! The longer you wait to get something checked out, the more likely it is to grow and spread if it does end up being cancer. Being in a new town without a regular doctor, lack of insurance and other “excuses” can prevent you from getting help right when you may need it most.
  • Consider disability insurance. If you can’t afford health insurance, disability insurance definitely seems like a needless extravagance, but you are far more likely to become permanently disabled than you are to die from an accident or chronic illness, and if you are insured before any of these problems pop up, then you can’t be denied later, and your rates are also likely to be much cheaper.
  • Eat Right. There is more an more evidence that chemicals in processed foods and pesticides can lead to health problems of all kinds. Fast food is so cheap and convenient that it is difficult to forego, especially in this economy, but the cost of eating it could be your health. Michael Pollan says in his book, In Defense of Food, that in the past sixty years, Americans have spent the same portion of their income on two line items – food and healthcare – but the amounts have flip-flopped. As processed food has become cheaper and cheaper, healthcare costs have skyrocketed. Better to spend money on high quality, healthy food than doctors and drugs.
  • Don’t Smoke or if you already do, quit. Most of the risk factors for cancer can be controlled by our lifestyles. Exercise, eating right, getting enough sleep and controlling stress are all key, but the best thing you can do to reduce your cancer risk is not to smoke or spend time around people who do.
  • Get Screened. There are age appropriate screenings that you need to pay attention to such as colonoscopy, mammogram, pap smears and prostrate exams, and others that are dependent upon risk factors. Be aware of recommendations and get screened. You can also do self-checks at home for potential skin cancers and breast abnormalities.
Some organizations advocating for and providing services to young adults with cancer:

I’m Too Young for This
Empowering young adults affected by cancer through a weekly online radio show called Stupid Cancer, a great website full of resources, and a network of social groups across the country.

Cancer Care
Professional counseling, facilitated peer support groups, creative workshops and financial assistance for young adults with cancer.

Cancer Climber
Offering experiential and motivational adventures and excursions such as extreme mountain climbing and summit tours.

First Descents
An innovative camp experience for young adults with cancer offering kayaking, extreme sports and professional athletics.

Fertile Hope
Provides reproductive health information, support and hope to cancer patients whose medical treatments present the risk of infertility.

Planet Cancer
Award-winning young adult-focused community offering survivor retreat programs, social networking, and online forums with real world advice and inspiring stories.

Rise Above It
Provides grants and scholarships to young adult survivors and care providers who face financial, emotional and spiritual challenges.

Young Survivor Coalition
An international network of breast cancer survivors and supporters dedicated to the concerns and issues that are unique to young women and breast cancer.

Works Cited

Albritton, Karen, M.D., Caligiuri, Michael, M.D., Anderson, Barry, M.D., Ph.D., Nichols, Cherie, M.B.A., Ulman, Doug; Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults with Cancer Report of the Adolescent and Young Adult Oncology Progress Review Group; August 2006; downloaded from