Fact: Nobody is too young for cancer. Alarmingly, America is experiencing a rise in rates of cancer diagnosed in young people. While researchers work to understand Why More Young Adults are Getting Cancer, clinicians and the public—you!—can do something right now to help save lives: Use social media and day-to-day interactions to help banish from use the phrase “too young for cancer.”
Young patients’ warning signs and symptoms are too often attributed to conditions such as irritable bowel, fibrocystic breast disease, or anxiety.
Even when patients know of young people with cancer (e.g., Princess Kate), after being told definitively “You are too young for cancer” they may not push for further evaluation or a second opinion about their worrisome symptoms. Maybe they:
Have never been seriously ill and don’t know whether their symptoms are “worrisome.”
Don’t feel qualified to challenge an expert, so they discount their intuition that their symptoms need further evaluation.
Welcome the relief of not worrying about cancer, of avoiding tests and bills, and of continuing life uninterrupted by illness.
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Long delays in testing allow some patients’ disease to become advanced—and less curable—by the time they are diagnosed. That said, proceeding with diagnostic tests right away for all young patients is not the answer. For many young patients with mild symptoms, the health risks of cancer workups outweigh the benefits.
A healthy approach is to keep “cancer” in the list of possibilities. Instead of concluding, “too young for cancer,” clinicians and patients can:
Focus on a fact: For patients this age, the cause of symptoms like these is rarely cancer.
Acknowledge the possibility: Cancer can happen in young people.
Assess the individual patient’s risks of proceeding with testing and risks of delaying. If proceeding with testing now poses greater risk than delaying a diagnosis, plan to re-evaluate the patient in a few weeks—sooner if symptoms change or worsen.
This approach means that many patients who don’t have cancer will pay the price of living with “cancer” on the list of possibilities until either the symptoms resolve or testing rules out cancer—a small price to pay.
Memoir to be reviewed in my next columnj