Navigating cancer as a young adult: Common issues and how to manage them

A cancer diagnosis can be scary at any age, but navigating cancer as a young adult presents unique challenges. We spoke with Wendy Griffith, program manager for our Adolescent and Young Adult (AYA) Program, who shared tips to help young adult cancer patients manage common issues.

Your body may change. Here’s how to accept your body image.

Whether you’re facing hair loss, scars from surgery or weight loss, cancer treatment can cause changes to your appearance that may negatively affect your body image.

“I always tell patients that with or without cancer, everyone struggles with body image,” says Griffith. “If you’re sitting in a room with 30 other people, almost all of them are worried about something – what people think of their clothes, what their skin looks like or something else.”

Some young adults counter that with body-positive affirmations, such as ‘I love my body’ and ‘My body is amazing.’ But some don’t feel this mindset is realistic.

“Sometimes the starting point is just not hating your body,” says Griffith. “Maybe you don’t like how the scar on your face looks, but you’ve talked with your doctor and know there is nothing that can improve its appearance. A good starting point is just acknowledging that it’s there. Then it becomes about gradually redefining your concept of self with that scar. But know that you don’t have to love it yet.”

A misconception is that a person immediately goes from being anxious and disliking their body to being proud and confident and loving their body.

“It doesn’t really happen that way,” Griffith says. “It’s an incremental process, and often the initial step is surrounding yourself with content that is body-positive.”

You could start by following body-positive social media accounts.

“Maybe you don’t like how you look or how your body feels. What do you like about yourself though? Can you focus on that?” says Griffith. “Maybe it’s the color of your eyes. Accentuate that with accessories or makeup, so you can feel even just slightly better about yourself when you go out.”

It’s important to recognize that everyone is different, and that’s OK.

“You are more than just your looks,” says Griffith. “You are your intelligence, your sense of humor, your values and your friendliness.”

Friendships will change. Communicate and nourish them as much as possible.

Seeing pictures of your friends having fun together while you sit at home alone can sting.

You may ask, ‘Why wasn’t I invited? Do they not want to hang out with me anymore because I have cancer?’

Changes in friendships are a nuanced part of cancer treatment for many young adults. Not knowing why some friends become distant can be especially difficult.

“Expectations may be too high on both sides,” says Griffith. “It’s challenging because sometimes cancer makes it difficult for patients to be as carefree and present in their relationships as friends might be accustomed to.”

To be clear, it’s not intentional. Patients may find themselves fatigued all the time. Saying yes to an event and then not making it because you’re too sick or too tired is common. Phone calls and texts may go unanswered for days at a time. And when you do get around your friends, you may not feel like answering questions about how you’ve been or how you’re feeling.

“It’s normal to feel tired or not have the time or energy to engage like you used to,” says Griffith. “Communication is the key.”

So, what does that communication look like? Griffith suggests having a conversation about it.

If you start to notice that your friends aren’t inviting you to events, try reaching out and saying, ‘It really hurt my feelings when I saw those pictures of you all going out. How come you didn’t invite me?’ If they say they were worried you wouldn’t want to go or wouldn’t be able to go because of cancer, say to them, ‘Next time, ask me. I will always tell you if I’m too tired or if I can’t be in the sun or something else. Give me the option to accept or decline the invitation.’

“Pay attention to your friend’s behavior after that conversation,” says Griffith. “If a friend keeps excluding you, you’ve probably learned a valuable lesson about that friendship. If your friend does try to include you, then you know they care and are trying their best to maintain the friendship. Either way, you’ll start to learn who you can rely on and for what.”

It’s important to understand that neither party is at fault – your friends have valid needs too. Navigating friendships during cancer treatment can be tricky.

“There’s going to be a change in some friendships and a loss of others,” says Griffith. “Knowing all of your friendships may not survive can be a real heartache for patients. Be sure to nourish the relationships you care most about as much as you can.”    

Seek support to avoid feeling isolated.

Cancer patients can often feel isolated from friends and even family. But sometimes the desire to be around family and friends is no longer there, and patients seek isolation.

“It’s a protection mechanism,” says Griffith. “You think, ‘Wow. All of this is really hard, so I’m just going to pull back from everyone and focus on me.’”

This isn’t always a bad thing.

“Sometimes we need that introspection and time to ourselves,” Griffith says. “The struggle is everyone wants to pull you out of the dark place when, in reality, you don’t need them to. You just want them to sit with you in the darkness and hold space for you.”

Holding space, or being fully present for someone without judgment when they’re going through a rough time, is a skill that can be difficult for teenagers and young adults, who often don’t know how to hold space for friends.

“That’s why connecting with other people who understand can be really helpful,” says Griffith. “myCancerConnection, MD Anderson’s one-on-one cancer support community, is a great resource to connect with other patients.”

MD Anderson patients can also join support groups, and there’s even a private Facebook group for AYA cancer patients. The Facebook group, now 1,100 members strong, offers a space for patients to seek advice about starting treatment, get support from other patients or simply feel connected.

“Every now and then,” Griffith says, “I’ll see a comment from someone saying, ‘I’ve been a member of this group for a long time and never commented. But your story really touched me. Thank you for sharing your experience.’”

Connection can look different for every patient. Passive interaction, such as reading the comments in a Facebook group or watching someone’s stories on Instagram, can help patients feel like they’re not alone.

“For example, if you’re a young colorectal cancer patient with an ostomy bag, a 65-year-old who also has an ostomy bag may not be able to relate as much to the stress of finding a summer swimsuit that is both functional and flattering,” says Griffith. “You may want to connect with someone closer to your age who shares similar interests and experiences.”

That’s why Griffith urges patients to seek out as many support groups or social media groups that interest them.

“You’re never limited in how much you can dig in,” she says. “There are so many opportunities. Join some Facebook groups, go to some support group meetings, do some activities. If you find that they’re not for you, it’s always OK to leave and navigate to somewhere that you feel like you belong.”

Request an appointment at MD Anderson online or by calling 1-877-632-6789.