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This is a difficult place to be: negotiating through the years between childhood and adulthood, wanting to simultaneously assert your evolving identity and fit in among your peers. Who thought cancer could even work its way into that troubled space? But it certainly can, and when it does the disease brings along many special considerations for the adolescent with cancer.
According to the National Cancer Institute (NCI), approximately 70,000 young people ages 15 to 39 years receive a diagnosis of cancer annually in the United States, comprising approximately 5% of all cancer diagnoses in the United States.1 The prevalence of different types of cancer varies by age among this population. For example, leukemia, lymphoma, testicular cancer (germ cell tumors), and thyroid cancer are most common among people 15 to 24 years old, and breast cancer and melanoma increasingly afflict young adults ages 25 to 39 years.1 Table 1 lists the most common types of cancer in children and young adults.
TABLE 1. Most Common Cancers in Children and Young Adults
| Bone |
| Brain and other CNS tumors |
| Breast |
| Cervical |
| Colorectal |
| Germ cell tumors |
| Extracranial germ cell tumor (childhood) |
| Extragonadal germ cell tumor |
| Leukemia |
| Liver |
| Lymphoma |
| Melanoma |
| Sarcomas |
| Soft tissue sarcoma |
| Uterine sarcoma |
| Testicular |
| Thyroid |
Even given the large number of adolescents and young adults who develop cancer, a malignancy is usually not the first thing a doctor thinks of when a patient of this age presents with symptoms. As a result, diagnoses and subsequent treatment may be delayed while physicians rule out more common and recognizable diseases. Patient care may suffer. Because these patients are neither children nor adults, even after the initiation of a treatment protocol, continuity of care might be lacking. Clinical trials are also a difficult area for patients in this age group. Even if they qualify for clinical trials based on research criteria, adolescent participants rarely meet the age criteria.
