Nurturing a Smooth Transition to Cancer Survivorship for Adolescents

Hearing the words “You have cancer,” no matter a person’s age, can trigger a variety of emotions: fear, anxiety, sadness, confusion, and more. In the United States, approximately 5000 to 6000 teens or adolescents (persons aged 15 to 19 years) will hear those words each year.¹

However, many teens will also hear, “You are cancer-free.” Many are surprised when the end of treatment brings on these same emotions. This can be difficult as the people in their lives move on when validation, support, and encouragement are crucial to their smooth transition to survivorship.

What Makes Teens Special?

Transitioning into survivorship as an adolescent can be challenging. The shift in their daily routines and structures often lead to feelings of isolation. From diagnosis through treatment, they had been going nonstop: attending regular treatment and follow-up appointments and keeping up with their medical team. They incorporated their cancer into their daily life.

The consistency of support from their medical team created a sense of safety. Once treatment is finished, they often feel abandoned, as their interactions with their medical team decrease.

While undergoing cancer treatment, teens may also receive support from peers and family members through visitations, interactions, and engagement in activities, but that attention changes once the patient enters survivorship and the physical signs of their cancer ease. This is consequential for populations at a higher risk of receiving insufficient psychosocial support.²

Navigating Uncertainty

Cancer is individualized and can look different for each adolescent. At diagnosis, the adolescent begins to identify themself as a cancer patient. As the patient shifts from treatment to survivorship, an identity crisis or a feeling of being lost is a common experience.³

An adolescent who has not had cancer may refer to “normal life” as attending school, parties with friends, or a sports event; whereas an adolescent with cancer may refer to “normal life” as being home-schooled, not engaging in sports due to treatment, and having to be isolated within the home environment. During survivorship, they try to feel a new kind of normal, one to which adapting quickly can be difficult.

Although survivorship can bring up feelings of joy and happiness, it can also trigger fear, insecurity, and isolation. Each new pain or ache holds the fear of relapse or recurrence. Self-awareness grows as support from the medical team decreases, and patients’ feelings are often heightened.  

As they get older, adolescents may have fears of infertility and other long-term adverse effects. They may feel isolated as peers and family members who once provided attention are not as involved in their day-to-day lives. Rather than having feelings of joy, they may be scared and feel insecure as they navigate their changing bodies and support systems.