We all hope that everyone in our family has a long healthy life, but sometimes health is put in jeopardy. Each year around 70,000 teens and young adults ages 15-35 are diagnosed with cancer. With the diagnosis of cancer, many people envision bald heads, the nausea associated with chemotherapy, and the threat of death. For teens facing the diagnosis, there are many other things that come to mind.

Adolescence is already a time of change. Teens are pulling away from family, spending more time with friends, experimenting in many different ways (relationships, sports, driving, sometimes drugs and alcohol), and really trying to figure out who they are as an individual. The diagnosis of cancer can threaten this normal development. With the diagnosis comes treatment. Treatment often involves chemotherapy and/or radiation that can involve hospitalization. If a teen is in the hospital, they aren’t in school. This means they aren’t going to classes, hanging out with friends, and learning to drive. All of this can lead to falling behind in course work, lost relationships with peers, and even poor self esteem and depression.

Cancer treatment itself isn’t easy either. Many people being treated end up having surgery to place more permanent intravenous lines for blood draws and to receive medications. With chemotherapy comes side effects. Not only can it lead to nausea and vomiting and hair loss, the therapy itself decreases immune system counts putting people at risk of life threatening infection. Some treatments can also lead to infertility. For teens, who are used to thinking about what outfit they’re going to wear in the morning, thinking about fertility and having a family one day is the last thing on their mind, yet having cancer forces them to think about adult decisions and concerns.

Though medical science has come a long way in the past 50 years, the diagnosis of cancer also forces teens to think about their own mortality. This is in direct conflict with the normal adolescent mindset of ‘I can do anything’ and ‘it won’t happen to me.’ I have witnessed teens accept their mortality well before anyone in their family is willing to consider it as well as teens who refuse to think about it. Either way, this also can be emotionally draining and stressful.

After diagnosis and treatment, teens and young adults enter into the new phase of being cancer survivors. This is a joyous time full of relief, but can also be tumultuous in the return to routine life. Cancer treatment can take months to years. Surviving might mean living with physical scars, but can also mean starting over with school, building friendships, and fitting back into their families in a role that is not the ‘sick child.’ This transition, while very happy, can also be a time of stress.

The Adolescent and Young Adult (AYA) Cancer Program at Seattle Children’s uses a multidisciplinary approach (with oncology, social work, palliative care, adolescent medicine and psychiatry) to help teens and young adults through the process of cancer diagnosis, treatment, and survival. AYA has a new video series from real teens who are living (or have lived) with a cancer diagnosis. If you want to learn more check out the Good Times and Bald Times to hear their perspectives and stories.