Researchers say there is 'lack of
appreciation' in health community for challenges young cancer patients face in
getting proper support
From Friday's Globe and Mail, April 17, 2009
The number of teenagers and young adults developing cancer is on the rise,
and they face tough challenges getting proper diagnosis and treatment, according
to a new report.
There are often delays in diagnosis - largely because doctors rarely consider
that young adults could have cancer, the report says. Young people often don't
feel comfortable in support groups designed for older adults, and often deal
with devastating side effects of treatment such as infertility and substantially
higher odds of cancer later in life.
"Young people need support from diagnosis to cure and beyond," said Ronald
Barr, a professor of pediatrics at McMaster University in Hamilton, and chair of
the adolescents and young adults committee at the Canadian Cancer
Society.
The society's report - Cancer Statistics 2009 - says about 2,075 young people
aged 15 to 29 will be diagnosed with cancer this year. About 325 cancer deaths
are expected in this age group, which represents 1.5 per cent of total cancer
deaths.
But the relatively small number of deaths doesn't reflect the huge impact the
disease has on the young patients, their families and society, said Loraine
Marrett, a senior scientist at Cancer Care Ontario and chair of the statistics
steering committee at the cancer society. There is a "lack of appreciation" for
the patterns of cancer in young people, she said, "and for the challenges they
face fighting a deadly disease at a time when they should be studying, building
careers and starting families."
Sommer Ellis was fresh out of high school and looking forward to her first
day at the University of Western Ontario when she was diagnosed with cancer in
2004. It was only because her mother tends to worry that she went to the doctor
complaining of swollen glands, she said.
"I didn't think cancer was even a possibility for me because I was so young,"
said Ms. Ellis, now 24. "Then the oncologist came in smiling with a bounce in
her step and said, 'I have great news. You have Hodgkin's lymphoma.' I thought
that was an oxymoron, but she explained that Hodgkin's was one of the best
cancer diagnoses to have."
The hours of difficult, sickening chemotherapy began right away, yet Ms.
Ellis resolved to go ahead with her studies, signing up for a full course load.
She arrived at Western that September wearing a blond wig to hide her baldness.
Every Friday morning she went to her biology lab, and every Friday afternoon to
the cancer ward for more treatment. While her friends spent weekends recovering
from long nights of drinking and dancing, she tried to recover from the
chemicals being fed to her intravenously.
"It was life-altering, that whole year. It defined who I am," she said. "But
I wanted to lead a normal life and refused to let it take over."
Ms. Ellis survived and went on to become an active volunteer with cancer
charities. She now works in public relations in Toronto.
Shawn Sajkowski was 25 and had just landed a high-tech job when he was
diagnosed with non-Hodgkin's lymphoma, the most common cancer diagnosis in young
people.
Over the next six years, Mr. Sajkowski suffered through three relapses, 19
rounds of chemotherapy and an arduous stem-cell transplant. He missed 20 months
of work, and his long-term relationship collapsed under the
strain.
"I felt cheated," he said.
Lymphomas are one of the most commonly diagnosed types of cancer in young
people, the report says. Among young women, thyroid cancer is the most
frequently diagnosed, while among young men it is testicular cancer. However,
leukemia accounts for the most cancer deaths in this age group, regardless of
gender.
The overall incidence of cancer among young people has risen slowly but
steadily over the past decade. That is due, in part, to better detection, but
scientists simply do not know why testicular and thyroid cancer rates are
climbing, said Heather Logan, senior director of cancer control policy at the
Canadian Cancer Society.
The silver lining is that the death rate has declined: The five-year survival
rate for young adults is 85 per cent, better than the rate for children (82 per
cent) and older adults (62 per cent). Ms. Logan said young people need to be
more aware of their bodies and take cancer prevention seriously. In particular,
young men should be conscious of changes in their testicles that could be
indicative of cancer, and young women should get regular Pap tests, consider
getting the HPV vaccine and be aware of lumps in their breasts.
More generally, young people should make lifestyle choices to reduce their
future cancer risk, including avoiding overexposure to the sun and tanning beds,
not smoking, drinking alcohol in moderation, eating a healthy diet, being
active, maintaining a healthy body weight and not engaging in risky sexual
activity, she said.
An estimated 171,000 new cases of cancer will be diagnosed in Canada in 2009
- about one every three minutes, the report says. (This total excludes 75,100
non-melanoma skin cancers.) About 75,300 deaths from cancer are expected to
occur this year - one every seven minutes.
The incidence of cancer is stable in men and up slightly in women, while the
mortality rate is falling for both genders, Ms. Logan said.
The most common cancers are prostate in men (25,500 new cases in 2009) and
breast cancer (22,700 cases in women and 180 in men). The biggest cancer killer
is, by far, lung cancer, which will cause an estimated 20,500 deaths this year,
followed by colorectal cancer at 9,100 deaths.
