When a large pro­por­tion of our patients are older, we get to know the needs of their age group.

This past week, it seemed like I saw a pre­pon­der­ance of young peo­ple in our clinic, although maybe it was a ran­dom event that their appoint­ments hap­pened to fall on the days I worked.

Peo­ple in their 20s are try­ing to be inde­pen­dent and are still fig­ur­ing out who they are. They want to be with their friends, break­ing away from their par­ents, and mak­ing their own decisions.

When they get sick, all of that comes to a halt, espe­cially with a pro­longed course of treat­ment. They need their par­ents again and might need to move back home. They can’t be as phys­i­cally and socially active as their friends, and they’re hav­ing to deal with a whole new world of infor­ma­tion and con­cerns peo­ple their age rarely think about. They might, or might not, have the matu­rity to han­dle the impli­ca­tions of their dis­ease. Some of them may already be over­whelmed with respon­si­bil­i­ties that they are not fully able to han­dle, like par­ent­ing. Some are recently mar­ried and adjust­ing to life as a cou­ple when the diag­no­sis comes.

Depend­ing on how healthy their rela­tion­ship with their fam­i­lies of ori­gin, many other stres­sors come into the pic­ture. Some­times patients cope bet­ter than their par­ents do. Often their par­ents are young too, not even old enough to be think­ing about health con­cerns related to aging for themselves.

Young peo­ple still need guid­ance, even though they can be in var­i­ous stages of matu­rity. Some don’t have a strong parental pres­ence in their lives, or they haven’t been around peo­ple who are mature adults who pro­vide the sup­port they need. When diag­nosed with can­cer, they can expe­ri­ence a col­li­sion of two worlds: their illu­sion of immor­tal­ity crashes head-​​on with mor­tal­ity. They need extra coach­ing and teach­ing to adjust their way of thinking.

The con­cerns I hear include how to deal with child care dur­ing treat­ment or hos­pi­tal­iza­tion, and they need guid­ance on pre­vent­ing expo­sure to sick chil­dren when the kids bring colds home from day care. Or they don’t fully under­stand what low platelet counts have to do with the fact that they can’t go hik­ing or ice skat­ing with their friends this week­end. “I’ll be okay, nothing’s going to hap­pen to me out there.” When a young cou­ple asks about pre­cau­tions dur­ing chemo for sex­ual activ­ity, I com­mend them for ask­ing the ques­tions. I was pleased to hear that the physi­cian talked to them about sex, too.

In a small com­mu­nity, sup­port net­works might not be avail­able specif­i­cally for peo­ple in their 20s fac­ing can­cer. The con­cerns of older adults are very dif­fer­ent, and young peo­ple can feel awk­ward among peo­ple the same age as their par­ents or grand­par­ents in a sup­port group.

Being young and basi­cally healthy can be an asset, but the bur­den of stress is no less for 20-​​somethings. We need to make sure we are pro­vid­ing infor­ma­tion to help them, that is age-​​group appropriate.