For months, Chastity Wentworth experienced sharp, periodic pains near her right ribs. The 43-year-old suspected a stress ulcer or hemorrhoids like the ones she had when she was pregnant. But when the nausea set in and her appetite waned, she decided to give her doctor a call. Several blood tests and scans later, she received an unexpected diagnosis:stage 4 colon cancer.

The disease had taken root in her colon and spread to her liver, coating it in tumors. She would need to be onchemotherapyfor the rest of her life and she wasn’t a candidate for surgery, her oncologist told her. She likely only had a few years left with her two sons, who were 5 and 7 years old.

“My whole entire life, I’ve always wanted to be a mom. I wasn’t a mom until my mid-30s. Now I finally am and this happens to me—I’m going to die and my kids are going to have to live without me. That just wasn’t fair,” Wentworth said.

Wentworth’s desire to spend more time with her family buoyed her through months of intensive treatment. She eventually became eligible for surgery to clear her cancer.

How Colon Cancer Is Treated

“My boys are my world. I don’t know how things would have been if I didn’t have my boys. They kept me going.” Wentworth said. “Once I started my treatment, I stayed as optimistic as I could and super focused on just getting the chemo done and getting the surgery done. I had such a huge strong support system through it all. That really, really helped me.”

Wentworth is among a growingcohort of young adults who face diagnoses that are more commonly associated with late-in-life afflictions.

Those early-onset diagnoses are not only more frequent but also more aggressive—mortality rates have been steadily rising in young adults since 2012.

The trend isn’t limited to colorectal cancers. Cancers of thebreast, female reproductive system, and other parts of the gastrointestinal tract are becoming more common in young adults, too.

“Cancer at any age is challenging at a baseline. However, there really are some unique challenges for the younger population,” saidLaura Makaroff, DO, senior vice president of prevention and early detection at the American Cancer Society. “Older adolescents and young adults are at the stage of life where they may be just starting careers, in school, and starting young families—all of that is tremendously disrupted when you have cancer.”

Cancer Treatment Can Upend a Young Life

When Howard Brown was 23 years old, he took a trip to Ohio to receive his first big work promotion. He noticed a small red spot on his cheek but thought nothing of it. When that spot swelled to the size of a golf ball, he took his parents’ advice to see a doctor.

He was sent to Dana-Farber Cancer Institute in Boston and diagnosed with stage 4T-cell lymphoma, a rare type of non-Hodgkin lymphoma.

Brown, now 57, recalls how much he felt like an outlier in hospital waiting rooms. As a young adult, he felt too old for the pediatric section and too young to be lumped with the older adults.

“I’m signing away my life not knowing if I’m going to live or die, and all the paperwork they give you is for a scientist—it’s not for a kid to sign,” Brown said.

Brown received a bone marrow transplant (now called from his twin sister after several failed chemotherapy regimens. During treatment, he was stuck living in a sterile environment—a common cold could overwhelm his compromised immune system. He had to make do without the comradery of his friends and the joys of playing basketball.

“My life got really small. My life got very isolated,” Brown said. “When it’s isolated, there’s darkness. You can learn lessons from darkness, but you can’t stay there too long. I was hanging out with my mom and dad again, a lot.”

I Was Diagnosed With Breast Cancer Before Age 40

Fertility Preservation Should Be Part of the Conversation

Before Brown began any serious treatment, his doctor demonstrated the foresight to prevent a different kind of darkness later in life: the challenges ofinfertility. As a fresh college graduate, kids weren’t yet on Brown’s mind. But chemotherapy, radiation, and other cancer treatments can render sperm and eggs untenable. Brown’s doctor directed him to bank his sperm before he received his first round of chemotherapy.

Not everyone will lose their fertility during cancer treatment. It’smore likelythat women who are treated before the age of 35 or who can avoid radiation near the uterus and brain may remain fertile.

After he achieved remission, Brown moved west to California, where he restarted his career and met his wife. Through in vitro fertilization, Brown’s wife gave birth to their biological daughter, or their “miracle girl,” as Brown calls her.

Fertility preservation can be complicated for newly diagnosed young adults who may not yet be ready to have kids. It can cost thousands of dollars to bank and store one’s eggs or sperm, and insurance rarely covers the procedure, according to Makaroff.

“Sometimes the cancer that the adolescent or young adult is faced with is a more aggressive form of the disease, so having the time and ability to go through all the steps of fertility preservation can be complex and challenging for both males and females,” Makaroff said.

Fertility preservation is now a standard part of young adult cancer care. Still, the American Cancer Societyrecommendsthat young adults be prepared to broach that conversation in case the health provider doesn’t address fertility on their own.

Laura Makaroff, DOOlder adolescents and young adults are at the stage of life where they may be just starting careers, in school, and starting young families—all of that is tremendously disrupted when you have cancer.

Laura Makaroff, DO

Older adolescents and young adults are at the stage of life where they may be just starting careers, in school, and starting young families—all of that is tremendously disrupted when you have cancer.

For Wentworth, becoming a parent was no longer a concern, but remaining an active parent was a constant challenge.

“If I was 20 years older, they would be older and not need so much of my attention,” Wentworth said. “But with them being so young, they look for my attention. Not being able to do as much with them while I went through my treatments was really hard.”

Throughout treatment, Wentworth tried to overcome the persistent fatigue to spend quality time with her sons. She cheered on their sports teams and helped them through remote schooling during the COVID-19 pandemic. But for the two years when her treatments were most intensive, she said she spent most of her time at home sleeping and recovering.

All she and her husband could do was be honest. “Mama has cancer and I’m going to have a lot of appointments,” she told the boys from the moment she came home with a chemotherapy pump. She had a good team of doctors and would take medicines that would kill the cancer. She would fight hard to get rid of it.

Young Cancer Survivors Are at Higher Risk for Recurrence

Once someone has survived cancer, it’s more likely that they will be diagnosed with the same or a new type of cancer. Recurrent cancer is especially common in young adults compared to older adults and children, perhaps because of a genetic predisposition or due to the effects of chemotherapy and radiation early in life.

According to the American Cancer Society, there’s no good data on just how common recurrence is in young adults. But certain early-onset cancer types put people at a higher risk for recurrence. Those include non-Hodgkin’s lymphoma—Brown’s first cancer.

At age 50, a quarter century after beating cancer once, Brown went to get his first routine colonoscopy and discovered he had stage 3 colon cancer. His initial treatments failed, and the cancer progressed to metastatic stage 4.

Why Does Cancer Come Back?

After undergoing an aggressive combination surgery and heated chemotherapy treatment, Brown was declared to haveno evidence of diseasefor the second time. That treatment, however, left him with a tall stack of medical bills.

“I have to go get a job at age 57 because I burned through my entire savings. I burned through my entire 401k. With ageism in the market and with cancer—when you search me you find cancer—it’s very hard to get a job,” Brown said. “Hopefully, if I don’t get cancer again, I’ve got a good 10 or 15 productive years at least to work, and that’s what I have to do or else I’m going to be homeless.”

Young adults are more likely to experience financial toxicity than older adults, who have had more time to build up their savings and move into careers with good health insurance, according to Makaroff.

“Medical debt is the leading cause of bankruptcy in this country and that’s extra concerning for the younger population,” she said.

Could Medical Debt Be Forgiven Like Student Loan Debt?

Online Community Offers Spiritual Support and Resources

Both Brown and Wentworth are members of Colontown, an online support network for people with colorectal cancer. Across more than 130 Facebook groups, members share their stories, wisdom, and resources.

It was there that Wentworth learned about a surgeon at Mass General Hospital in Boston who could perform anALPPS surgery.The procedure would be aggressive and possibly deadly, the surgeon warned her, but it was perhaps her best chance of achieving remission. The surgery worked. After healing from a surgery complication and undergoing radiation, she was declared cancer-free.

“For people who have cancer, find that support group and find a team that you’re comfortable with. And get a second opinion,” Wentworth said. “Without having a community of people with the same cancer experiences, it can be hard to know who to go to for a second opinion or where to look.”

Where to Find Cancer ResourcesAmerican Cancer Society offers a mobile app calledACS CARES™that connects patients to educational resources, programs, and non-clinical support as they navigate cancer. The organization also runs a24-hour hotlinethat offers cancer information and guidance (1-800-227-2345).

Where to Find Cancer Resources

American Cancer Society offers a mobile app calledACS CARES™that connects patients to educational resources, programs, and non-clinical support as they navigate cancer. The organization also runs a24-hour hotlinethat offers cancer information and guidance (1-800-227-2345).

For other cancer survivors like Marshella Griffin-Larry, who had breast cancer, religion sustained her through treatment in addition to patient support networks.

“That’s one of the things that got me through—leaning into my faith and having a support system in family and friends,” Griffin-Larry said. “If I had not had my Christian faith, I really believe that I could have mentally gone down a very dark path and not kept the positivity that I had through the whole situation.”

Now, Griffin-Larry’s involved with efforts like American Cancer Society’s Cancer Screen Week to encourage early detection. Bolstering community around preventive health, she said, could help break down barriers for Black communities and other underserved groups in which it’s sometimes “taboo to go to the doctor.”

Life After Cancer

Griffin-Larry said that during cancer treatment, not being able to travel, work, or live life like she had once expected to cast “a dark shadow” over her life.

“Your whole life passes before you—all the plans that you had. Then you’re in your head like, ‘Why did I not just have kids in my 20s? Who cares if I wasn’t married? I should have just gone out and done it,’” Griffin-Larry said.

Howard BrownMy life got really small. My life got very isolated. When it’s isolated, there’s darkness. You can learn lessons from darkness, but you can’t stay there too long.

Howard Brown

My life got really small. My life got very isolated. When it’s isolated, there’s darkness. You can learn lessons from darkness, but you can’t stay there too long.

Griffin-Larry said she clung to an optimistic outlook on life and kept her family close. Now, she said she doesn’t make grand plans for her life, because something always comes up.

“Me and my husband, we don’t plan. We’re just so happy to wake up every day and breathe and to just be able to live life,” she said.

Griffin-Larry said her cancer experience has compelled her to take a leap and start writing her own music. Now she creates songs and music videos, some of which intend to uplift other people with cancer.

“Going through cancer made me push past the fear. It’s like, ‘If I can get through this, then I can do anything, so why am I why am I walking in fear and not doing the thing that I’m passionate about?’” she said. “When you go through something so hard, it makes it easy to see the good.”

2 Sources

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American Cancer Society.Cancer Facts & Figures 2024.

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