This section is designed specifically for teenage and young adult patients. Adolescence and young adulthood is a time of rapid change and development. As your body physically matures, you search for a new self-image and identity. Teenagers strive for independence as they learn how to function as adults. Because of all these changes and growth, many teenagers are unsure of themselves, their looks, and their abilities.
Facing these challenges is difficult for everyone. A diagnosis of cancer adds another huge challenge on top of the normal issues that you face.
How to Take Part in Your Treatment
As a young adult, you can take an active role in the treatment of your illness. There are lots of things you can do to better understand what is happening and to help your treatment be easier. Ask questions! Write down any questions you can think of so you can remember them when you get a chance to talk with the doctor, nurse, child life specialist, or social worker. It is their job to find answers to your questions. Here are some suggestions of things to ask:
- What kind of cancer do I have? How is it spelled?
- What part of the body does the cancer affect?
- Do you know anyone I could talk to who’s had this kind of cancer?
- What kind of treatment will I be having? How does the treatment work?
- If there will be side effects, what are they, how long will they last, and what can I do about them?
- How often will I need to have treatments?
- Can I keep going to school?
- Can I do all the things I usually do?
You may not be able to do all that you were used to doing before you were diagnosed with cancer. This may be because of the decreased ability of your body and the decreased energy from the treatments. It is a good idea to continue exercising and being active. You want to be able to strengthen your heart and lungs, stretch your muscles, and build endurance.
While there are many things you can do, if your platelet count is low, we encourage you to stay away from activities and sports that involve contact or high risk of injury such as roller blading, mountain biking, horseback riding, football, etc. Talk with your doctor or nurse if you have questions about when you can participate in these activities and sports.
- Stay involved with friends and family.
- Give yourself time to adjust to the changes in your life.
- Remain active (but be careful when your platelet count is low).
- Ask for physical help, emotional support, or additional information, if you need it.
- Remember to use a sunscreen with an SPF of 15 or greater when in the sun. Some chemotherapy drugs make your skin sensitive to the sunlight. Your skin will burn very easily when you take these medicines.
You are at the age when people often experiment with their body: new hair styles, different clothing styles, etc. Trying new fashions is great and may help you feel better. However, some fashions may put you at risk for serious infection or bleeding.
- Get a tattoo, get pierced, or shave anything without talking with your doctor.
- Drink alcohol or smoke cigarettes.
- Take drugs, herbs, or supplements of any kind without talking to your doctor first.
- Have unprotected sex.
Your friends may have some misconceptions about cancer. You may want to take the time to explain the basics of your cancer to them so they understand what is going on. Your social worker, child life specialist, or nurse can help you prepare information to present to your class at school. Knowledge makes a big difference!
These years are filled with many body changes as you go through puberty. Cancer treatment can have an impact on these changes. Puberty may be delayed for younger teens that are going through treatment. Teenage girls may see changes in their menses and may need to take medication to prevent heavy bleeding. Treatment may change your ability to have children in the future since cancer treatments affect the testes and ovaries. You should discuss these changes with your doctors. Then you can understand the risks and make good decisions about how to care for yourself during this time.
It is not a good idea to have unprotected sex while you are being treated for cancer for the following reasons:
- Having sexual intercourse can increase your chances of getting an infection during cancer treatment because your immune system will be compromised. Any infection will require additional treatment, it may delay your cancer treatment, and you may need to be hospitalized. •
- Sexually transmitted diseases (STDs) such as gonorrhea, syphilis and HIV, which causes AIDS, are infections that will also put you at great risk and require additional treatment.
- You could get pregnant, or your girlfriend might become pregnant. The drugs you receive might cause malformation of the baby. Please talk with your parents, social worker, doctor, nurse, or school counselor before beginning or continuing to be sexually active.
It is important that you don’t take illegal drugs during your treatment. Remember, you are receiving drugs (chemotherapy) already. Your kidneys and liver are working extra hard to process these drugs. Taking more drugs (including alcohol and cigarettes) will over-stress these organs and may cause damage. This organ damage may also make your treatments less effective. Another reason not to take illegal drugs is the risk for infection. Marijuana for example can cause fungal infections.
Will I Be Able to Have Children?
Many people are surviving childhood cancer and living to raise children of their own. However, much is still unknown about the types and extent of reproductive problems later in life. There is evidence that some cancer survivors suffer from fertility problems. The type and severity of sexual or reproductive problems later in life depends on several factors including: age when treated, sex, type of cancer, dosage of cancer treatments, and duration of therapy. Each cancer treatment can affect fertility in different ways. Rates of birth defects and other problems in the children of cancer survivors appear to be no different from the general population. As long-term studies are completed, more information will be available. Please talk with your provider for the latest update on the effect that your specific treatment plan may have on fertility and reproductive health. Below is some general information for fertility issues in males and females.
The overall effect of chemotherapy and radiation on male fertility is unpredictable. The quality and quantity of sperm production may be affected. Once treatment is completed, sperm production may return to previous levels. There is no way to predict when this will happen. Although sperm banking is an option, many males have abnormal sperm counts at the time of cancer diagnosis. Some chemotherapy can interfere with sperm production. For a minority of patients, the effect may last after therapy is completed.
Radiation affects fertility, depending on what area of the body is radiated and what dose of radiation is given. Although radiation is not often directed to the testes, radiation to the pelvis or lower abdominal area can have a similar effect as chemotherapy on sperm production.
If you have surgery on the reproductive system or in the lower pelvic region, you may have a physical interruption which can interfere with or eliminate sperm production.
As with males, surgery, chemotherapy, and radiation can all have an effect on future fertility. Certain types of chemotherapy have been shown to decrease fertility in females, but not always. In general, females are less likely to experience fertility problems than males.
Radiation or surgery that occurs in the region of the uterus and ovaries may result in interruption or removal of reproductive organs.
Are there risks related to menstruation?
Heavy bleeding during the menstrual cycle poses a risk for teenage girls during times when the platelet count is low. If your menstrual flow is prolonged or heavy, ask your doctor how to prevent too much bleeding. This may be done with the use of birth control pills to suppress menstruation. Tampons may injure the vagina during periods when blood counts are low, which could lead to infection. You should use sanitary napkins or pads when your counts are low.
What About Sexual Activity?
The diagnosis and treatment of cancer may not affect sexual development or interest in sexual activity. Sexual interest and activity should be assumed to be the same as in any healthy adolescent/young adult. In fact, facing the fear of an uncertain future, a teenager/young adult may act out sexually as a way to feel alive and independent. Even though it may feel uncomfortable or embarrassing to talk about sexual issues, there is added importance in discussing these issues. When counts are low, sexual intercourse may increase the risk of infection. These infections include sexually transmitted diseases.
Pregnancy during chemotherapy or radiation therapy will expose an unborn baby to medicines known to cause birth defects in developing fetuses. You should consider not participating in sexual intercourse. If you decide to participate in sexual intercourse, be sure to use a condom and wait until your blood counts are not low.
Will I Ever Feel Like Myself Again?
You will experience many changes during treatment. Your body will change: your hair may fall out, your face may become puffy and round, you may have a central line, etc. Give yourself time to adjust to these physical changes. It may not be easy at first, but you will get used to the changes and eventually your hair will grow back, your face won’t be puffy and you won’t need a central line anymore.
No matter how much you change on the outside, you will still be you on the inside. The qualities that other people like about you, like your sense of humor, your kindness, your courage, your loyalty as a friend, will still be there. These qualities will help you through treatment and you will meet new people and friends along the way. You may also find that you have strengths and qualities that you didn’t realize before this diagnosis.
It is safe to say that your life will never be the same because you now have cancer, but as you go through treatment you will learn and grow and become a stronger and better person.
Working With Your Parents
As you grow older, you are supposed to become more independent and less reliant on your parents. Because of your cancer treatment, you may feel like you are doing just the opposite and relying on your parents more. Your parents may take you to doctor appointments, remind you to take your medicine, worry about your activities, and continually ask how you are feeling. You may feel as if your parents are treating you like a kid and you have no control over what happens to you. This can make it difficult to get along with your parents.
Gaining independence and freedom is an important part of growing up, even if you have cancer. It may be difficult for your parents to allow you this freedom because of the worries and fears they have about you. You will need to work with your parents in order to help them understand your needs and allow you the independence that you need.
You may notice that when you do not feel well physically your emotions will also be affected. You may be happy one minute and crying the next. You may find that you snap at family members or friends when they try to help you and you not feel well. These are normal feelings, but you need to find ways to let your family and friends know when you need space without making them angry with you. When you are feeling good, find ways to build happy memories with your family and friends.