Five tools to help young adults cope with cancer

Despite the real mental and physical toll of developing cancer at younger ages, many patients find clarity through the process, experts say. Some patients say they are no longer going to work 60 hours a week. Some become more adept at setting boundaries. Some are inspired to take better care of their health.

“Patients in this age range are actually incredibly resilient,” said Duke University psychologist Caroline Dorfman, PhD. “When given the right tools and attention and the permission to not be OK, they actually do really well.” Here are some of those tools.

[Related: As patients develop cancer at younger ages, psycho-oncologists are studying the mental health impact]

Like most younger cancer patients, Ola Abdelhadi, PhD, a researcher at the University of California, Berkeley, felt isolated after her Hodgkin lymphoma diagnosis at 19. “I often found myself too tired and exhausted from treatment to go out with friends,” she said. “Frequent hospital visits and a lack of understanding from friends who had not faced similar health challenges compounded this isolation.”

But connecting with other cancer patients or survivors in the same life phase can ease a sense of isolation. The Dana-Farber Cancer Institute’s Young Adult Program in Boston, for one, offers programming for cancer patients ages 18 to early 40s, ranging from the educational (like sessions on how to advocate for oneself) to the purely fun (like Red Sox outings and book clubs). The program recently opened a lounge for this age group.

“The program provides many different ways for our young adults to connect, realizing that peer connection is critically important for them,” said Cristina Pozo-Kaderman, PhD, a senior psychologist at the institute.

While cognitive behavioral therapy (CBT) is often a front-line treatment to address emotional distress and mood and anxiety disorders in adult cancer patients and survivors, it’s typically not designed to consider the specific context of younger patients’ lives. It can also be less accessible to younger patients if, for instance, sessions are during the workday.

To address that gap, Dorfman and colleagues are testing a group-based interventionopens in new window, delivered via videoconferencing, that draws on CBT and other approaches and is catered to the specific needs of young adult cancer survivors. While the project is ongoing, Abdelhadi says tailored interventions like it work.

“CBT that focuses on the unique concerns of young adults, such as body image issues, independence, and life planning, can be highly effective,” she said. “This therapy helps patients develop healthy coping strategies and manage distressing thoughts and emotions.”

Research shows that younger cancer patients experience fear of recurrenceopens in new window more often than patients over 40 years old. This could be related to the fact that younger patients have more time for the cancer to recur and more future life milestones that those potential recurrences threaten to disrupt.

For this and other concerns, acceptance and commitment therapyopens in new window is a promising intervention that aims to help people accept reality (for example, that recurrence is possible) while living mindfully and in line with their values.

“The focus is not on getting rid of the stress; the focus is on how to live your life, realizing that it’s going to be a part of your life,” Pozo-Kaderman said. “How can you still stay focused on your values and living a value-guided life?”

At the University of California, Los Angeles, psychologist Julienne Bower, PhD, and colleagues have been testing the effectiveness of mindfulness-based interventions on breast cancer survivors younger than 50. They’re finding that these programs, like a 6-week mindfulness group course that helps participants manage physical and emotional discomfort, might not only improve stress, depression, and other symptoms but also lead to positive changes in the immune system and overall well-being.

“We asked, can we reduce stress, reduce inflammation—which we think may be influenced by this intervention and we know could be relevant for cancer outcomes—and can we dial up positive psychological experiences, feelings of meaning and peace in life, feelings of positive affect?” she said. “Because it’s not all about stress reduction; it’s also about enhancing people’s positive experiences in the world.” So far, it seems like the answer is yes.

Meaning-centered psychotherapyopens in new window, developed by psychiatrist William Breitbard, MD, at the Memorial Sloan Kettering Cancer Center, which aims to enhance patients’ sense of meaning and purpose, has been shown to effectively reduce psychological and spiritual distressopens in new window among adult cancer patients.

There is reason to believe variations of it work well among younger adults with cancer, too. In one study in the Journal of Adolescent and Young Adult Oncology, cancer patients and survivors between ages 17 and 36 went through a 10-week program that prompted them to post photos on social media and answer related questions like “How has cancer changed who I am?” The researchers found participants had significantly lower depressive symptoms and a significantly better quality of life both at the end of the 10 weeks and 2 months later (Pailler, M. E., et al., Journal of Adolescent and Young Adult Oncology, Vol. 9, No. 4, 2020opens in new window).