What to Know About Rising Rates of ‘Early-Onset’ Cancer > News > Yale Medicine

Nancy Borstelmann, PhD, MPH, LCSW, co-director of Yale’s Early-Onset Cancer Program, says that while a cancer diagnosis and treatment are challenging for most people, there are some heightened and unique concerns for someone in their 20s, 30s, or 40s.

One key example is family planning, since some cancers and treatments can create challenges with being able to become pregnant or produce sperm. “It depends on each person’s situation—for example, their age, type of cancer, and treatment plan. But patients may face a decision about freezing eggs or embryos, or whether to consider sperm banking,” Borstelmann says. “Reproductive concerns can add to the distress that cancer patients are already experiencing, and they are important issues for patients and their doctors to discuss. Additional challenges include worries about insurance coverage and the financial impact of taking steps related to family planning.”

Younger women may also be concerned that cancer treatment could pose a risk of early menopause. Chemotherapy may induce menopause, or, in some cases, hormonal treatments are part of a treatment plan specifically designed to produce an early menopause. Whatever the cause, Borstelmann notes, early menopause shortens a person’s fertility window and can have other effects on their overall physical and emotional well-being.

Body image is yet another concern. There are many aspects to body image, but, for some, a clearly visible issue to manage is hair loss, which can be a side effect of chemotherapy, Borstelmann says. “For some, it’s very distressing.”

Sexual function and sexual health issues are also common and can range from changes in bodily sensation (for example, for a woman who has had a mastectomy) to erectile dysfunction (for example, after prostate cancer treatment). Younger individuals diagnosed with any type of cancer, however, may struggle with the direct or indirect impact of cancer on their sexual health and how they feel about their bodies. Some describe a sense of loss and fear related to developing or sustaining intimate relationships.

What’s more, because cancer is happening at such young ages, even after treatment, there is the possibility that the cancer could come back, which is especially difficult for survivors who still have decades of life ahead of them. This is a particular concern for those with thyroid cancer, who face a risk of recurrence that is highest in the first five years after diagnosis and treatment, but persists throughout their lifetime, says Yale Medicine endocrine surgeon Courtney Gibson, MD, MS. “Since the life expectancy of young adults remains largely unchanged after a thyroid cancer diagnosis, the fact that recurrence can happen at any time is very unsettling,” she says. “However, we can provide reassurance that if it returns, we still have effective ways to treat it.”