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患有癌症的青少年
癌症研究人員,倡導者和癌症倖存者介紹了青春期和年輕成人癌症的話題。
年輕人中的癌症類型
在美國,每年約有70,000年輕人(15至39歲)被診斷出患有癌症,占美國癌症診斷的5%。 這大約是0至14歲兒童被診斷出癌症的六倍。
與成年人或兒童相比,年輕人更有可能被診斷出患有某些癌症,例如霍奇金淋巴瘤,睾丸癌和肉瘤。 但是,特定癌症類型的發生率隨年齡而變化。 在15至24歲的人群中,白血病,淋巴瘤,睾丸癌和甲狀腺癌是最常見的癌症。 在25至39歲之間,乳腺癌和黑色素瘤最為常見。
有證據表明,青少年和年輕人中的某些癌症可能具有獨特的遺傳和生物學特徵。 研究人員正在努力學習更多有關年輕人癌症的生物學知識,以便他們可以鑑定出對這些癌症可能有效的分子靶向療法。
青少年和年輕人(AYAs)中最常見的癌症是:
- 生殖細胞腫瘤
- 顱外生殖細胞腫瘤 (童年)
- 肉瘤
Cancer is the leading cause of disease-related death in the AYA population. Among AYAs, only accidents, suicide, and homicide claimed more lives than cancer in 2011.
Finding a Doctor and Hospital
Because cancer in young adults is rare, it is important to find an oncologist who specializes in treating the type of cancer you have. Research is finding that for some types of cancer, young adults may have better outcomes if treated with pediatric, rather than adult, treatment regimens.
Young adults who have a cancer that typically occurs in children and adolescents, such as brain tumors, leukemia, osteosarcoma, and Ewing sarcoma, may be treated by a pediatric oncologist. These doctors are often affiliated with a hospital that is a member of the Children’s Oncology Group. However, young adults who have cancers that are more common in adults are often treated by a medical oncologist through hospitals that are affiliated with an NCI-Designated Cancer Center or a clinical research network such as NCTN or NCORP.
Learn more about finding a doctor and how to get a second opinion in Finding Health Care Services. A second opinion may be especially helpful when there are complicated medical decisions that need to be made, there are different treatment options to choose from, you have a rare cancer, or the first opinion on the treatment plan comes from a doctor who doesn’t specialize in or treat many young adults with the type of cancer that you have.
Treatment Choices
The type of treatment you receive is based on the type of cancer you have and how advanced the cancer is (its stage or grade). Factors such as your age, overall health, and personal preference are also important.
Your treatment options may include a clinical trial or standard medical care.
- Standard medical care (also called standard of care) is treatment that experts agree is appropriate and accepted for a specific disease. The A to Z List of Cancers has information about treatment for specific types of cancer. You can also learn about treatments such as chemotherapy, immunotherapy, radiation therapy, stem cell transplants, surgery, and targeted therapies in Types of Treatment.
- Clinical trials, also called clinical studies, are carefully controlled research studies that test new ways to treat diseases, such as cancer. Clinical trials are conducted in a series of steps, called phases. Each phase aims to answer specific medical questions. Once a new treatment has been shown to be safe and effective in clinical trials, it may become the standard of care. You can get answers to commonly asked questions about clinical trials and search for clinical trials for the type of cancer you have.
Fertility Preservation Options
It is important to talk with your doctor about how treatment may affect your fertility. Learn about all of your fertility preservation options and see a fertility specialist before starting treatment. Research has found that although discussions of fertility preservation between doctors and young adult cancer patientsExit Disclaimer are becoming more common, improvements are still needed.
Organizations such as MyOncofertility.org and LIVESTRONG Fertilityalso provide fertility-related support and advice to young adults and health care professionals.
Coping and Support
Cancer can create a sense of isolation from your friends and family, who may not understand what you are going through. As a young adult, you may feel like you are losing your independence at a time when you were just starting to gain it. Perhaps you just began college, landed a job, or started a family. A cancer diagnosis puts most people on a rollercoaster of emotions. Because cancer is relatively rare in young adults, you may encounter few patients your age. Moreover, treatment may require hospitalization far from home which can lead to emotional isolation. A desire for normalcy may keep you from sharing your cancer experience with your healthy peers, adding to a sense of isolation.
However, you are not alone. Cancer is treated by a team of experts who address not only the disease but also your emotional and psychological needs. Some hospitals offer comprehensive support programs. Support can come in many forms, including counseling, retreats sponsored by organizations that serve young adults with cancer, and support groups. This support can relieve feelings of isolation and help restore a sense of normalcy.
Young people with cancer say it’s especially helpful to connect with other young people who can offer insights based on their own experiences with cancer.
After Treatment
For many young people, the completion of treatment is something to celebrate. However, this time may also bring new challenges. You may worry that cancer will return or struggle to get used to new routines. Some young people enter this new phase feeling stronger, whereas others are more fragile. Most young people say the transition after treatment took longer and was more challenging than they anticipated. While most of the side effects that you had during treatment will go away, long-term side effects, such as fatigue, may take time to go away. Other side effects, called late effects, may not occur until months or even years after treatment.
Although follow-up care is important for all survivors, it is especially important for young adults. These check-ups can both reassure you and help to prevent and/or treat medical and psychological problems. Some young adults receive follow-up care at the hospital where they were treated, and others see specialists at late effect clinics. Talk with your health care team to learn what follow-up care you should receive and about possible places to receive it.
Two important documents to get written copies of, and to discuss with your doctor, include:
- A treatment summary, with detailed records about your diagnosis and the type(s) of treatment you received.
- A survivorship care plan or follow-up care plan, which addresses both physical and psychological follow-up care that you should receive after cancer treatment. The plan is usually different for each person, depending on the type of cancer and treatment received.
Studies have found that many young adult cancer survivors are often unaware of or underestimate their risk for late effects. Learn more about issues related to survivorship, and questions to ask your doctor, in our follow-up medical care section.
Organizations Serving AYAs
A growing number of organizations serve the needs of AYAs with cancer. Some organizations help young people cope or connect with peers who are going through the same things. Others address topics such as fertility and survivorship. You can also search a range of general emotional, practical, and financial support services in NCI’s list of Organizations That Offer Support Services. You are not alone.
Young Adults
Teens and Adolescents
Coping and Support
Fertility
Survivorship