The Patient

A young adult with cancer experiences challenges unique to their age. Unlike their older counterparts, young adults may struggle to cope with the unexpected disruption of their life, and potentially, death, disease recurrence, or life-long adverse effects.2

Employment can also be a source of worry. The patient may not be fully settled in his or her career or may be physically unable to work while in treatment, and as a result, left with inadequate or no medical insurance. When in a dyadic relationship, patients worry not only about themselves but about their partners’ well-being as well. They have to become more reliant on their partners, which can be challenging for someone who has recently discovered their independence.2 Patients might also require intimate care from their partner; care that they could not have imagined needing until they were significantly older.

Feelings of guilt are experienced because patients know that their partner now has to fill the enormous role of caregiver. In an attempt to protect their partner from worrying, they might keep their fears and emotions to themselves.2 This can cause them to feel isolated and depressed. Physical changes due to treatment may cause body image issues, in turn, affecting a young couple’s intimacy. The patient will also have to cope with being the cause of a potential loss of the ability to reproduce and its effect on their relationship.

The Partner as a Caregiver

The partner in a relationship between young adults experiences a wide array of challenges as a caregiver. He or she may find themselves thinking, “This isn’t what I signed up for,” or “Will I be happy in a relationship if I am unable to have children of my own?”3 Although these types of automatic thoughts are normal, they can cause the caregiver to experience feelings of guilt, anxiety, and depression. Caregivers might feel overwhelmed by their newfound responsibilities of caring for their partners and find that there is little time for themselves and their own health.

Caregivers may have to put their own career on hold to ensure that they are present, physically and emotionally, for their partner. Caregiving can be especially overwhelming if their partner is in treatment for a long period of time or indefinitely. The caregiver may need to share their caregiving duties with their in-laws, which can be helpful but still challenging for a young adult couple starting their lives together. 

If the patient is given a terminal diagnosis, the partner will have to cope with the loss of a loved one before their lives together have truly begun.

Support

Knowledge of available support resources for both the patient and caregiver-partner in a YA relationship is essential. Couples and individual counseling are options for both members of the relationship to process emotions specific to either the patient or the partner. YA patient and caregiver support groups provide the opportunity to connect to others in similar situations.

Counseling services with licensed oncology social workers via the phone, in person, and online are available at CancerCare. Guidance on many YA-specific organizations that provide financial, emotional, career, education, and networking advice is available, as well as counseling on sexuality and family planning, which is so important to young adults.


Marlee Kiel is an oncology social worker with CancerCare. 


References

1. Paul S. Coping With Cancer as a Young Adult. New York, NY: CancerCare; 2012. https://www.cancercare.org/publications/164-coping_with_cancer_as_a_young_adult#!introduction. Accessed April 13, 2018.

2. Zebrack B, Isaacson S. Psychosocial care of adolescent and young adult patients with cancer and survivors. J Clin Oncol. 2012;30(11):1121-1126.

3. Bolte S. Young adults (20-39) with cancer. In: Christ G, Messner C, Behar L, eds. Handbook of Oncology Social Work: Psychosocial Care for People with Cancer. New York, NY: Oxford University Press; 2015:507-513.