Cancer is diagnosed in more than 70,000 young adults (YAs) each year in the United States.1 The YA population (ages 20 to 39 years) continues to face unique challenges in the wake of a cancer diagnosis. These challenges result in a myriad of psychosocial needs that may be different from those of other populations within the oncology community. Young adults are widely believed to be less likely to develop cancer due to their age, which can lead to misdiagnoses and delays in starting treatment, with many having advanced stage or metastatic cancer at diagnosis.

Although the survival rate for young adults is not as high as in other age populations, many survivors are becoming outliers in research by outliving survival statistics. Higher survival rates have shed light on the complex psychosocial needs of this population.2 Oncology professionals’ awareness of these needs is imperative to provide specialized support for this population. This article is informed by research and personalized experiences of young adults with metastatic disease.

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But You Don’t Look Sick

One of the greatest challenges this patient population faces is the shifting parallel between being on active treatment but not fitting the visual stereotype of a cancer patient. Young adults navigating metastatic disease must come to terms with the idea that they may be on treatment indefinitely. In addition, due to the novel advancements in oncology care, many treatments do not cause the same physical side effects as standardized treatments of the past.

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Young adults commonly feel frustrated by people who lack compassion and understanding for their journey. Often, they must manage the expectations of loved ones who assume they are cured or no longer experiencing side effects or difficulties. Those with stable metastatic disease continue to work; thus, they must also manage disclosure in the workplace and how it may affect their career goals. Often, places of work have a difficult time understanding why a young adult might need time off for additional treatment when they “look great.”