Grief is a unique burden for young adults with advanced cancer, and it is a burden over and above performance status, according to a recent study.

Grief is characterized by yearning for what was lost, and its symptoms include disbelief, anger, emotional numbness, and lost sense of self. Grief is distinct from depression and anxiety. Cancer can interfere with the developmental tasks of young adulthood, such as pursuing advanced education, initiating careers, and developing romantic relationships and families. This study, published in Journal of Adolescent and Young Adult Oncology, sought to examine grief due to cancer-related losses in young adults with advanced cancer.

The study enrolled 53 young adults, age 20 to 40 years, with advanced cancer. The patients completed structured clinical interviews that included measures of grief due to cancer-related losses and life disruption due to cancer symptoms. The relationship between grief and life disruption was examined by regression analyses.

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Beyond the obvious physical challenges that cancer presents, this population is at risk for psychological and emotional suffering related to the many ways that advanced cancer and its treatment may interfere with their educational and career goals, early romantic relationships, parenting responsibilities, and financial and personal independence. Even those young adults who are physically functioning well may be suffering from grief and associated life disruption.

“Patients are grieving not only the effects of their cancer, but also for the life stages and transitions they would normally be experiencing as a young adult, and this article raises the importance of clinical interventions to help these patients cope with the grief associated with cancer-related losses and life disruption,” says Editor-in-Chief Leonard S. Sender, MD, University of California, Irvine and CHOC Children’s Hospital.

The researchers concluded that grief is problematic for young adults with advanced cancer, and these patients may benefit from clinical assessment of and interventions for grief. The research team stated that longitudinal designs with larger data sets are needed to confirm the burden of grief in young adults with advanced cancer.