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Q
Too Young for Cancer?
My friend's 30-year-old son was just diagnosed with colon cancer. There's no family history and no clue why such a young man developed cancer. Do you have any insights that may be helpful?
A
Answer (Published 4/10/2007)

Unfortunately, cancer rates are increasing in people between the ages of 20 and 39. The other bad news is that the survival rate for this group – while significantly better than the rate among older people – hasn't improved substantially. According to the American Cancer Society, in 2006 there were 55,200 new cancer cases and 9,300 cancer deaths among younger adults, ages 15 to 39. On the brighter side, while the five-year survival rate hasn't risen, it's pretty good. Overall, 78.5 percent of cancer patients ages 20 to 39 remain alive five years after diagnosis, compared to 68 percent among adults between the ages of 40 and 69.

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The types of cancer that seem to be increasing in young people are colorectal, thyroid, and testicular. Cancer is now the fourth leading cause of death in this age range, behind accidents, suicides and homicides. We don't yet know why rates of the disease are rising in the young. Also unfortunate is the fact that cancers typically are diagnosed at more advanced stages in younger patients, for two reasons: (1) the disease is so uncommon in this age group that doctors don't expect to see it and, therefore, may miss it and (2) young people aren't screened for cancer as older people are. One of the reasons why survival rates in young cancer patients haven't improved much may be the fact that these patients rarely participate in clinical trials. A 2005 study from the M.D. Anderson Cancer Center in Houston found that the 15-45 year age group is one of the least studied and also the least likely to be treated at large health care institutions that offer clinical trials. Participation in cancer clinical trials has been shown to improve survival, the authors noted, adding that one of the benefits to patients is the increased knowledge of tumor biology that derives from these trials.

You might also be interested to know that young people consider connecting with other cancer patients of the same age more important than support from family and friends. This finding came from a study from the University of Southern California School of Social Work. Researchers surveyed young cancer patients, oncologists, psychologists, nurses and social workers for the study. For young people the burden of cancer can complicate other aspects of life – getting started in a career, marriage, starting a family, issues that they may feel most comfortable discussing with their peers. You might suggest that your friend's son investigate Internet sites for young people with cancer to connect with others in his age group who are living with the disease. Two that I recommend are: www.imtooyoungforthis.org and www.stepsforliving.org

Andrew Weil, M.D.
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