Elsevier

Seminars in Oncology

Volume 36, Issue 3, June 2009, Pages 275-280
Seminars in Oncology

Impact of malignant disease on young adults
Psychosocial Issues and Quality of Life

https://doi.org/10.1053/j.seminoncol.2009.03.005Get rights and content

The age group 20 to 39 years includes survivors of childhood cancer and those diagnosed with and treated for cancer during young adult life. Much of what is known about the psychosocial consequences of cancer in this age range is based on work involving survivors of cancer in childhood. We argue that the impact of cancer in young adults is different from experiences during childhood. Key developmental tasks include negotiation of independence from the nuclear family, achievement of intimacy, and generativity (concern to establish and guide the next generation). All of these tasks can be challenged by cancer, and have led to concern about health-related quality of life. Given the diverse ways in which cancer can compromise young adults, there is a need for timely interventions. Attempts to improve knowledge, re-integrate into normal life and work, and promote self-care (eg, awareness of risks associated with smoking) are described.

Section snippets

Developmental Tasks and Challenges in Adolescent and Young Adult Cancer Patients and Survivors

According to Erikson,8 psychosocial development is characterized by eight age-related stages that span infancy to old age. Each stage is characterized by a specific crisis, or set of developmental issues, that must be resolved successfully if the individual is to proceed to the next stage of life. The fifth stage, identity versus role confusion, characterizes adolescence to early adulthood. The key developmental tasks of adolescence and young adult life include negotiation of independence from

Psychosocial Effects of Cancer in Young Adult Life

Against this background of developmental tasks that characterize young adult life, the experience of cancer poses a considerable threat. Chesler and Barbarin9 have described and organized these threats around five dimensions: intellectual, practical, interpersonal, emotional, and existential. The intellectual issues revolve around communication, dealing with information, and decision-making. Young people who have gained independence from their family may be confronted with highly complex

Definitions and Measurement of Quality of Life

The scientific study of quality of life is made complicated by the diverse ways in which the term is used in everyday language. To many people, quality of life is synonymous with happiness and relationships with family and friends. To others it is about material wealth. Beliefs about quality of life are dependent on the specific social, cultural, spiritual, and historical circumstances in which an individual lives. In the United States and Western Europe we take for granted running water, good

Psychosocial Interventions

Given that cancer affects so many aspects of people's lives, there is a need for psychosocial interventions across the disease trajectory. These interventions need to address the issues of specific concern to patients and their families, to have clear goals and systems of evaluation.

At diagnosis and during the early stages of treatment, there is a need for information of all kinds. This includes information about treatment protocols, as well as about how to integrate care into daily life.

Conclusions

We present a case that the psychosocial consequences of cancer have unique impacts on 20- to 39-year-olds, but current understanding is limited because inferences are made from work involving either children or older adults. Future work is dependent on development of age-appropriate HRQL measures. It is vital to initiate more basic research documenting the specific issues confronting the young adult age group. There is scope also to explore the value of psychosocial interventions generally,

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