How are cancers in young adults treated?
Older people are much more likely than younger people to get cancer, so most doctors who treat cancer see mainly older adults. (Doctors who treat cancer are called oncologists.) Some doctors (called pediatric oncologists) specialize in treating childhood cancers. Each type of doctor tends to work in an office or cancer center geared toward treating either older adults or children. There are very few doctors who focus specifically on young adults with cancer, so it’s not always clear which type of doctor (or treatment center) might be best. It often depends on the patient’s age and the type of cancer.
Cancers in young adults that are more common in children, such as acute lymphocytic leukemia (ALL), bone sarcomas, and rhabdomyosarcoma, are often best treated by (or at least with input from) pediatric oncologists, who have more experience with these types of cancers. On the other hand, young adults with “adult” cancers such as breast cancer, colorectal cancer, or melanoma are more likely to benefit from doctors who treat older adults and see these types of cancers more often.
Doctors tend to use more intense treatments when treating children with cancer than when treating adults. Children’s bodies are generally better able to recover from higher doses of chemotherapy than are adults’ bodies. And in general, childhood cancers often respond better to chemotherapy because they tend to be cancers that grow fast. (Most forms of chemotherapy affect cells that are growing quickly.)
For some cancers (especially “childhood” cancers like ALL and bone sarcomas), the more aggressive treatments used for children have been found to improve outcomes for young adults as well, but for other cancers the results are not as clear. Again, this can depend on the patient’s age and the type of cancer.
Types of cancer treatments
The main types of treatment for cancers in young adults are the same as those used in other age groups. The choice of treatment depends mainly on the type and stage (extent) of the cancer. Sometimes more than one type of treatment is used.
It’s important to discuss all of your treatment options as well as their possible side effects with your doctors to help make the decision that best fits your needs.
Surgery is a common treatment, especially for early stage cancers. The type and amount of surgery needed depends on the type and location of the cancer.
Young adults have some advantages when it comes to surgery in that they usually have fewer health problems than older adults, and there are fewer concerns about anesthesia than there are with children. (Anesthesia is the use of drugs or gases to put you into a deep sleep and not feel pain.)
For more information, see our document Understanding Cancer Surgery: A Guide for Patients and Families.
Radiation therapy is the use of high-energy rays (such as x-rays) or particles to kill cancer cells. Young adults are less likely to have major side effects from radiation than children because their bodies are no longer growing as quickly. But many parts of the body can still be affected by radiation. Radiation can cause some late or long-term side effects, which are discussed in the section “Late and long-term effects of cancer treatment in young adults.”
For more information, see the “Radiation Therapy” section of our website or our document Understanding Radiation Therapy: A Guide for Patients and Families.
Chemotherapy and other drugs
Chemotherapy (chemo) is the use of drugs to treat cancer. Some drugs can be swallowed in pill form, while others are injected by needle into a vein or muscle. Chemo is often used to treat cancers that have spread, but it can also be used for earlier stage cancers (usually along with other treatments).
Chemo drugs can cause side effects because they affect cells that are dividing quickly. Young adults can usually withstand higher doses of chemo than older adults, but these higher doses can also cause more short- and long-term side effects.
For more information, see the “Chemotherapy” section of our website or our document Understanding Chemotherapy: A Guide for Patients and Families.
For some types of cancer, newer targeted drugs can be used instead of or along with standard chemo drugs. These drugs work by attacking certain parts of cancer cells (or nearby cells) that help them grow. Targeted drugs sometimes work when standard chemo drugs don’t, and they have different (and often less severe) side effects.
For more information, see our document Targeted Therapy.
Some medicines work by helping the body’s own immune system attack the cancer cells. These treatments are called immunotherapies or biological therapies. They can be very helpful against some types of cancer, and they also tend to have different (and less severe) side effects than standard chemo drugs.
For more information, see our document Immunotherapy.
Stem cell transplant
A stem cell transplant, formerly called a bone marrow transplant, is a way for doctors to give very high doses of chemotherapy (sometimes along with radiation therapy). It’s an option for treating some cancers, usually if other treatments are not working.
Without a stem cell transplant, the doses of chemo drugs that can be given are limited because they could severely damage the bone marrow, which is where new blood cells are made. This could lead to life-threatening infections, bleeding, and other problems because of low blood cell counts.
When a stem cell transplant is done, blood-forming stem cells are first collected from the blood of either the patient or from a matched stem cell donor using a special machine. The stem cells are kept frozen while then the patient gets very high doses of chemo (and sometimes radiation) to kill the cancer cells. Afterwards, the stem cells are given into a vein much like a blood transfusion. They settle in the bone marrow and start making new blood cells over the next few weeks.
A stem cell transplant is a complex treatment that can cause life-threatening side effects. Stem cell transplants often require a lengthy hospital stay and cost a lot. It’s important to understand the possible benefits, risks, and costs of this procedure if it’s an option.
For more information, see our document Stem Cell Transplant (Peripheral Blood, Bone Marrow, and Cord Blood Transplants).
The cancer treatment team
You may have different types of doctors on your treatment team, depending on the type and stage of your cancer and your treatment options. These doctors might include:
- Cancer surgeons (sometimes called surgical oncologists): doctors who use surgery to treat cancer. Surgeons often specialize in treating a certain part of the body or a body system (such as the reproductive system or the gastrointestinal tract).
- Medical oncologists: doctors who use chemotherapy and other medicines to treat adults with cancer
- Pediatric oncologists: doctors who use medicines to treat cancers usually seen in children and teens
- Radiation oncologists: doctors who specialize in using radiation to treat cancer
- Nurse practitioners and physician assistants (PAs): nurses and other professionals who are specially trained and licensed to practice medicine alongside doctors
Many other specialists might be involved in your care as well, including nurses, rehabilitation and physical therapists, nutritionists, social workers, and other health professionals. They can provide help and guidance with many issues facing young adults and their families, such as treatment effects on fertility, education or employment needs, health insurance concerns, family planning, and financial issues.
Clinical trials are carefully controlled research studies that are done with patients who volunteer for them. They are used to learn more about promising new treatments or procedures.
Clinical trials are one way to get state-of-the art cancer treatment. Sometimes they may be the only way to get access to some newer treatments. They are also the only way for doctors to learn better ways to treat cancer. Still, they are not right for everyone.
Children’s cancer centers often conduct many clinical trials at any one time, and most children treated at these centers take part in a clinical trial as part of their treatment. This is one of the reasons why there has been great progress in treating many childhood cancers in recent decades.
Overall, adults are less likely to take part in clinical trials, and young adults tend to have the lowest enrollment rates of any age group. There are many reasons for this, including the many different cancer types and treatment settings, lack of knowledge about clinical trials (from both doctors and patients), patient/family reluctance to enter clinical trials, and financial issues. Unfortunately, many experts believe this low enrollment in clinical trials is one of the main reasons for the lack of progress in treating cancers in young adults.
If you would like to know more about clinical trials, start by asking your doctor if your clinic or hospital takes part in clinical trials. You can also call our clinical trials matching service for a list of studies that might be right for you. You can reach this service at 1-800-303-5691 or on our website at www.cancer.org/clinicaltrials. You can also get a list of current clinical trials by calling the National Cancer Institute’s Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) or by visiting the NCI clinical trials website at www.cancer.gov/clinicaltrials.
To learn more about clinical trials, see our document Clinical Trials: What You Need to Know.
Last Medical Review: 02/18/2014
Last Revised: 02/18/2014