Facing Blood Cancer as a Young Adult
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As a hematologist-oncologist at Fox Chase Cancer Center Blood Cancer and Cellular Therapy Institute, I see a lot of patients with blood cancer, including many young adults. Many of my patients are in college, just starting their careers, developing independence, or forming relationships and/or growing their own families. A blood cancer diagnosis can impact all of these milestones and disrupt their young lives.
For most people in their late teens and 20s, a serious disease like blood cancer isn’t on their radar. That’s one reason why young people with blood cancer sometimes delay getting the help they need.
What is blood cancer?
Blood cancer is a type of cancer that can affect the blood cells, the bone marrow, or the lymphatic system. Although there are rarer forms of blood cancer, the three most common are:
- Leukemia, which starts in the bone marrow, where all blood cells are made, and affects the blood.
- Lymphoma, which starts in the white blood cells known as lymphocytes. These are part of your body’s immune system that helps protect you from infections. Most lymphomas are either Hodgkin or non-Hodgkin lymphomas.
- Myeloma, which starts in the bone marrow and affects plasma cells, which are another type of white blood cell.
Of these three types of blood cancer, leukemia and lymphoma are most likely to be diagnosed in young adults and teens. Young adults make up roughly 9% of all the blood cancer cases in the U.S.
Recognizing the early signs of blood cancer
Diagnosing blood cancer early can lead to more successful treatment outcomes. And yet, I’ve noticed that diagnoses of these cancers can sometimes be delayed because people don’t realize their symptoms could be cancer. They may mistake them for other common health issues — even routine illnesses like the flu. And young adults are often generally healthy, so they, their families, and providers may not even consider cancer at first.
The signs and symptoms of blood cancer can vary by type, but often include:
- Frequent infections. Blood Cancers can lead to fewer white blood cells, making it harder to fight infections. As a result, some people have repeated or persistent infections, flu-like symptoms, and fevers.
- Fatigue and shortness of breath. Blood cancer can cause anemia (low red blood cell count), which leads to symptoms such as tiredness, headaches, dizziness, and shortness of breath.
- Swollen lymph nodes are caused by white blood cells accumulating in the lymph glands. Common sites for these include the neck, armpit, or groin. Swollen lymph nodes can occur with routine illnesses, but swollen lymph nodes present for a few weeks are concerning.
- Night sweats. Some people sweat heavily at night, sometimes enough to soak their sheets or sleeping clothes.
- Unusual bruising, bleeding, or areas that resemble skin rashes. Bleeding can come from your nose or gums or be found in your urine or stool. Some people develop red or purple spots on their body related to blood vessels bleeding or leaking under the skin. These don’t go away when you press on them.
- Losing weight without trying to diet or exercise.
If you have any of these signs or symptoms, it doesn’t necessarily mean you have blood cancer. But I recommend that you see your doctor if you have any of these warning signs.
To diagnose the problem, your doctor might start by asking about your symptoms and medical history and performing a physical exam. You might need tests, such as complete blood counts, imaging tests, and possibly a bone marrow biopsy.
Treatment options for blood cancer
The good news about blood cancer is that more and more people are surviving and staying disease-free longer. That’s due, in part, to advances in treatment and the specialized care available at comprehensive cancer centers like Fox Chase. Through the Blood Cancer and Cellular Therapy Institute, patients have access to blood cancer specialists, advanced treatments, cellular therapies, stem cell transplantation and clinical trials, all through one integrated program.
I tell my patients that the right treatment depends on the type and stage of blood cancer, as well as other factors. For example, some of the approaches we may use are:
- Chemotherapy (drugs that kill cancer cells)
- Targeted therapies (drugs that target vulnerabilities in cancer cells, including gene mutations)
- Immunotherapy (treatments that help your immune system fight cancer)
- Stem cell transplants (using healthy stem cells from your body or a donor to help your body make healthy new cells)
Navigating a blood cancer journey when you’re young
As a doctor who treats many younger patients who have blood cancer, I know that they often have other concerns beyond diagnosis and treatment. At Fox Chase, my colleagues and I work also work to address:
Concerns about family planning. Some blood cancer treatments can affect fertility and make it harder to have children. I recommend talking to your cancer team about any concerns you have before you start treatment. You’ll want to learn, among other things, whether your specific treatments may affect your fertility and what options are available (such as embryo or egg freezing) to preserve your ability to have children.
School and work. Some of my patients are able to keep going to classes or work during treatment, while others cannot. I always encourage my patients to talk with their care team about what to expect throughout treatment, so they can make the decision that’s right for them. If my patient is interested in continuing school or work during treatment and I believe it is safe to, I encourage them to do so.
Keep in mind that a medical leave of absence from college is sometimes an option worth discussing with school staff. When you return to work after treatment, you can talk to your employer about any accommodations you might need.
Mental health. I also make a point of reminding my patients to pay close attention to their mental health and speak up if they feel like they’re struggling. Mental health struggles can be more common for young adults dealing with blood cancer. The pressures of managing a serious illness while navigating early adulthood and planning their future can take a toll.
Putting major life plans on hold, trying to date or start new relationships while dealing with cancer, parenting a young child during your cancer treatments, or struggling with body image concerns after hair loss or other body changes are just some of the things that can affect your mental well-being and can impact your sexual health.
Supporting young adults with cancer
Because these challenges can be difficult and often overwhelming, I point my patients to Fox Chase’s Young Adult Cancer Program. It’s designed to support young adults as they navigate any kind of cancer. The program addresses the challenges young adults face beyond their medical treatment, including work, school, fertility, sexual health, and financial concerns.
The program offers a growing variety of services, including:
- Virtual support groups
- Mental health counseling
- Information about fertility preservation options
- Guidance and support for families of young patients with cancer
It also provides access to Fox Chase resources, such as financial guidance, our Survivorship Program, and clinical trials.
Fox Chase has an experienced team of hematologic cancer doctors, nurses, and support staff to help if you or a loved one is diagnosed with blood cancer. Our Hematologic Cancer Program offers the latest therapies for patients with blood cancers, as well as access to clinical trials and treatments they may not have access to elsewhere.
To schedule a consultation with a blood cancer specialist at Fox Chase Blood Cancer and Cellular Therapy Institute, call 888-369-2427 or request an appointment online.
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