A Q&A with Karen Fasciano, clinical psychologist at the Dana-Farber Cancer Institute, highlights the challenges and progress in treating the non-medical issues young adults with cancer face during and after treatment.
“Young adults have unique needs when coping with cancer,” says Karen Fasciano, clinical psychologist and director of the Dana-Farber Cancer Institute’s Young Adult Program in Boston. Her training and experience working in both the pediatric and young adult cancer settings bring a dual perspective to her work. “I can bring my clinical skills to each encounter but also the wisdom I have gained from each young person who has honestly shared their cancer journey.”
CURE asked Fasciano a few questions about her work with young adults, a group defined as those diagnosed with cancer between the ages of 18 and 39; however, the program evaluates anyone who identifies themselves as a “young adult” to see if it is a right fit for them.
CURE: What are some of the emotional and psychological issues you see in young adults diagnosed with cancer?
Fasciano: Young adults (YAs) often experience disruptions in many areas including: identity, self image, role in family and career and education. Young adulthood is a time when many YAs are exploring both independence and intimacy at the same time as they are trying to assert control over their future goals. Illness can expose young adults coping with cancer to a need for dependence on others, a sense of their own vulnerability, and a struggle with managing the many uncertainties that come along with treatment. YAs also face, many for the first time, the existential distress that comes with a life-threatening illness. Peers may not be struggling with the same issues, so YAs may feel isolated in the processing and sorting out of these complex issues. Life disruptions, for any of us, require recalibration which often comes with emotional distress: anxiety, grief over what has changed and fear.
CURE: Are there common issues that young adults with cancer face that they may not be expecting?
Fasciano: When diagnosed, most young adults assume that they will want to celebrate at the end of treatment. They don’t often expect that they will feel increased distress after cancer treatment is over. While this can be a difficult time for all cancer patients, young adults have some unique challenges. Transitions and changes during the young adult years are many and parts of the YA’s environment may have changed by the time treatment concludes (friends have graduated from college while they are returning to finish degrees; entry-level jobs that they were on leave from may not look the same a year or two later).