Blast Off

Being a young adult with cancer (AYA) places you on a different planet compared to everyone else. You are suddenly ejected from your life without warning. Your peers often perceive you as brave as you navigate your cancer journey and resilient because of your youth—”You’ve got this.” As if we have a choice.

Cancer patients struggle to be a part of everyday life during treatment and after recovery: “Houston, we have a problem.” Nothing feels straightforward anymore. Getting dressed, showering, and paying bills—tasks that once seemed simple—now become missions. You must prepare, break tasks into smaller steps, and sometimes ask for help. Imagine asking your mom to help you shower as an adult.

I blasted off at 31 and haven’t landed back on Earth yet. I circle and get close but never quite land. I never will; I have been launched into space indefinitely because my cancer doesn’t have a cure. Living with that is a challenge, a mission I didn’t sign up for. Humans tell me, “You are young; you can beat this,” or my favorite, “You are young; you have plenty of time ahead of you.” Age is just one factor in a prognosis. As an AYA, cancer comes in and trashes what you’re doing, boots you off the planet, and you must quickly learn an entirely new life. Baptism by fire. It’s not a slow process; forget having time to adjust to anything properly. You make life-and-death decisions instead of thinking about your career, going to college, planning your wedding, or starting a family.

As an AYA, certain expectations exist. For example, when treatment is finished, you will continue from where you left off. How is that a reasonable request? You are not the same person you were before cancer. You can’t always regain the experiences you missed or resume where you paused, as the world kept moving while yours suddenly stopped. While sick, you might have missed out on a college scholarship opportunity, or your priorities may have shifted; perhaps you now want to focus on traveling instead of pursuing a career. Experiencing a life-or-death situation as an AYA transforms your outlook and life trajectory. My GPS is constantly recalculating.

Being an AYA doesn’t make a cancer diagnosis easier; it comes with unique challenges. For instance, many AYAs must consider their fertility. Do they want to have a biological family? Can they afford to freeze and store eggs or sperm? AYAs face significant decisions about their future while balancing their immediate needs. Sometimes, we don’t even get a choice; the cancer is too advanced, and treatment must begin right away. Chemotherapy robbed me of my fertility; cancer cheated me out of ever being a ‘fit’ parent. Yes, I am alive, but not on my terms. However, I am still grateful. This alien wanted biological children. My youth has been spent as an experiment instead; I feel like a science project my oncologist signed up for. Take this drug, and let’s see what happens; let’s try this and see what occurs, rinse and repeat. Yes, aliens poke and prod, take samples, and collect boatloads of data.

AYAs make choices, sometimes without fully formed brains or the life experience of older adults. Stay with me for a minute. Our brains don’t stop developing until approximately 25 years old. The last part to develop is the frontal lobe, which oversees executive functioning, including decision-making. So, we are forced to make life-and-death decisions without all the needed equipment. That is a big ask and another unique challenge.

As AYAs, you share your story repeatedly. Because of your age, you often receive a specific look—a blend of pity, sympathy, and empathy—usually paired with a slight head tilt as you tell it. Everything I do is on display. Privacy is a joke because I find myself discussing everything from what I eat to when I poop to whether it hurts when I have sex. My peers manage to keep that information to themselves. This is a typical greeting to my oncologist: “Hi Dr. Blah, I’ve gained 3 pounds in water weight, my appetite is fine, I’m only throwing up in the evening, my poop is normal, my pee is normal, sleeping has been tough due to generalized bilateral pain, and my mood has been fluctuating since it’s winter and having cancer really sucks.” Yup, all in one breath. Dr. Blah eagerly writes everything down with a little smirk because we have had so many appointments; I know the drill.

As an AYA, I am a different life form from my peers and lead a divergent life. They can’t understand what I’m going through, and vice versa. I don’t know what juggling two kids and a career while staying sane is like. Then I think of AYAs who have kids and are then diagnosed with cancer. Parenthood is 24/7; you don’t get a break, even if you have cancer.

Right now, the people in my life are focused on their children, ensuring they remain happy and healthy. My offspring consists of three four-legged furry tyrants who constantly make demands, a species different from me. All I do is scoop poop, put food in dishes, and provide fresh water. I am not attending parent-teacher meetings, chaperoning field trips, or planning birthday parties. Instead, I am Googling whether this next round of medication will cause me to lose my hair or if this new symptom I’m experiencing is another illness or part of my leukemia. I am planning my funeral, covering the cost of my cremation, and meeting regularly with my death doula.

AYAs speak a different language: medical gobbledygook, and I’m fluent after 16 years. My life revolves around bowel movements, managing my pain, taking my medications on time, ensuring my blood counts are stable, and avoiding getting sicker. My milestones include having ‘good’ blood counts, pain-free days, and accomplishing tasks on my own. My most significant responsibility is to avoid germs—those nasty little pests. Germs don’t take a sick day (Dadjoke!). One cold can knock me out for weeks, while it lays up a peer for a much shorter time. A cold can lead to bronchitis, resulting in pneumonia, and the cycle continues while I struggle to keep up.

Don’t get me wrong; it’s not all doom and gloom. As I orbit Earth, I’m fortunate to have visitors on my ship and spend time with humans I love and cherish. On my good days, we enjoy activities that nourish my soul. Since blasting off and traveling through space, I’ve encountered many other aliens of similar species. These aliens are AYAs and are unique because they understand what it’s like to experience scan anxiety or to gag at the thought of another blood draw. We gather on other planets set up just for us in relaxing, welcoming, low-key, energizing, and uplifting environments—all wrapped up in one. Beautiful spaces and places I would have never known existed if it weren’t for the big C. These spaces fuel my rocket ship and help me keep going. I highly recommend checking them out. There are many organizations for AYAs; peruse Elephants and Tea’s website for a start. Whether you are on Earth, another planet, or an entirely different universe, remember we are all spinning out of control, trying to find our next landing point. Open your heart and mind; be a safe landing spot. Whether you identify as an AYA, an alien, a human, or all three, you are loved and wanted and not alone! May the force be with you.