Coping with cancer as youngsters are becoming more vulnerable

On this World Cancer Day, let's take a look at the idea of people-centered approaches to cancer care that fully integrate each individual’s needs with compassion and empathy
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This year’s theme for World Cancer Day is ‘united by unique’. The concept centres around the fact that behind every cancer diagnosis lies a unique human story of grief, pain, anxieties, healing, resilience, and emotional and physical trauma. It stems from the idea that ultimately, it will take all of us to create a world where we see the person before the patient.

Coping with cancer can be an issue, be it for those with newly diagnosed cancer, or those finishing the treatment, or during surveillance and recurrence. Teenagers, youngsters and middle-aged adults, who could be sick due to genetic and lifestyle factors, all might find both symptoms and treatment-related physical issues intolerable.

Many of the childhood cancers are curable. A large number of cancers appearing in young adults also fall into the same category, if detected early.

However, the trauma of battling the disease is another major issue among youngsters. Just like cancer affects physical health, it can bring in a wide range of fluctuations in the mental framework and create turmoil daily, hourly or even minute-to-minute.

A new diagnosis may generate shock, fear, anger, sadness, embarrassment, loneliness, worries, stress, depression, guilt and loss of self-esteem.

Here, multipronged support is paramount. The role of preserving organs, fertility, beauty, and body image are all part of it. Feeling wanted in the family, by the spouse, among peers and at workplace boosts morale and enhances recovery.

When cancer treatment is optimum, survival is better. With cures being reported, youngsters need to be explained regarding the same at the time of diagnosis.

Stress and anxiety are observed at a higher rate among youngsters than adults, which need more aggressive solutions. Stress often works as a limiting factor for surgery, aggressive chemotherapy and radiation schedules. It negatively impacts healing, sleep, and stress hormones affecting the outcomes with symptoms like increased heartbeat, unexplained headaches, muscle pains, loss of appetite, lack of taste for food, and cramps. These will become dangerous even if cancer is at a curable stage.

Here various rehabilitations and being involved in social engagements, etc, become important. Music, yoga, and brisk walking, while on treatment, add to fast recovery as metabolism changes in a beneficial way.

An in-depth discussion on the subject with an experienced cancer surgeon is a prerequisite to avoid depression associated with a specific type of surgery.

Self-image, sex and love

Appearances and physical relations have great priority as we are dealing with people in fertile age groups, teens, youths or middle-aged persons.

Cancers affecting solid organs can interfere with body image. Breast cancer being the most common cancer among women, one can imagine the mental trauma of losing it in the prime of youth. Sometimes even before a child is born or settling in life. Oncoplasticsurgeries have revolutionised the current surgical results offering natural-looking breasts after surgery.

The impact will be similar in head and neck surgeries, thyroid surgeries and colorectal cancers. An experienced onco-surgeon with reconstructive surgery background could advise on the final outcomes in such situations.

Cancer can affect the sex life too. Spouses and partners play a great role in sexual rehabilitation. Changes in body image should not be the point of discussion during intimacy. Finding solutions for treatment-related sexual problems is a crucial factor in addressing teens and youths with cancer.

From fertility issues and libido to newer approaches in sex should be addressed by clinicians, trained nurses, sex therapists and psychologists as a team.

Emotional issues like anxiety, depression, stress, lack of self-esteem, etc can affect the sex life. Some are worried about pain during sex, while others about changes in private parts due to chemotherapy or radiation.

Issues like lack of erection after prostate cancer surgery, cancer of the penis or testes, or some women undergoing hysterectomies combined with oophorectomies as part of treatments may lose libido and develop pain during intercourse.

There are several medications, gels and remedies for the same to help in rehabilitation. Artificial or natural methods to bypass physical issues are also available today.

Open discussions will add intimacy among partners to have a healthy sex life as the road to recovery progresses, offering well-rounded well-being.

The author is the Head of Oncology Department at St Joseph Hospital, Manjummel

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