18, 22, 25 or 32 year olds are not meant to be cancer patients. This is the age for achieving dreams and fulfilling aspirations. But, there is increased number of cases being reported, where cancer has sucked a young life. Stories of losing young loved ones to the cancer battle are not unheard of. Cancer has always been associated with ageing. Think cancer and one’s mind is immediately flooded with the images of frail and aged faces. Not any more, the belief that the young and vibrant population of the world is safe against cancer has earned them the tag of ‘the lost tribe’. This very misconception has shelved the attention of the medical fraternity from these adolescents and young adults (AYAs, 15-39 years of age) cancer patients. Adolescents and young adults are still underrepresented in oncology studies conducted across the world especially in a developing country like India.
In a report published in India Today, “15 per cent patients are children and young adults in India, compared to the global average of 0.5 per cent.”
Another review of population-based cancer registries came up with disturbing figures for childhood cancer incidence. Age-adjusted (0-14 years) cancer incidence rates ranged from 18.6 per million to 159.6 per million for boys and 11.3 to 112.4 for girls. The highest incidence was observed for males (159.6) in Southern region of the country and the lowest in North-east in both boys (18.6) and girls (11.3). Leukaemia and lymphoma were the commonest malignancies in boys whereas Leukaemia and brain tumors were commonest in girls.
If the figures for childhood cancer are so alarming, shouldn’t we be worried for the adolescent‘s cancer incident?
Most of the young adult cancers are set off with smoking, obesity, inactive lifestyle, faulty eating habits, stress, pollutions and excessive liquor consumption along with a strong influence from an inherited DNA’s malfunctioning.
One cannot deny the fact that there has been an improvement in the statistics of cancer survival rates overall, barring the figures for the ‘lost tribes.‘ All is not well when it comes to AYA’s and cancer. Firstly, there is a dearth of cancer researches and studies on these AYA’s. Few other studies that have focused on this age group have found worrisome facts about the prevalence of cancer amongst AYA’s.
Although cancer is comparatively rarer to be diagnosed in young people, but when they are, it is usually the aggressive form of the disease. Hodgkin lymphoma, Leukaemia, melanoma, testicular cancer, thyroid cancer, sarcomas, germ cell tumours and central nervous system tumours are most likely to be diagnosed in young adults than any other age group. Most of these young adults fail to get a proper diagnosis of the disease. Low rates of early detection has a significant influence on the outcomes and success of the cancer treatment. The common symptoms of chronic fatigue, tiredness, weight loss, is attributed to their hectic lifestyle. Delayed diagnosis means delayed medical attention, treatment, weakened immune system and advanced stages of cancer.
Interestingly, the cancer in the adolescents and the young adults has a complicated biology and a more aggressive behavior. Even every cancer of the adults, median age of diagnoses of most cancer is comparatively much younger in the Indian patients compared to their western counterparts.
It is quite possible for a medical practitioner to overlook the typical symptoms of cancer initially. For a country like India, where a medical consultation for most of the cancer symptoms could be misunderstood or limited to a casual discussion with the medical person. A random dosage of antibiotics, analgesics and paracetamol would take care of these symptoms at the expense of further complications. Furthermore, the family of such patients fail to relate the symptoms to a dreaded disease like cancer. There is still a social stigma attached to cancer. For most people, cancer is a disease that happens to someone else. And then there is a mind-set where health comes at the bottom of the priority list.
Where does this leave a young cancer patient? It would be unfair to blame the medical fraternity for ignoring young cancer patients. There has been a collective effort to bring awareness about cancers especially for the young population of India. The government and the non-profit organizations are constantly striving to educate on cancer prevention and screening. Medical science has been successful in revolutionizing cancer treatment through precision oncology and immunotherapy. Scientists are determined to defeat this ruthless disease.
Still, a lot depends on screening and early detection of the disease. The nation cannot afford to let its vulnerable young population become an easy target to cancerous cells. There is an urgent need to educate the classes and the masses on the possibility of cancer affecting their loved ones. Besides, the medical community has to accept the young adults as cancer patients.
About Dr. Meenu Walia
Dr. Meenu Walia is the first DNB Medical Oncologist in India, She has more than 21 years of experience in this field and is currently Director Medical Oncology & Haematology, at Max Super Speciality Hospital in Patparganj, Delhi. She is a renowned name in the field of Oncology and has been spearheading investigations in various multi-national, multi-centric global clinical trials. She has been actively contributing and creating awareness to the field of cancer through various articles/publications in various national and international journals/magazines.
She is a Member of American Society of Clinical Oncologists (ASCO), European Society for Medical Oncology (ESMO), Union for International Cancer Control (UICC), Affiliated to Indian Medical Association (IMA), Association of Physician of India (API), Affiliated to Delhi Medical Council (DMC), API (Delhi State Chapter) and Indian Academy & Clinical Medicine (IACM). Some of the services provided by the doctor are for: Solid Cancer and Hematological Cancer etc.
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