SIDEBAR: Don’t Expect Questions: Be Proactive with Younger Patients

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It is unrealistic to expect adolescents and young adults with cancer to initiate questions about disease-related or or treatment-related issues that are troubling them, according to Bradley Zebrack, PhD, MSW, MPH, Associate Professor of Social Work at the University of Michigan, Ann Arbor. Oncologists need to repeatedly ask their adolescent and young adult patients how they are coping with cancer, pain, treatment-related side effects, and emotional and sexual issues.

If cancer or its treatment may impact a patient’s ability to have children in the future, the oncologist should not only proactively raise the issue, but also discuss specific fertility preservation methods, such as cryopreservation and sperm-banking. “If doctors are not offering that up, the young people certainly are not going to ask about it,” Dr. Zebrack said. “If they hear about fertility issues later, they may wonder why their doctor didn’t address them.”

Another way oncologists can help meet the psychosocial needs of adolescents and young adults is to “have a small cadre of veteran young adult patients who they can connect with their newly diagnosed patients. At the very least, new patients can be connected with an organization like Imerman Angels,” Dr. Zebrack said. This organization matches cancer patients, as well as survivors and caregivers, with Mentor Angels, for one-on-one support. “A Mentor Angel is a cancer survivor or caregiver who is of the same age, same gender, and most importantly, who has beaten the same type of cancer,” according to the Imerman Angels website ( The service is free and connects people worldwide. ■

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