Cancer in young adults: Challenges, support services and prevention

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In adolescents and young adults, cancer has an impact on many areas of life - from career choices and career opportunities to family planning. The Comprehensive Cancer Center Munich (CCCM), the oncology center of excellence at LMU Klinikum München and TUM University Hospital, is therefore taking this year's World Cancer Day on February 4 as an opportunity to focus on young people with cancer - and to provide information about special support services as well as prevention options.

"A cancer diagnosis is a particular challenge for young adults, as they have to plan their future anew," says Prof. Dr. med. Volker Heinemann, Director of the CCC MunichLMU. "They need comprehensive support to ensure their quality of life and to be able to participate fully in life again."

Prof. Dr. med. Hana Algül, Director of CCC MünchenTUM, agrees: "The challenges of a tumor disease in young adults in vocational training or even at the beginning of their careers differ from the effects of cancer in later phases of employment or in retirement age," he says. "This is by no means a question of relativizing the consequences for older people. Rather, the consequences of cancer in young adults are sometimes different and more complex - and therefore require special consideration and their own solutions."

Cancer in adolescents: Fear of the future and social isolation

For adolescents, a cancer diagnosis is a major turning point: "In addition to the physical stress caused by the disease and the treatment, they have to deal with fears about the future, social isolation and changes in their body image," says Prof. Dr. med. Irene Teichert-von Lüttichau, Head of the Pediatric Hematology/Oncology and Stem Cell Transplantation Unit at the Children's Hospital Munich Schwabing, a cooperation between the TUM University Hospital and the Munich Clinic. The disease can significantly affect their development and future plans.

Under the umbrella of the CCCM, the various locations therefore offer a wide range of support services (see also information sheet) that go far beyond medical treatment. In addition to a follow-up consultation for children and adolescents in Schwabing, there is also a transition consultation at the TUM University Hospital, supported by the Initiative Krebskranke Kinder München e.V.: This is intended to ease the often difficult transition from pediatric medical care to adult medicine ("transition"). Young adults with cancer also find support in the AYA consultation hours at the LMU Clinic - a service offered as part of the AYA (Adolescent and Young Adult Cancer) project. This comprises a range of initiatives and programs that are specifically geared towards the concerns of adolescents and young adults with cancer.

From their mid-20s, other issues come to the fore: "Many young adults ask themselves whether they will ever have children and how they can financially secure a family despite their illness," says Bastian Schwarz, who himself was diagnosed with sarcoma in his early 30s. "They experience discrimination, for example through disability insurance, which generally excludes cancer patients and cancer survivors." This is another reason why Schwarz is involved in the German Foundation for Young Adults with Cancer and is also part of the Patient Advisory Board of the CCCM and the Patient Advisory Board of the German Cancer Research Center (DKFZ). He says: "Everyone should have the same opportunity to lead a fulfilling life - regardless of cancer."

Active against cancer: prevention and reducing the risk of recurrence

For young people with cancer, it is particularly important to eat healthily and get enough exercise. "By adopting a healthy lifestyle, we can make a major contribution to protecting our health - and minimizing the risk of developing cancer for the first time or developing it again," says Dr. rer. biol. hum. Nicole Erickson, nutritionist at the LMU Hospital and coordinator of health literacy at the CCC MunichLMU. "Plant-based foods should take center stage in the diet." On the other hand, you should cut back on red meat such as beef, pork and lamb as well as salami, ham and bacon - and generally watch your weight. Because: "Being overweight and obese increases the risk of certain types of cancer," warns Erickson. This also applies to alcohol, which increases the risk of cancer "in any quantity". "This means that the more alcohol you drink, the greater your risk of developing cancer."

The European Code Against Cancer lists a total of twelve pieces of advice for the prevention of cancer. One of these is exercise, which also plays an important role during treatment - and can make chemotherapy more tolerable, for example. "Physical training before, during and during breaks in therapy can make the cycles more manageable," says Prof. Dr. Martin Halle, Director of the Polyclinic for Preventive Sports Medicine and Sports Cardiology at the TUM University Hospital, Klinikum rechts der Isar. However, intensive exercise can be too much for people undergoing chemotherapy, and regeneration is also slowed down. They therefore need adapted concepts. As a general preventative measure, Halle recommends not exercising for too long at a time, but doing so every day if possible. "It's not so important to do a lot of sporting activity. For example, ten minutes a day is crucial, but the intensity should be higher."

Orientation and help for cancer survivors

Andrea Helfer was eight years old when she was diagnosed with bone sarcoma. The disease not only shaped her childhood. Even today, in her early 40s, the disease still has an impact on her life. "The late effects of my cancer affect both physical and numerous organizational challenges," she says. This became particularly clear nine years ago when her endoprosthesis in her leg suddenly broke. "During this time, I was plagued by great pain, anxiety and, above all, uncertainty as to whether the leg could be saved after all the previous operations and hardships." Bureaucratic problems delayed the treatment, and it was only after a week that she was finally able to undergo surgery. Andrea Helfer even had to give up her previous job some time ago - another consequence of her early illness. She is all the more careful to manage her health consciously - "to avoid further problems where possible and to be able to live the best life I can".

People like Andrea Helfer who have survived cancer are also known as "cancer survivors". According to expert estimates, around 4.5 million people in Germany are currently living with or after cancer. And: "Thanks to ever-improving early detection and treatment options, the group of cancer survivors is growing all the time," says Markus Besseler, qualified psychologist and Managing Director of the Bavarian Cancer Society (BKG). "These are often people affected by breast and prostate cancer, colon cancer or malignant melanoma. They have completed their acute treatment and go into the future with the knowledge and hope of being cured. This is the target group of NachsorgePLUS!, our advisory service at BKG." Even after surviving cancer, people still face many challenges: They have to cope with the physical, psychological and social consequences of their illness and therapy. AftercarePLUS! is designed to offer them guidance on the path to a new life after cancer - and also to help them in the often difficult search for the right contacts for their many challenges.

Support services for young people with and after cancer

AYA consultation for young adults with cancer at the LMU Clinic
The AYA consultation is a service offered by the CCCM as part of the AYA (Adolescent and Young Adult Cancer) project, which comprises a range of initiatives and programs specifically designed to address the concerns of adolescents and young adults with cancer.

Medical Clinic III
Special Oncology Outpatient Clinic (Room 841)
Secretariat: M. Giltidou
Phone +49 89 4400 - 73019
E-mail: med3.junge-onkologie@med.uni-muenchen.de

Aftercare and long-term follow-up consultation for oncology patients up to the age of 18
Munich Schwabing Clinic
Oncology day clinic (House 10)
Kölner Platz 1
80804 Munich
Phone: +49 89 3068 2077
E-mail: tagesklinik.10at.ks@muenchen-klinik.de

KONA: A coordination center for psychosocial aftercare for families with children with cancer
KONA office with Jugend & Zukunft
Belgradstr. 32 - 34
80796 Munich
Phone: +49 89 954 5924-88
E-mail: info@kona-nachsorge.de

Transition and long-term aftercare consultation for young adults aged 18 and over
Transition” refers to the transition from pediatric to adult medical care - a critical phase, as young adults often find it difficult to suddenly have to provide the necessary medical care themselves. The transition consultation helps them to take responsibility for their health and close any gaps in their care. Long-term follow-up care is intended to prevent and detect late effects at an early stage. The service at the TUM University Hospital is supported by the Initiative Krebskranke Kinder München e.V. (Munich Children with Cancer Initiative).

Interdisciplinary Tumor Outpatient Clinic (ITA) of the TUM University Hospital, Klinikum rechts der Isar
Ismaninger Str. 22
81675 Munich
Registration via coordinator Dr. phil. Birgit Mück
Phone: +49 89 3068 3442
E-mail: langzeitnachsorge.ki@mri.tum.de

AftercarePLUS!
AftercarePLUS! is a specialized counselling service offered by the Bavarian Cancer Society for anyone whose cancer treatment has already been completed.
Online counseling: Book an appointment online at: https://www.bayerische-krebsgesellschaft.de/krebsberatungsstellen/
Personal counseling by the psychosocial counseling center of the Bavarian Cancer Society in Nuremberg: Make an appointment by calling +49 911 240 304 0