Rethinking Cancer Care for a New Generation of Patients

Cancer incidence among younger adults is increasing, bringing greater attention to the unique challenges this group faces, according to Dr. Christopher H. Lieu. Unlike older populations, younger patients are frequently navigating major life milestones at the same time as a cancer diagnosis. These competing priorities, combined with concerns such as financial strain, fertility preservation and long-term side effects underscore the need for a more tailored and multidisciplinary approach to care.

These themes were a key focus at the NCCN Annual Conference, where CURE spoke with Lieu, associate director for Clinical Research and co-director of Gastrointestinal Medical Oncology at the University of Colorado Anschutz, to further examine these critical issues.

CURE: Younger adults with cancer often face unique challenges compared with older populations. What are the most pressing unmet needs you are seeing in this group today?

Lieu: There are even specialized clinics being developed across the country focusing on young adults, and they just address these unmet needs or these gaps in care that come up whenever we are dealing with a young patient compared with an older patient. We know that young patients are at a vulnerable stage in their lives. They may have young children, they may be just married, they may be in school, or they may be just starting their careers, which also means that a lot of times, our younger patients don't have the financial resources that, say, an older patient who is already retired may have.

When you think about some of the gaps in care, it is a little bit beyond just the medical piece of this. We want our patients, all patients, but especially our young patients, to receive great multidisciplinary care from all the right doctors and providers simultaneously. We really need to think about things like preserving fertility. What if somebody wants to have kids later in their lives? Well, obviously, cancer treatment can interfere with that.

So, what are some of the strategies that we can implement now to make sure that if somebody wants kids in the future, they are able to do that? What about the social work to address the financial toxicity? What about a social peer group? Can we connect our young patients with people who have had similar experiences, those who have already had that lived experience? Can we provide for our patients, patient advocates, and survivors who have lived through some of this, so that there is at least some kind of peer network?

These are just some representative gaps that we know our young patients face. The key here is that we need to communicate well with our patients and provide these resources. And one of the things that really came out in our discussion this morning was the importance of repeating those discussions, because when you get that diagnosis, you are going to remember only half of what you are told.

Coming back to these discussions, making sure that these services are continuously offered to our patients, and surrounding our young patients with the appropriate team is what we want.

With that said, how are treatment decisions evolving to better reflect the life stage and priorities of younger patients?

I'm going to use an example in colorectal cancer because that's my area of expertise. When we think about preserving fertility and we talk about delivering radiation to the pelvis, we need to start thinking about what ways we can change the standard of care that allows our patients to meet their goals. So, in a young woman's case, maybe the ability to have kids in the future while also not compromising her survival from this cancer.

It's a tricky area where we have to provide the best therapy possible to get rid of cancer. We don't want to compromise that. Having said that, if there are ways to do this without harming a patient's ability to do things that they want to do in the future — and also keeping in mind some of the late and long-term side effects of the treatments that we give — if we come to the patient with the right attitude of meeting their goals and understanding what it is that they want, and then trying to modify their treatment plans in a way that won't hurt them, that's the outcome that we really want.

Like you said, there's other concerns, unfortunately, beyond just cancer that young adults have, and some of those include financial toxicities and career disruptions. So, what resources or strategies can help mitigate these burdens?

I strongly believe that any young patient who is diagnosed with any cancer really needs to have a mandatory consultation with our social workers. The question is, what are the resources that we can provide to our patients? Say, from a financial standpoint, are there resources to help with the fact that these are expensive treatments at a time when young patients haven't really accumulated much wealth, if any?

What about psychosocial needs, just the anxiety and the stress of all this? Can we surround a patient with the right counselors and support, and even peer groups, to be able to help someone through their journey? What about a patient's loved ones? Can we support their family members as they're dealing with someone who is obviously so young to have this diagnosis? Can we support the caregivers as well?

A lot of this is managed and helped by our social workers, and that's why I think any young patient really deserves a social work consultation. Then we need to be able to provide as many resources as possible, which might include financial resources, counseling, peer support, or social support. These are the things that we want for our young patients.

What role does survivorship planning play for younger adults, and how early should it begin?

The old way of thinking about survivorship is that whenever you've completed your cancer therapy, it's like, "Okay, well, you're a survivor, and you're in survivorship." However, the true definition of survivorship is that it begins at the moment that you're diagnosed. You are a cancer survivor. I think that survivorship encompasses so much, and we need to think outside of the box beyond just, “You're going to get routine CT scans and labs." That monitoring of the disease is part of survivorship, but I would say the management of the chaos that has happened after someone receives the diagnosis is just as important, if not more important.

Being able to have the psychosocial support of living through a diagnosis and treatment, and management of long-term side effects. This can be physical. What if you have neuropathy and you have to live with that for a long time? Are there some side effects that you just continue to experience after you complete your treatment? But this is also the long-term side effects of the financial toxicity and what happens when you've gone through this lived experience that very, very few people can relate to. That can be a very isolating experience.

Survivorship, I think, is critical to not only address while someone is in treatment, but even when someone is done with their treatment. That is almost a time when we need to surround our patients with even more resources, because a lot of our young patients will tell you, "As I was going through treatment, it was just a whirlwind, and I was just going to my appointments. Then all of a sudden, the appointments stopped, then the tests stopped, and I felt like I was all alone." That's the moment where survivorship becomes increasingly and more critically important.

Transcript has been edited for clarity and conciseness.

References

1. “Understanding the Unique Needs of Younger Adults With Cancer,” by Dr. Christopher H. Lieu. CURE; March 27, 2026. https://www.curetoday.com/view/understanding-the-unique-needs-of-younger-adults-with-cancer.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.