Cancer is usually a curse of time. In the United States, the vast majority of cancer diagnoses are in people over age 50. Our bodies’ cells accumulate DNA damage over time, and older immune systems are not as good at making repairs. At the same time, decades of interaction with sunlight, tobacco products, alcohol, carcinogenic chemicals and other risk factors also take their toll.
But in recent years, cancer has been increasingly attacking younger adults. Global incidence rates of several types of cancer are rising in people in their 20s, 30s and 40s, many with no family history of the disease. Scientists don’t know why diagnoses are soaring in people under age 50, and they are racing to find out. But as freelance journalist Fred Schwaller reports in this issue, identifying how risk factors like diet or environmental exposures could be at fault is notoriously difficult because there are so many potential influences at play.
For one, cancers in young adults may advance much more quickly than they do in older people, belying the assumption that healthy young bodies would excel at eradicating malignant cells.
What’s more, cancer screening recommendations in many countries aren’t currently designed to detect the disease in younger people. Young adult patients often say their concerns that something wasn’t right are dismissed by doctors who say they are “too young to have cancer,” even when they repeatedly voice their concerns. And that can lead to delayed diagnosis and treatment.
In this issue, we also explore a glimmer of hope for people who get cancer as very young children. Harsh treatments like radiation and chemotherapy can damage immature egg cells and cells that make sperm, making it impossible for some people who had cancer in childhood to have biological children. Teenage and adult patients may be able to freeze eggs or sperm, but children who haven’t gone through puberty don’t have those options. Senior writer Meghan Rosen reports on emerging research intended to help make that possible, including a conversation with the first childhood cancer survivor to have testicular stem cells transplanted back into his body.
Parents of children with cancer are increasingly considering these options for both boys and girls. And while scientists say the work is still in its infancy, they hope more childhood cancer survivors will one day have the option to thrive as parents.