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By Rachel Odo, LCSW Clinical Oncology Social Worker CancerCare, Inc. New York, New York

Clarissa Potter, LCSW Clinical Oncology Social Worker Manager, Quality of Care Initiative Memorial Sloan-Kettering Cancer Center New York, New York | October 8, 2009 Young cancer survivors are often unprepared to face the complexities of adjusting to post-treatment life. They may be pleased that treatment is ending but worried about losing the support, security, and scrutiny provided by their healthcare team. Uncertainty about the prognosis for long-term, cancer-free survival often threatens their sense of control, emotional well-being, functional adjustment, and comfort with future planning. Many feel isolated, mistrust their bodies, and must adjust to an altered self-image as well as changes in relationships and sexual functioning. It can be daunting to deal with physical late effects, challenges to daily living, and employment and insurance issues. Using direct quotations from young cancer survivors, this article shares their special perspective and provides guidance as to their informational, practical, and psychosocial needs. __________________________________________________________________________________ For young adult survivors, coming to terms with a life-threatening illness is a unique dilemma. They face the developmental tasks of youth with a challenged world view and a compromised physiology; completion of treatment does not mean the end of cancer. They may have difficulty returning to school, work, or other activities and are often forced into greater dependency on their family of origin, during a period when separation is a major life-cycle task. The transition from life as a patient undergoing treatment for cancer to a more independent role in close relationships and the world at large can be particularly challenging. Social relationships may not withstand the stigma of cancer, and the potential for recurrence of cancer can be anxiety-provoking even with a good prognosis.

Young adults (15–39 years of age) are eight times more likely than children under the age of 15 years to be diagnosed with cancer. Each year in the US, an estimated 70,000 young adults are diagnosed with cancer, and about 1 million young adult survivors are already grappling with issues related to the aftermath of the disease and its treatment.[1] Unfortunately, these survivors often lack access to networking and professionally led services geared towards the post-treatment period. This article will discuss issues relevant to young adult survivors. Personal statements quoted here come from young adults who participated in support services at an academic cancer center. All identifying information has been changed to maintain confidentiality.

IMPACT OF SURVIVORSHIP Survivors often describe themselves as “rubber bands,” stretched increasingly taut through the treatment period and sometimes beyond. After treatment ends, the band may “snap” and the emotional impact of the cancer experience can catch up with them. This is the point at which many survivors begin to process the totality of their cancer experience; the physiological, emotional, and practical impact.

PHYSIOLOGICAL CHANGES Most cancer survivors experience physical changes and challenges that are direct results of cancer and treatment. Adapting to short and long-term consequences of treatment often takes longer than anticipated. Common concerns include fatigue, physical losses, scarring, cognitive changes, sexuality, fertility, and sudden-onset menopause.[2–4] All of these issues have a significant impact on young adults and are best summarized in the phrase “loss of healthy self.”

Survivors often experience physical changes as concrete reminders of the impact and ongoing meaning of cancer in their lives: “How do I begin to explain the deformities? I have an access for dialysis which is very noticeable. I can see it, feel the blood gushing constantly, and I can hear it. It's a constant reminder, like the scars, of everything I've been through." The process of physical recovery after treatment is affected by the process of emotional recovery and vice versa: “I'm 24. I'm tired of being weak, in pain, a cripple.”

Some of the changes will be visible, forcing survivors to develop new systems for negotiating social contact as they determine how best to address the inevitable stares, questions, and comments. Even when changes are not visible, survivors must adapt to the reality of living with physical challenges that only they can choose to disclose. For many, this raises issues related to self-image and the need to define the line between privacy and secrecy: “The image everyone else sees is someone put together and ‘normal.' What we see is scarred, reduced in strength or stature.”

Among young adult survivors, the issue of compromised fertility can be particularly salient.[5–7] It is “invisible,” yet it can have a significant impact on both private and public aspects of identity. Young adult survivors living with cancer-related infertility must not only integrate this change into their own sense of self, but also must determine how and when to disclose this issue to friends, family, and potential partners: “I won't be able to have children. I'm not only dealing with a huge loss but [also] I'm not married, and looking for a partner is difficult enough; all this extra stuff to deal with is overwhelming.”

For young survivors who do retain their fertility, there will be other issues to confront: “We found out that I am pregnant. I want this baby. I don't want to have to give it up to take chemo if I have a recurrence. I want it so badly that I fear this is when the bad test results [indicating recurrence] will come.” The physiological aspects of survivorship weigh heavily on young survivors' ability to allow themselves to contemplate, to plan, or even to hope for their future.

Among the physical after-effects, fatigue is nearly universal and can be particularly distressing.[8–10] “When people look at me they see a young woman who should be bursting with energy. Being so weak is the hardest thing. Everyone in the group could relate.” Many young adults are not aware of fatigue as a potential consequence of treatment and may misinterpret this post-treatment symptom as a sign of failure to recover or as a recurrence: “It was reassuring to hear people talk about fatigue. I'm unnerved by how tired I still am even now, almost 2 years later.”

They may interpret this physiological symptom from a psychological standpoint as a lack of motivation or depression. Further, many hold themselves responsible for it, adding guilt and frustration to their healing process: “I don't know why I can't seem to get myself going; there must be something wrong with me.” Most are relieved to learn that fatigue is a common problem and that there are techniques for coping.

Most young survivors have not previously dealt with serious health challenges. Nor have they focused in any significant way on general health maintenance. Cancer is a crash course. They assume responsibility for managing complicated post-treatment medical care with little or no preparation, background, or experience. They find themselves facing an unexpected learning curve at a time when they need to focus on the developmental tasks of young adulthood—identity building, family separation, social networking, establishing intimate relationships, career development, and education.[11]

Thus, the ending of treatment and/or changes in follow-up schedules can become particularly difficult transitional periods, fraught with new concerns and insecurities: “Similar to the anxiety involved in ending treatment is the anxiety involved in reducing the frequency of follow-up appointments and scans. Sometimes I don't want to go, [but] sometimes I feel as though I'm only okay when I have a report stating as much."

Many young adult survivors are unprepared, and often unwilling, to grapple with the complexity and time involved in mastering information related to the varied late-effects of treatment. As a result, they are vulnerable to poor or inconsistent follow-up care.[12,13]

EMOTIONAL Young adulthood is not a stage of life in which one normally confronts illness. Cancer disrupts the natural course of development and sets the stage for a period of emotional adjustment that will influence every aspect of life. One crucial aspect of adjustment is the reworking of previously held perceptions of normalcy to fit a scarred sense of health, integrating the cancer experience into a still-developing adult identity: “What I most hope to accomplish is to face the pain that I have endured, face the fears that I have been left with, and come to terms with my new paradigm.”

Myriad emotional issues can arise when treatment ends. Chief among them is a confrontation with uncertainty. While most young adults face the world with a feeling of invulnerability, a belief in possibilities, and an anticipation of their future, a diagnosis of cancer jeopardizes all of this: “I feel like I lost my innocence, my youth, my sense of invincibility that meant so much to me.” In the aftermath of a life-threatening illness, many young adults report that their perception of security has been altered. This heightened sense of vulnerability can lead to hypervigilance of the body, consuming fear of recurrence, and an inability to move forward or to plan for the future.[9,14] “I no longer have this naiveté about myself and my body. I can't enjoy my relatively healthy state. It's like I'm waiting for the axe to fall.” Paradoxically, these feelings can lead to high risk behaviors: medical nonadherence, smoking, alcohol ordrug use, unsafe sex, and a failure to attend to practical responsibilities.[15]

Feelings of uncertainty and loss of control have far-reaching implications, including an impact on self-image. For the young adult constructing an adult identity, this untimely insecurity confuses and hinders the process of development. Cancer and its treatment often force young adults back into the family of origin and a more dependent role. This regression, both understandable and common, can be experienced as a “double-edged sword”; necessary and comforting on one level, infantilizing on another.

At no point does this become more poignant than the transition off-treatment, when patients are losing the comfort and scrutiny provided by their medical team and family members are, emotionally, moving on. The ambivalence of the transition back to “adult life” takes on a new sense of complexity and urgency: “I am constantly questioning myself. Should I work? Should I travel? Should I save for graduate school? How am I going to move out if I don't get a job?”

For many survivors it also forces a premature confrontation with the limitations of relationships and familial connections: “It has always been comforting to know that my parents were there to rescue me. Not the case during my illness and thereafter. They certainly were there and would do anything for me, but for the first time in my life, I knew that they couldn't rescue me. I alone must face [my] fear of death.”

The cancer experience is also notable for its impact on formative belief systems. Issues of race, ethnicity, class, sexual orientation, religion—culture—have a significant influence on how survivors will make sense of their illness: “I'm Japanese-American; I'm not sure how my parents would have handled a ‘woe-is-me” attitude. They wouldn't have reacted negatively, but it would have been a change from the more Japanese approach of ‘internal suffering' and swallowing bitterness.” Religion is another aspect of culture where this dynamic is often expressed. As young adults wrestle with the role that spirituality plays in their lives, cancer can deepen their commitment or threaten their faith.[16] Often it does both.

Whether or not a survivor identifies with a religion, the post-treatment period presents an opportunity to explore spiritual and existential issues. Many young survivors find it deeply healing to consciously process the experience as they seek ways to understand it—to assign it meaning and purpose in their lives. This process of adjusting to a new sense of self can precipitate an early experience of existential “aloneness” that magnifies feelings of difference, isolation, loneliness, envy and, sometimes, contempt for healthy peers who are not confronting these issues in such a powerful way: “I listen to friends now, but I just can't relate. You just want to shake people and tell them to get a grip.”

Ultimately, survivors have a need to process and make sense of the cancer experience as a “whole”; of who they are both in spite of and because of it, to make sense of their peers and their relationships given their altered perspectives: “I feel that I am able to see things much more clearly than before. This clarity sometimes is not wanted.” They need to mourn losses and changes, to learn how to cope with uncertainty while remaining fully invested in their daily lives.

A critical aspect of this “investment” is the willingness to connect with others. Young adult survivors face the challenge of re-entering their peer group with an intimate knowledge of their vulnerability and mortality. The typically healthy young adult may not be able to relate to the experiences of those with a catastrophic illness: “My noncancer friends are well-meaning, but they don't understand and just say, ‘you look great.'” The sense of being misunderstood and unsupported or misunderstood and smothered can fuel an impulse to rethink and even terminate relationships.

These feelings, coupled with fears of rejection and loss, often challenge the ability to build new relationships. “I'm never going to find a mate. Who is going to want me with all this baggage? Who is going to deal with my insanity, my menopausal 80-year-old body?” Issues of disclosure, particularly for those who are dating, become paramount: “You never know when is too early to tell someone but the longer you wait, the more you start to wonder if you waited too long.”

Some young adult survivors will successfully maintain their pre-existing relationships and build new ones,[17] but they too may harbor a sense of “aloneness” that even their most intimate relationships cannot pierce: “This experience with cancer is a very selfish one—I recognize that it impacts those around me—but it truly is mine and mine alone.”

Cancer sparks an “early” confrontation with personal mortality that can deepen the typical existential musings of this group: “When your mortality is brought out of the abstract and turned into a reality, it is a hard cross to bear, and even harder because you do it alone. While my husband may grieve over the This heightenedpossibility of losing me, I would be saying goodbye to him, our son, and to life itself.” This heightened sense of mortality can play itself out in numerous ways. For many, the process of coping with multiple emotional issues and identity shifts can lead to self-imposed pressure to make sweeping lifestyle changes.

This pressure, combined with societal expectations of the cancer survivor—the myth of the epiphany—can be a tremendous burden for young survivors: “Shouldn't I always be thankful, shouldn't it be that I never get upset by the small things and always focus on how fragile life is? I feel that I have betrayed myself because I am not acknowledging how lucky I am all the time.” While some will make major life changes, many will not and will find this pressure to be an impediment to the process of acclimation to life beyond cancer.[18]

PRACTICAL CONCERNS Just as the cancer experience has an impact on physiological and emotional aspects of development, practical matters are also affected: roles, relationships, goal-setting, education, career, finances, insurance.[19–21] Cancer and its treatments interrupt normal developmental pathways. In addition to the emotional aspects of intimate disclosure, for example, young adults may struggle with the practical aspects of public disclosure. They may be inclined to disclose that they are cancer survivors because of the prominence of the experience in their lives, but they may be justifiably concerned about the implications of telling educators, employers, and new acquaintances about their illness: “At first, you tell everyone. Then you realize your vulnerability. Then you share more wisely.”

School, work, financial development, plans, and relationships can be cut off, put on hold, or challenged in any number of ways during treatment. All of this must be addressed during the post-treatment period: “I have lost my self-discipline, my sense of achievement. Every hurdle, whether it is prejudice in hiring a cancer survivor or anything else, diminishes my hope of pursuing my dreams.” These concerns are the external defining elements of daily life that enable young adults to develop a sense of identity and purpose and to function in the world. Often, these are the issues that survivors first identify as distressing.

Ultimately, social issues at every level become salient for young adult survivors. Access to information relevant to cancer survivors' legal rights, resume writing, job hunting, disclosure, and the opportunity to connect with others who have faced the social hurdles that arise in the wake of cancer, can be an indispensable asset in the process of recovery.[22] “We're all similar in a big way— everyone thinks we're out of the cancer world and dealing REALLY well. But, in our own minds we're not, we're still very much there. It's comforting to know that there are people who understand what it feels like to be you.”

CONCLUSION The end of treatment can signal a complex period of recovery. For young adults, the most salient concerns that arise are as closely related to their developmental stage as to the cancer experience itself. Physical, emotional, and practical recovery can be assisted and supported through appropriate clinical services and interventions. Psychoeducational support services such as those provided by organizations like Memorial Sloan-Kettering's Post-Treatment Resource Program, CancerCare, the Lance Armstrong Foundation, I'm Too Young For This, or Planet Cancer can be critical factors in healing.

These organizations can be significant resources as young adults grapple with the process of integrating the cancer experience and seek to reduce the negative and intractable power of cancer. A sense of normalcy can be regained and the motivation to move forward can be more firmly established. The illness and its aftermath can come to be understood not as a defining aspect of the self but as just one of many aspects of a survivor's identity: “It's all part of feeling a new sense of being you. It's strange how this can simultaneously make you feel more confident and more insecure.”

Given the current national interest in cancer survivorship,[23] and the issues unique to this population, the field is ripe for an increased focus on young adult survivorship. The intersection of post-treatment recovery and young adult development presents highly promising entities for clinicians and researchers. In spite of the losses, the sadness, the anger, and the confusion, young adult survivorship is potentially a period of significant growth, possibility, and hope.

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Lindsey Ann Miller, the pretty 26-year-old UCLA student suffering with a rare form of pancreatic cancer was so moved by the performance of Joseph Gordon-Levitt in the film 50/50 that she’s made a very public YouTube plea for a coffee date with the Hollywood actor.

Gordon-Levitt, 30, best known for his role in the TV sitcom 3rd Rock From the Sun, was praised for his unique portrayal of a young man diagnosed with cancer in this fall’s hit 50/50.

Miller was diagnosed a year ago with neuroendocrine pancreatic cancer, underwent surgery in December to remove tumours from her liver and continues to endure nauseating bouts of chemotherapy treatments.

She’s feeling better now but accepts that some day she may require a liver transplant.

“I think I identify with your character more than most people because I am 26 and I have cancer,” she reveals in the video on her blog.

“Even though I look healthy, dating has been a little difficult because I’m not sure how to explain what I’ve been going through. But after a year of living with this I’ve decided to get back on the dating scene and I’d like my first date to be with you,” she says — just a cup of coffee.

Miller, who is studying urban planning, acknowledges the video is a long shot. But why not, she figures, “life is short.”

Miller has blogged extensively since her diagnosis about her experiences, from surgery and chemotherapy to the health-care system in the U.S. to her new outlook on life.

“Initially I wasn’t sure I wanted to see the movie,” she told the Star in a telephone interview from her home in Los Angeles. “I thought it might be too difficult because aspects of it were very fresh in my mind.” But a group of friends were going so she tagged along.

Miller says 50/50 “was hard to watch in some ways, especially the scenes with the family in the waiting room. I saw my own family in that position. I became aware of their stress.”

Miller, who found strength in “mindfulness meditation and visualization exercises,” insists she can make the distinction between actor and character — she gets it that Gordon-Levitt played the role of a young man struggling with his experiences with cancer.

She’s undeterred though.

Miller says the actor understands what she’s endured. “Having to get into that character,” she says, “He knows.”

Part comedy, part drama, 50/50 was written by Will Reiser based on his own experiences with cancer in his late twenties.

“I know the guy who wrote the screenplay must have understood it better because he actually experienced it,” she says.

Still, it’s Gordon-Levitt she’d like to meet.

“I’ve watched interviews that Joseph has done. He gets it. Being a young adult with cancer is different. Our most common experience with cancer is with uncles and aunts — older people.”

“Joseph seems like a thoughtful and interesting individual,” she says. “And yes, he’s cute. I wouldn’t have done the video if he wasn’t cute.”

“I’d just like to have a normal conversation with him. I don’t want to talk about cancer necessarily, just a date.”

Miller is cautiously optimistic the actor will contact her. It’s how she lives her life these days.

“Yesterday I would have thought my chances were slim but this seems to have blown up on the Internet. I know he’s a busy guy, but there’s a pretty good chance I’ll hear from him. I won’t hold it against him if he doesn’t though.”

Miller can’t predict much with any accuracy these days. “I’m going to have to live with cancer,” she says. “But here I am and I look healthy. There’s still a sense you either live with it or die.”

She cracks a joke: “I am a liver.”

http://www.youtube.com/watch?v=Qa8X56fKzYQ&feature=player_embedded

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The clock is ticking for Amit Gupta.

One moment, the 32-year-old American felt fine. The next he was hit with a mixed bag of symptoms: fatigue, breathlessness and sudden weight loss. On Sept. 22, he was diagnosed with acute leukemia.

He has about six weeks to find a bone marrow match, which could save his life. The thing is, Gupta is of Indian descent and in the United States only 1 per cent of registered bone marrow donors are South Asian. None are a match.

Still Gupta remains hopeful. In large part, because of a growing movement on social media — started by his cybersavvy friends — to get people registered as bone marrow donors and find him a match.

In recent weeks, there have been countless blog posts and tweets about Gupta, a web entrepreneur who now has about 15,000 followers on Twitter.

Across the United States, Gupta's supporters have organized donor drives — the Brown Bones Benefit Party in New York City last Friday kicked off the nation-wide effort. A donor drive is even scheduled in Australia. The procedure is as simple as having your cheek swabbed with a free kit.

Three friends are offering a $30,000 reward to the first successful match. Because the prize will be awarded even if the person refuses to donate, the trio isn't breaking U.S. law, which prohibits paying for an organ or tissue donation.

The outpouring of support, worldwide, has been awe-inspiring.

“I'm totally blown away,” said Gupta, whose website amitguptaneedsyou.com offers tips on how to help. “I thought my friends would tweet about it, but I didn't think total strangers would tweet about it.

“I'm so grateful,” he told the Toronto Star, from his parents home in Connecticut. “I was glad for the attention but I didn't think it would last. I don't know what to say. I don't understand what's happening.”

The tremendous support has bolstered Gupta's spirits.

“The first week was definitely the hardest . . . It didn't seem real when I thought about how much my life is going to change, that it might be over in six months or that I might not ever have kids.

“I cried more in that week than I had in my entire life. I was at a pretty low point.

“If nothing else, all of this really lifted my spirits, just knowing there are so many people out there wanting to help and do good. I know we might not find a match for me but all these people are trying and just knowing that makes things easier. And even if we don't (find a match for me) we'll find matches for a bunch of other people.”

Gupta, who is undergoing chemotherapy, is slated to have a bone marrow transplant in January. Because of the length of time it takes to process the test kits and get potential donors registered in the database, the next six weeks of drives are crucial to finding a match.

Finding a donor is a painstaking process because successful marrow transplants rely on matching 10 different genetic markers, which means matches are typically found within the same ethnic group.

That's why Gupta is turning his attention to India, where there are a few private registries but no centralized national registry, he says. There's been expressed interest in his case, but each test kit, and the accompanying DNA test, costs about $50. In India, that's “an astronomical sum,” he says, adding his friends have committed $20,000 to pay for the testing.

In Canada, minorities are under-represented in the stem cell and bone marrow registry. There are 307,000 people registered, 77 per cent are caucasian and just 3.2 per cent are South Asian.

It's crucial to diversify the donor registry so that it “represents the changing face of Canada,” says Olga Pazukha of OneMatchStem Cell and Marrow Network (onematch.ca), which finds and matches volunteer donors to patients who require transplants. There are 959 Canadians awaiting transplants, 33 of whom are South Asian.

“We want to engage more young people, and ethnically diverse people into the conversation and make sure they're familiar with how easy it is to join the registry.”

“Its important for the donors to understand that if they are matched to any other patient it can be a life-saving donation, so they should be prepared to donate to any patient in need anywhere around the world.”

OneMatch is part of an international network of registries, enabling physicians worldwide to search the Canadian registry.

Starting next week, OneMatch will be running donor drives at Canadian universities across the country. Although not focused on South Asians, Gupta hopes Indian students will participate. Maybe, a match can be found here.

Dr. Prateek Lalaof South Asians for Life, says the group will help anyone who wants to organize a donor drive.

Mississauga resident Loveen Kaur Gill, who runs Amar Karma Organ Donation Society, (amarkarma.org) is considering a donor drive in November to help Gupta, and boost Canada's donor pool.

Gill, who started the organization to promote organ and tissue donations within the South Asian community, says misconceptions keep many at bay.

“People think it will be painful to give bone marrow,” she said. “They think the procedure will be complicated.”

Dispelling such myths are critical, says Pazukha of OneMatch, noting transplants are a relatively painless procedure.

For more info visit onematch.ca

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When screenwriter Will Reiser was 24 and diagnosed with a rare form of spinal cancer, he coped by thinking up ideas for cancer comedies with his best friend, actor Seth Rogen.

"We wanted to do a parody of The Bucket List where you do really absurd and ridiculous things," he tells Fresh Air's Terry Gross. "Like skydiving with hookers and things that were completely outlandish. But it was a joke, and it was sort of a coping mechanism for me at the time."

Six years after his diagnosis, Reiser is now cancer-free. He's also now a screenwriter, for a comedic film loosely based on his experiences throughout his cancer diagnosis and treatment. The movie, called 50/50 after Reiser's initial survival odds, stars Rogen alongside Joseph Gordon-Levitt as a kind of Reiser stand-in.

Gordon-Levitt, a veteran actor who has been in films like Inception, Hesher, and (500) Days of Summer, says he was drawn to the part of Adam because Reiser's script was one of the rare comedic scripts he's received that doesn't have cliched plot points or stereotypes.

"I read the script, and I quite liked it. I was laughing. I was concerned. I didn't know what was going to happen next," Gordon-Levitt says. "These are all what makes me want to get involved with a project. So I flew up to meet [the cast and crew] and accepted the role the next day."

And over the next few weeks, Gordon-Levitt repeatedly interviewed Reiser about his physical and emotional transformation over the course of his cancer treatments.

"I'd ask him, 'What hurt? Where? When? For how long? How badly?' " says Gordon-Levitt. "That was always really useful. ... But the more interesting stuff that we would talk about was not medical at all. It was, 'How do you feel? What were you thinking about?' And that's really what the movie is about, to me."

Enlarge Chris Helcermanas-Benge/Summit Publicity

Writer Will Reiser (left) was working as an associate producer on Da Ali G Show when he found out he had cancer.

Chris Helcermanas-Benge/Summit Publicity

Writer Will Reiser (left) was working as an associate producer on Da Ali G Show when he found out he had cancer.

The movie does have its funny moments. Reiser says the film doesn't make fun of cancer itself, but instead finds humor in how people close to cancer patients react to their diagnosis. Adam's on-screen mother, played by Anjelica Huston, tries to smother her son — which is exactly what Reiser's mom did in real life.

"She got on a plane and flew to L.A. We went to one doctor's appointment, and I just could not handle being babied. I was 25, and I was just at the age where I was really kind of finding my own independence," Reiser says. "The idea of having my mother take care of me just seemed so unbearable. So I put her on a plane and made her go back to New York. ... It's hard at 25 to know how to ask for help from your mother, because it's the person you're trying to break away from."

His best friend Rogen, meanwhile, tried to be helpful by making Reiser laugh — and by changing his bandages despite having an aversion to bodily fluids.

Related NPR Stories

Rogen, Reiser Go In '50/50' On A Few Sick Laughs Sept. 18, 2011 Seth Rogen, Not Such A Loser In Real Life Jan. 2, 2009

"Seth was incredibly squeamish," says Reiser. "Despite what you might think about Seth, he is an incredibly fragile human being who does not like the sight of blood or cuts or scrapes or anything like that. For him, changing the dressing and seeing my giant wound was a traumatic experience for him. But he did it — he just complained about it the whole time, much as he does in the movie."

Rogen also suggested to Reiser that he use his cancer diagnosis as a sympathetic pick-up line. But that didn't work out so well.

"People would give me a lot of sympathy, but really, it was the kind of sympathy that you'd give a sick dog," he says. "It wasn't like women found me really attractive because I had cancer. It's because they felt bad for me. It was pity-sympathy. It wasn't sex-sympathy."

Reiser says he looks back on his illness differently now.

"I did feel like I was a victim right after I went through the entire ordeal, but now I've really kind of processed that and moved on from that period," he says. "But there was a time when it was really difficult, and I felt like who I was was entangled in being 'a sick person.' ... It's pretty incredible for me to take what was the most painful experience in my life and turn it into something that I'm really proud of and that I've made with my friends. I think it's pretty great."

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Being diagnosed with cancer as a young adult is different.

By Terra Dafoe, M.A. PhD Student, Counselling Psychology Program and Program Leader, Wellspring You Can Connect Program

Terra powerfully explores the common yet different realities of being a young adult living with cancer. 

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FREDERICTON — Tanning salons in New Brunswick are feeling a little hot under the collar over a new provincial ad campaign that likens tanning beds to coffins.

The ad, which is endorsed by the Canadian Cancer Society, appears on Facebook depicting a teenage girl in a bathing suit and sun-tanning goggles, basking in the glow of ultraviolet rays — but in a casket.

The ad copy reads: "Using a tanning bed for prom? Know what you're getting into."

The Facebook ad then links to a government web page entitled "Tanning beds are out — Who knew?" and includes a larger poster that says using a tanning bed just once a month increases the risk of melanoma by 75 per cent.

A poster campaign is also in production, the Department of Health said.

Last summer, the province brought banned people under the age of 18 and anyone with the fairest skin type from using tanning beds.

Tanning salon operators in New Brunswick are also prohibited from advertising any health benefits they say can come from artificial tanning methods and must limit clients to one use every 48 hours.

"I am appalled by this ad, because the provincial government imposed guidelines that we are going by already," said Frank Findlay, who owns and operates New Brunswick's largest tanning company, Miami Tanning Salons, which has outlets in Fredericton, Saint John and Moncton.

"We are not letting teens tan, so this is over the top and an attack on small business.

"It's unnecessary; it puts people into fear mode. Anyone out in the sun is putting themselves at risk, but they are attacking us directly."

An association representing tanning salon operators across Canada questioned the figure that tanning just once a month increases the risk of melanoma by 75 per cent.

Joint Canadian Tanning Association executive director Steve Gilroy said that number is a combination of tanning units in homes and for medical treatment, which are different than commercial tanning units.

Gilroy said the percentage is closer to six per cent and should not be the focus of advertisements.

"What they should then have is a coffin on the beach, a coffin on the golf course, a coffin on the baseball field, because if you are going to talk about risk from (ultraviolet rays) exposure there are more risks of exposure than a tanning bed will ever be," said Gilroy. "This has gone way over the line."

The Canadian Cancer Society estimates that 5,300 Canadians will be diagnosed with the skin cancer melanoma in 2011, and that more than 1,000 will die.

Melanoma is the third most common cancer found in young adults ages 15 to 19.

"The Canadian Cancer Society and the government of New Brunswick decided the types of communications that needed to go out to youth had to be edgy," said Ellen Snider, a spokeswoman for the Canadian Cancer Society in New Brunswick.

"A fair amount of research and data shows that the traditional methods of communicating health risks just don't work with teens.

"The campaign is strong because the risk is serious."

© Copyright (c) New Brunswick Telegraph Journal

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ROSALYN SOLOMON, QMI Agency

Less than a year ago, Katie Evans never gave breast cancer a thought.

But after finding a lump in her breast last July, it was all she could think about.

The Ottawa woman lived life like any other 26 year old. She had earned three degrees in education from the University of Ottawa, and was working full-time as an accountant for Shoppers Drug Mart until something came up in her field. She lived with her boyfriend of five years, and had a loving family and circle of friends.

"Just six months ago, in my head I thought breast cancer was something that happened to women in their 40s or 50s. It didn't hit anybody in their 20s, especially someone with no family history of it like me," Evans said.

Having grown up in Lindsay, Ontario and then moving to Ottawa, Evans says she always lived an active and social life and maintained a healthy diet.

"Six months ago, I worked a lot of hours in the week and did a lot of socializing, going out for dinners and the movies, walks and all that good stuff. Now it just depends on how I feel that day," Evans says.

"My life has certainly turned into a medical approach to living rather than social. Now I'm just 100% focusing on my health, but I couldn't ask for better support. My boyfriend has been incredible and my family has been great. I certainly don't feel like I'm going through this alone."

After receiving a biopsy in March and learning for certain that it was breast cancer, Evans had one breast removed less than three weeks later.

At her age, Evans faces much different challenges than a woman in her 50s with cancer, mainly when it comes to fertility. Despite the risks with chemotherapy, Evans remains optimistic about one day having a family.

"We're really just crossing our fingers and every time I got into chemo I prep my ovaries, 'OK ladies, just hang on, I need you in a few years,'" she says with a laugh.

According to the Canadian Cancer Society's annual report on Canadian cancer statistics, 177,800 people would be diagnosed with cancer this year. For those ages 20 to 29, that number drops to 2,100 cases and breast cancer specifically would touch 90 women in this age group.

"Adolescents and young adults are a largely understudied population," said Sarah Bouma, Senior Manager of Research, Canadian Cancer Society, Ontario.

"Primarily because we have a series of health care systems that treat cancer that are either focused on pediatrics or children with cancer, and mature adults, cancer is primarily a disease of the older population over the age of 50."

In comparing statistics, breast cancer specifically for 20-somethings is rare, but it doesn't diminish the fact they face different challenges, to help address this, in 2008, Sunnybrook's Odette Cancer Centre in Toronto started the PYNK: Breast Cancer Program for young women.

The program is tailored to women 40 and under, a population that makes up five percent of women with breast cancer.

Dr. Ellen Warner, lead for the program and medical oncologist at the Odette Cancer Centre, Sunnybrook says there are many challenges a young woman with breast cancer faces, versus a woman in her fifties both from a health standpoint and a social one.

"There are a lot of differences, fertility and the family issues are the most obvious," Dr. Warner said.

"For older women with cancer, they are often retired or at the end of their careers. These young women are just starting out, they're still writing exams, just starting a business or a new career and there are a ton of financial issues. Older women have savings and other support where these women have mortgages and sometimes young kids, which makes it even more difficult."

For young women, tumours are often found in the later stages, mainly because they are not in the age group that is regularly screened and the cancer is more aggressive. They are also more likely to relapse, although the exact reasons are not yet known.

Dr. Warner says because the majority of studies focus on older women, more research is needed to better treat young women with breast cancer, as well as discover what puts them at risk of the disease.

Evans, in the meantime, is focused on recovery. With six rounds of chemotherapy at Ottawa General Hospital, she expects the treatment to end in October. She hopes to return to work next year, but for now is taking it a day at time, keeping a daily journal and working with FacingCancer.ca to get a blog going on the website.

She is also reaching out to every woman she can and sharing all that she knows.

"Be your own advocate, maintain your breast health and be aware of the possibility that cancer doesn't discriminate and it really doesn't matter who you are, or what you have," Evans says.

"If I can help even just one woman with my story, I would be so happy just to let them know they're not alone."

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News by Cinco Vidas

May is Melanoma month. You’ve heard the warnings. You know UV rays can be harmful. But sometimes you may forget your sunscreen, or wonder just how careful you need to be. To make it super simple, I’ve put together a summer “cheat sheet.” Post this on your refrigerator, or fold it up and tuck it in your purse. Here are the basic guidelines you need to know to keep you and your family safe in the summer sun.

Skin Cancer—Don’t Forget That:

- According to the Centers for Disease Control and Prevention (CDC), over 50,000 people were diagnosed with melanoma (the most serious form of skin cancer) in 2007. Over 8,000 people died from it.

- According to the Skin Cancer Foundation, skin cancer is the most common form of cancer in the U.S. Each year, there are more new cases of skin cancer than of breast, prostate, lung, and colon cancer combined.

- Between 40 and 50 percent of Americans who live to the age of 65 will have skin cancer at least once.1

- Melanoma is the most common form of cancer for young adults 25-29 years old, and the second most common for young people 15-29 years old.2

Risk Factors—Be Extra Careful If:

- You’re a white men over age 50 (diagnosed with melanoma more often than any other group).3

- You have blond or red hair, light-colored eyes, and freckled skin that sunburns easily.

- You use or have ever used a tanning bed. (Indoor tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.4)

- You got a lot of sunburns when you were a kid or a teen.

- You live at a higher elevation.

- You have a lot of moles.

- Someone in your family—a parent or a sibling—had skin cancer.

- You had a weakened immune system at some point in your life.

Prevention—Protect Yourself:

- Avoid the sun when it is most intense, between the hours of 10 am and 3 pm.

- Wear protective clothing when you go out like UV-protecting sunglasses, long pants and long sleeves, and broad-brimmed hats.

- Always use a safe sunscreen with a minimum SPF of 30. Reapply every two hours, and after exercising, swimming, or sweating.

- Stay away from tanning beds!

- Be extra cautious when you’re on medications—some increase sun sensitivity.

- Check your skin regularly. Watch for moles or dark spots that have an irregular shape, have mixed colors (tan to brown to black), or continue to grow larger than about a quarter inch. Make regular appointments with your dermatologist.

Are you taking care of your skin this summer? Let us know of the steps you’re taking to reduce your risk of skin cancer.

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Down the river with a paddle

The documentary Wrong Way to Hope tells the tale of eight young Canadian cancer survivors and a kayak trip, Joanne Laucius reports

By Joanne Laucius, Ottawa Citizen April 26, 2011   

Laurie Hinsperger was 28 and working as a contract kindergarten teacher in 2004 when she was diagnosed with colon cancer. Within days, she lost most of her large intestine.

Five years later, the Ottawa woman and seven other young Canadian cancer survivors found themselves in inflatable kayaks paddling down the remote Owyhee River in southern Oregon. With them was a camera crew that filmed their adventure for a documentary, Wrong Way to Hope.

More than 6,000 Canadians between the ages of 18 and 40 are diagnosed with cancer in Canada every year, according to Young Adults With Cancer Canada. When only those between the ages of 15 and 29 are considered, it's 2,000 diagnoses a year.

These patients are neither children nor adults who are established in their families and jobs. They have a different set of obstacles: putting an education or a first job on hold, juggling young children and debt and learning to work around disabilities that make them feel old before their time.

"We're the forgotten ones. There's hardly any research on us or support for us," Hinsperger says. "My first support group was all people over 50. They had nothing in common with me. They had cottages, children. They had finished their careers."

Peter Mazereeuw, 23, was just finished Grade 12 when he was diagnosed with acute lymphoblastic leukemia. He found himself in an in-between place. A few months too old to be treated at a children's hospital, he spent the next 2½ years between home and the Princess Margaret Hospital in Toronto.

"I didn't do anything but be sick and watch everyone else advance ahead of me. You miss some important years of your life."

Now 23, Mazereeuw is a journalism student at Carleton University with two years left to go before he graduates.

"Most of my friends are finished their undergraduate degrees and are trying to establish a career," he says. "You can't just go out and get on with your life."

Hinsperger was trying to get her career established when she was diagnosed. She had no permanent job and was struggling to repay student loans. She could not afford to quit working, as doctors advised her to do.

"It was my first foot in the door. I couldn't turn my back on that."

Mazereeuw agreed to go on the kayak trip when the idea was floated by cancer survivor Mike Lang at a Young Adult Cancer Canada retreat in Lake Louise, Alta.

Lang, who produced Wrong Way to Hope, was 25 when he was diagnosed with Hodgkins lymphoma, a newlywed with scant savings who had to move back into his parents' Calgary basement.

Young people with cancer have to deal with a lot of career, financial and relationship instability in their lives.

"When you throw cancer into it, it's so much more stressful," says Lang, whose documentary has been screened about 100 times in Canada and the U.S., both for general audiences and for doctors and nurses in oncology departments.

The name Wrong Way to Hope refers to young cancer survivors who find themselves on a detour, but moving in the right direction, says Lang.

Hinsperger's family doctor advised her not to go, but she received the go-ahead from her surgeon.

"I have to stop listening to people who say, 'You can't do that. You can't go there. You can't eat that.' I need to listen to myself and try things," she says. The trip taught her to stop being afraid.

At first Mazereeuw didn't want to go on the trip. He had never been in a kayak, and the effects of his leukemia treatment caused lingering joint pain. When Mazereeuw finished his treatment, he felt like he was trapped in an 80-year-old body.

"You define yourself by your illness. This gave me a sense of being able to do normal things."

Wrong Way to Hope will be screened tonight at 7 at the Mayfair Theatre. Doors open at 6: 30 p.m. Admission is a minimum donation of $5. Tickets are available at the door or online at wrongwaytohope.com. Proceeds will help take the documentary to other venues across Canada.

© Copyright (c) The Ottawa Citizen

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By Peter Mazereeuw, Ottawa Citizen April 25, 2011   

As I scanned the surging rapids before me, I tried to remember how I had gone from battling leukemia to fighting through whitewater in just over a year.

That was the summer of 2009, when I joined a small group of young adult cancer survivors embarking on a week-long kayaking expedition down the turbulent Owyhee River in Oregon. Most of us had never met, and had come in search of adventure as we recovered from our illness.

The trip was the brainchild of Mike Lang, an outdoor enthusiast who was diagnosed with lymphoma in 2008 at age 25. A year later, he successfully completed his treatment for the disease, and hatched a plan to help other young adults to reclaim the youth that cancer had stolen from them.

Lang and his wife, Bonnie, pitched their idea at retreats and conferences for young adult cancer patients. It was simple; they were offering us the adventure of a lifetime, and a chance to test our willpower against the river. No kayaking experience necessary, and it would all be caught on film.

The result was Wrong Way to Hope, a documentary of our collective catharsis as we fought to conquer the Owyhee’s rapids, and reflect on our struggles with cancer.

The film makes its Ottawa debut April 26 at 7 p.m. at the Mayfair Theatre. For those who know the unique challenges facing young adults with cancer, it serves as proof that we can regain our outer strength, and shed the identity of a sickly hospital patient.

For those who don’t, it offers a look into the experience of dealing with the crippling blow of cancer while trying to gain your independence.

Beating cancer by age 23 has put the rest of my life in a different context. It’s like watching a movie where the villain dies in the first 10 minutes. Everything afterwards is ... manageable.

The future still looms large. What will I become? Family, career, accomplishments and success, are all still up in the air.

But the feeling is different than it was before. There is a certain maturity gained by knowing you have suffered, had your body reduced to a broken down burden, and persevered through it all to start again.

My body will never be what it was before 2 years of chemo, but now I know it doesn’t need to be. Like a ‘95 Impala, it just has to get me to where I’m going.

It did just that on the river, rising to challenges in a way I thought was no longer possible. Rest assured, however, that Wrong Way to Hope still caught me navigating the odd rapid sans-boat.

I will be attending the premiere at the Mayfair, as will Mike Lang and our co-star, Laurie Hinsperger. We will be fielding any and all questions from the audience after the movie.

More than 6,000 young adults are diagnosed with cancer every year in Canada, but most go through their treatment without the benefit of support systems like those set up for elderly or child cancer patients.

Cancer doesn’t care if you are young, healthy, or starting your career. It can strike those in the prime of their life, and young adults with cancer need our help to get back on their feet, and out of their hospital slippers.

© Copyright (c) The Ottawa Citizen

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Brandie Weikle

HEALTHZONE.CA EDITOR

Elana Waldman was in treatment for unexplained secondary infertility (a term for problems that arise after conceiving a first child easily) when she received the news no one wants to hear.

Tissue taken from what her doctor believed to be an ovarian cyst was malignant. At age 32, she had stage IIIC ovarian cancer, an illness that strikes most often at midlife.

Waldman was given only a 30-per-cent change of surviving five years. That was August 2005.

“When I was first diagnosed, I went through two weeks of being upset, scared, angry,” she says. “But I felt that ease once I had a plan. You move forward and you can move into action.”

Waldman was able to lean on life experience more than most people facing a scary diagnosis.

“I’m slightly uniquely placed, in that my mother had breast cancer twice. So I had gone through her bouts of cancer with her, and we had developed our own internal support network.”

Waldman has been drawing on that support — and her own deep reserves of strength — to benefit others.

In an effort to provide support to others, and to help people better understand ovarian cancer, she speaks at luncheons and hosts a fundraiser called aWEARness (awearnesscanada.com) on May 1 each year.

Better understanding and more research dollars are dearly needed for the disease that is all-too-often caught late in the game.

Part of the problem is that the symptoms of ovarian cancer are so easily confused with other ailments. They can include gas, bloating, lower-back or abdominal pain, changes in bowel movements, fatigue, urgent urination or pain during intercourse.

“If you present any of these symptoms in your 40s, chances are your doctor will think you’re just periomenopausal,” Waldman says. Symptoms can also be confused with regular menstrual symptoms, lactose intolerance or irritable bowel syndrome — all relatively common ailments for women. “That’s the challenge.”

In Waldman’s case, she was experiencing digestive symptoms and lower-back pain, but the fertility drugs she was taking were known to cause the exact same symptoms.

Looking back, unexplained infertility should have alerted her caregivers to the possibility of ovarian cancer, because it, too, can be a symptom. But her young age — and the fact the disease affects just 2,600 women in Canada each year — put it put it entirely off the radar.

Waldman’s hope is that physicians will begin to think more often of ovarian cancer when trying to diagnose any ongoing problem in female patients.

Although there’s no standard test for the condition, a blood test called CA-125 can spot a marker that could either indicate an ovarian tumour or endometriosis. A result higher than the normal range (or a change in results over a period of time) could indicate that a CAT scan should be ordered.

“To me, it should be included with everything. If you’re doing blood tests, do the CA-125. As the population ages, you’re going to see more of it.”

When it’s caught in stage 1, ovarian cancer is survivable in 90 per cent of cases. The vague symptoms and the relatively rare incidence of the disease mean it’s too often caught late in the game. That’s why it’s often referred to as “the cancer that whispers.”

That nickname is why Waldman’s new website, itstimetoshout.com, is so aptly named. “We need to make our voices heard. We need to not whisper anymore. We need to shout,” she says in the site’s opening video.

The website’s mission is to raise awareness of the illness by collecting videos from survivors and people currently in treatment. The site just posted its 100th video, an exciting milestone for Waldman, who also has a video blog on Chatelaine.com.

“It’s been an experience on a couple of levels,” she says. “At first, I didn’t know if people would respond. Would people want to hear from me? I get 1,500 to 2,000 views of my blog every week. It just blows my mind.”

It’s been a great vehicle for her to connect with other people who are battling the illness. Waldman is experiencing her second recurrence and is in a clinical trial at Princess Margaret taking an oral medication that doesn’t have the side-effects of chemo.

“I also have some people in the ovarian cancer community who have reached out to me. There are not a lot of us out there,” she says. “It’s not like breast cancer, where the community is so pervasive and it’s very easy to find that kind of peer support. In ovarian cancer, because the numbers are lower, it’s a little hard to find.”

Waldman reached out to her readership when she had to tell her daughter, now 7, that her cancer had returned:

“What I still have to figure out is how to tell Sydney,” she wrote. “She knows about cancer and she doesn’t like it. She knows it means I can’t have more children and that it takes me away from her because my ‘medicine’ makes me feel tired. I don’t think she understands more than that yet. The really bad news is that I will have to see the sadness in her eyes when I tell her that mommy is sick again.”

With her cancer responding to the clinical trial and without the symptoms of chemo, things are looking up. In fact, her daughter recently said, “Oh, I thought you didn’t have it [cancer] anymore” because she hadn’t been acting tired. To Waldman, it’s great news that her daughter’s life — at least for now — is pretty normal.

If Waldman’s daughter takes after the women before her, she’ll be in good stead.

“I sort of drew from the example that my mom set more than anything else,” Waldman says. “She didn’t let cancer define who she was. It’s something that we have to deal with. It’s something that we have but it’s not who I am. It’s not what defines me. I don’t let it take control of my whole life. It’s one of those things that I can no longer control and I focus on the things that I can.”

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CTV.ca News Staff

Date: Wednesday Mar. 9, 2011 9:56 AM ET

It happens every year: young Canadians who are planning to head south for Spring Break head to their local tanning salon to try to get a "base tan" before hitting the beach, in hopes it will help to protect them from sunburn.

But the Canadian Cancer Society wants them to know that not only will a visit to a tanning booth put them at risk of skin cancer, the "base tan" concept is a myth.

A new poll commissioned by the Canadian Cancer Society's Ontario division shows that 49 per cent of students in Ontario and 36 per cent of those aged 18-29 falsely believe that using indoor tanning equipment to get a so-called "base tan" before going on a winter sun vacation protects from sunburn.

In fact, the Cancer Society says, a tan offers almost no protection from sunlight or burning. What's more, some tanning beds can expose skin to five times more radiation than the sun.

"We're concerned that too many Ontarians continue to seek a tan, especially before and during a winter vacation in a sunny climate," says Dr. Loraine Marrett, co-chair Ontario Sun Safety Working Group and director of Surveillance, Prevention and Cancer Control at Cancer Care Ontario.

"There is simply no safe way to get a tan."

The Society says that any amount of exposure to UV rays, no matter what the type, can be harmful, as it causes DNA damage that increases a person's cancer risk. And any use of indoor tanning equipment before the age of 35 has been found to increase the risk of melanoma by 75 per cent, the agency says.

The Environics survey also found that more than half of respondents (51 per cent) believe people look more attractive and healthier with a tan.

Interestingly, younger Canadians attitudes about tanning differ from their parents' and grandparents' generations. Older adults were more likely than younger age groups to attribute healthy looks to a suntan -- 66 per cent of those 75-plus, versus 41 per cent of those aged 18 to 29.

"We need to work towards a social norm that does not include a tan as a sign of beauty or health," Salima Allibhai-Hussein, Senior Manager of Prevention at the Canadian Cancer Society, Ontario Division, said in a news release.

"Aside from legislation to protect youth, more needs to be done to raise awareness of the cancer risk of UV radiation, from both sun and tanning equipment."

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Each year, two million new cases of skin cancer are diagnosed but even if you don't spend a lot of time in the sun you could still be one of those numbers. Sancy Leachman, a dermatologist from the Huntsman Cancer Institute came in to talk about the warning signs and risks of skin cancer. She provided us with this information: Facts about skin cancer: · Melanoma, the deadliest form of skin cancer, is responsible for more than 75 percent of all deaths from skin cancer. · Because of Utah's high altitude, people who live in Salt Lake City are at higher risk to develop skin cancer. · Melanoma is the second most common form of cancer for adolescents and young adults (15-29 years old). · Five-year survival rates for melanoma caught and treated early, before it has spread, is 98 percent. Who is at risk? · Anyone with a personal or family (parent, sibling, or child) history of melanoma. · People with light skin that burns or blisters easily and blue, green or gray eyes. · People who experienced excessive sun exposure during childhood and teen years; blistering and sunburns before age 18. · Anyone with one or more unusual moles-that is, moles larger than a pencil eraser, and moles with color variations and/or irregular borders. · Fair-skinned men over the age of 50 are at increased risk to develop melanoma. What can you do? · Use a broad-spectrum sunblock with titanium dioxide or zinc oxide and an SPF of at least 25-30. · Avoid the sun between 10 a.m. and 4 p.m. · Apply sunblock 20 minutes before sun exposure and 20 minutes after going outdoors. Reapply every two hours. · Wear protective clothing, including sunglasses, hats, and long sleeves. · Watch your skin for changes and have a physician examine your skin annually.

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Craig Skeard has been cancer free for about five years.

Last week, Mr. Skeard and Chris (O.B.) O’Brien had their heads shaved as part of Shave for the Brave. The money raised goes to programs supporting young adult cancer patients and survivors.

It’s a good cause and he’s had cancer. Those are two reasons Mr. Skeard took part.

“There are always people who need help,” he said.

In 2002, Mr. Skeard had thyroid cancer. After it was removed, it spread to the other side of his neck. He had another surgery in 2003. He came down with leukemia in 2005.

“That was another blow, I guess you could say,” said Mr. Skeard.

He said he got through it with a lot of family support, including his children who were home. His second child was born after his first round of treatment.

“I really never got to see her for the first two or three months because I was in St. John’s and I was unable to leave,” he said.

Mr. Skeard said to someone who might be in a similar position to his he would say there’s always hope.

“Hold on right and don’t give up,” he said.

Mr. Skeard said since having cancer, he’s begun to eat better and he’s lost weight. He’s said he’s doing well now.

“I just try to put it behind me and go on about my daily business,” Mr. Skeard.

Mr. Skeard and Mr. O’Brien raised approximately $1,000.

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March 18, 2011

by Karin DuBois

Before saying goodnight, a group of young cancer survivors sit in a circle on the sandy edges of Oregon’s Owyhee River. An orange flag with the word "isolation" printed in black ink is planted in the middle. The group has just spent the day hurtling down challenging class-three rapids in single-occupant kayaks, and now, they're getting emotional. Jen Luce, a 33-year-old brown-haired woman, rocks herself back and forth as she shares how she felt like she was in a deep, dark hole during treatment, not wanting to talk to anybody. As I watch her on TV, I nod along, understanding all too well.

Most of these adults, all in their 20s and 30s, are new to kayaking; some met for the first time only days before. But even though they are in the middle of a desert, hundreds of kilometres away from friends, family, and cellphone reception, they are far from being isolated, because they all share a common bond—they, like me, have all faced cancer.

Their very personal discussions are captured in Wrong Way to Hope , a documentary directed by Aaron Bryant and produced by Calgary native and cancer survivor Mike Lang. The film follows the nine-day journey of eight Canadian young adult cancer survivors as they kayak through rough waters while navigating emotional roadblocks.

Watch the trailer for Wrong Way to Hope .

I met Lang in 2009, at Young Adult Cancer Canada’s third annual survivor conference in St. John’s, Newfoundland. He explained to me how he began this documentary project only five months after he had finished treatments for Hodgkin’s Lymphoma. Being a cancer survivor myself (I was diagnosed with alveolar rhabdomyosarcoma, a rare type of childhood cancer, when I was 20), I was thrilled to find out that a film about young adult cancer survivors—an age group that receives little cancer awareness—was in the works.

I found the end result deeply inspiring. In the film, the young men and women openly discuss the personal demons they face as a result of their cancer diagnosis, including isolation, fear, uncertainty, and “reintrajectorization”—a term, coined by a survivor, used to describe the process of re-entering life after cancer treatment.

Cheryl Roby, a 36-year-old cervical cancer survivor from Winnipeg, tearfully describes how her relationship with her husband is dissolving as a result of her cancer battle. Alston Adams, a young man from Montreal (who later died in 2010 from recurring esophageal cancer at the age of 35), feels derailed by his disease, which came just one month after landing his dream job. Leaning back on a black foam chair, he gestures emphatically as he talks about how he hates fear. It reminds me of how, almost six years after finishing treatments, I am still learning to live beyond cancer-related anxiety.

Later, Adams summarizes his cancer experience, from the removal of 85 percent of his esophagus to the numerous failed treatments, and—in a moment that I found remarkably touching—says he has learned acceptance, and that he can face more. When I saw him leap off a cliff after repeated hesitations, my eyes welled up, knowing he had pushed through fear and discovered just how resilient he truly was.

Local individuals in this group include 28-year-old Jared Brick from Vancouver, 32-year-old Vikram Bubber from Surrey, and the aforementioned 33-year-old Jen Luce from Richmond.

I am moved that young people who have already gone through the trauma of cancer—the closest thing to hell-on-earth that I have experienced—would share their stories so openly on camera and willingly subject themselves to such a physically and mentally demanding trip.

Near the end of Wrong Way To Hope , the group sits around a post strewn with multi-coloured flags, each depicting a theme, such as isolation, relationships, and fear and uncertainty. The flag with the words “Choose your own adventure” is the last to be added.

“Stuff happens to you, you know, that you can’t control,” Lang says, sitting directly behind the post with his legs stretched out. “But you can choose where you go from there.”

Perhaps making that choice is indeed the right way to hope.

Wrong Way to Hope  kicks off a cross-Canada tour at the Ridge Theatre (3131 Arbutus Street) on Sunday (March 20) at 4 p.m. The screening will be followed by a panel discussion with young adult cancer survivors, including Lang. Proceeds will benefit young adult cancer support programs at the Callanish Healing Society in Vancouver. Upcoming B.C. screenings include Langley (March 23) and Victoria (March 26).

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Cell phone safety warnings are generally designed for a large man with a big head who talks less than half an hour a day. The average toddler's head, however, weighs about half as much and is far more susceptible to the microwave radiation the phone emits, said environmental health expert Devra Lee Davis, founder of the Environmental Health Trust, which campaigns for safer cell phone use. As the debate over cell phones and cancer continues to rage, concern is growing over the effects of the phones — as well as devices such as the iPad — on children. A recent study published in the Journal of the American Medical Association found that pressing a cell phone to the ear for 50 minutes altered the brain activity in 47 adult volunteers.

The study doesn't answer the million dollar question: whether the change in brain activity causes any harm. The wireless industry group says no research has proven cell phones to be dangerous. The National Cancer Institute, meanwhile, says there is no consistent link between cell phones and cancer. But the NCI also notes that there's currently no data on cell phone use and risk of cancer in children and that children may be at a greater risk because their nervous systems are still developing at the time of exposure. Meanwhile, cell phone use by children and adolescents is increasingly rapidly. Experts worry that children's brains, encased in a thinner skull, may be more vulnerable to the effects of the radiation emitted by the phones. Dr. Nora Volkow, the lead author of the JAMA study, said modeling studies have shown that a child's brain would absorb more radiation than those of adults. But Volkow said she's unaware of studies that have looked at the different developmental effects. Some studies have suggested that the radiation can cross or affect the entire brain of children, who are still developing, versus a particular area in adults," said Dr. Stephanie Wagner, co-medical director of the neuro-oncology program at Indiana University Health and the IU Simon Cancer Center in Indianapolis. But studies looking at the effects of electromagnetic radiation in children and the risk of epilepsy and behavioral problems such as attention deficit disorder and aggressive behavior showed conflicting results, Wagner said. Still, why take a chance, Volkow said. She suggested that parents "teach their children to use their cell phones with a wired earphone and/or use the speakerphone mode and to avoid putting their cell phones directly on their ear."