Every year, there are about 2,300 new cases of cancer among the teenage and young adults (TYA) group in Tamil Nadu. Cancers in this age group — aged 15 to 29 years — account for nearly 3.7% of all cancers in the State, according to the Tamil Nadu Cancer Registry Project. With oncologists recognising TYA as a separate group — like paediatric and adult groups — they say management of cancers among TYA needs special attention and a holistic approach.

Citing data from the Tamil Nadu Cancer Registry Project, R. Swaminathan, assistant director, Cancer Institute, Adyar, said the rate of occurrence of cancer in this age group was 11 per one lakh population.

A study of three to four year data of patients at the Rajiv Gandhi Government General Hospital showed that TYA cancers accounted for nearly 4% cent of all cancers, retired professor of Medical Oncology, K. Kalaichelvi said.

“We evaluated 1,009 patients between 2013 and 2015. Haematological malignancies accounted for 40% and solid tumours for 60%. Of the solid tumours, gastrointestinal tract malignancies were more common, accounting for 16.5% followed by head and neck cancers at 10.5%. Breast cancers accounted for seven to eight per cent,” she said.

A cause for concern was that 40% of them did not complete treatment due to family background and financial situation. “While family support is essential, cancer survivors require rehabilitation. When treating, we need to keep their future in mind,” she said.

Why focus on this age group? Rakesh Jalali, director, Apollo Proton Cancer Centre, lists a few reasons: this population has difficult challenges to face such as education, employment, body image, peer pressure, psychosocial issues and suicide ideation.

Unique issues

“We have paediatric and adult protocols for cancer management. TYA are in between and have their unique issues. Now, there is momentum to recognise TYA as a separate group because of the challenges. This is a unique age group that is growing into adulthood.

They could lose hair, have low self-esteem and struggle with their own interpersonal relationships and sexuality,” he said.

There was a greater need to manage not just the cancer but also look holistically at this population. “Schools and colleges should be sensitised to provide extra benefits for patients during and after treatment. Governments, NGOs and private companies should be sensitised to provide them employment. Society should be encouraged to treat them as normal to enable them to get married and lead normal lives,” he emphasised. Mr. Swaminathan said cancer management in TYA needed special attention with emphasis on counselling. “There is a sharp rise in oral cancer among young men in recent years primarily due to use of smokeless tobacco and this needs to be checked,” he said.

Arvind Krishnamurthy, professor and head, Surgical Oncology, Cancer Institute, said this distinct group always existed due to its own set of psychosocial issues. “There are plenty of challenges such as education, vocation, social, long-term goals, career and fertility. The challenge for clinicians is not just to treat them but also to prevent long-term morbidity, preservation of fertility, professional and social goals,” he said.

Sparse data

“Of recent, there is interest in this age group but data across India is sparse. When robust data is lacking, the available numbers are open to everybody’s interpretation. We need robust data to study in detail,” he said.