The process of sorting out who they are and who they want to be is often nerve-racking and painful for young people.
A cancer diagnosis at any age is difficult to cope with, but if received during their transition to adulthood, it can be particularly disruptive and damaging to a person’s psychosocial health.
Research has shown that younger age is consistently associated with greater distress in cancer patients, including clinical depression and anxiety.
However, there is a dearth of age-appropriate support services for teenagers throughout their cancer journey.
Added to this, young men are less likely to seek support and information than young women. The taboo against talking to someone about your problems is entrenched amongst teenage boys, who can view it as ‘unmanly’ to demonstrate any vulnerability, sensitivity or confusion. In short, even if they are experiencing such feelings, it is highly unlikely that they will admit to them.
Young men report that the social support they receive from their peers is inadequate or non-existent. Instead of helping, friends who lack the social tools instead create distance. All of which puts young men at greater risk and creates further challenges to them when coping with their cancer diagnosis, and maintaining their own self-identity and self-esteem.
“Being a man, you always have to cover up your suffering as much as possible. ‘Never let them see you hurting’ is something that always went through my head…. I felt like I had to be strong for everyone else. Well, that’s probably one of the mistakes I made. Maybe letting others see the suffering I was going through might have made them stand up and help carry me along.” 1
Currently, young men treated at The Royal Marsden follow one of two psychological support pathways. Those under 18yrs follow the children and young people’s pathway with access to clinical psychologists, a neuro-psychologist and a psychiatrist and interventions across treatment and into survivorship or to coping with a terminal prognosis.
Those aged 18yrs and older follow the adult pathway with access to nurse counsellors and psychiatric liaison nurses, a psychiatrist, a health psychologist, with limited access to clinical psychologists, and intervention is largely restricted to the time of treatment.
Both these pathways serve their intended client group but neither is solely dedicated to an age-group and gender known to experience significantly greater levels of psychological/emotional distress when compared to children and older adults – that of young men.
Certain interventions have been found to meet both the age and gender specific needs for young men with cancer. With your support, we can employ two part-time clinical psychologists to work directly with our young male patients throughout their cancer journey. The service is designed to meet specific needs; our psychologists would determine which interventions would work best on an individual basis but could include:
Our team will work with young men to help them express their feelings, in order to help reduce feelings of anger, depression or anxiety. Men who are able to seek the help of peers strongly assert how beneficial their support is, despite its rarity. Helping young men open up to their peers and maintain their friendship groups is fundamental to their wellbeing, in particular their mental health.
“Even if there are less-than-ideal circumstances that wind up being a result of it [a cancer diagnosis], you can deal with it. Having that support structure will help you get through. If it works out and you’re cancer free for the rest of your life, fantastic. If you have to struggle through it, it sucks, but at least you’d have friends.” 2
Putting young men with cancer in touch with each other via facilitated support groups would also be very beneficial – even the opportunity for peer support is valued.
“You don’t have to listen to certain people, or you can listen to certain people. You’re given an opportunity. And, at least in my opinion, it’s better to be given the option than to not even know it’s there in the first place.”3
The group and individual work will provide communication training to help men express feelings without threatening their masculine identity e.g by using humour. The sessions would promote coping mechanisms, motivation and self-management.
The growing success of digital media forums suggests the relative anonymity makes expressing thoughts and feelings easier, particularly when discussing sensitive issues such as sexuality and fertility. Monitored online support forums can afford the opportunity to discuss these topics without embarrassment.
Connecting men through other activities, not explicitly connected with cancer, such as sports or social events have demonstrated positive mental-health outcomes and wellbeing in young adult, male cancer patients. The focus here is not on young men’s cancer experiences, but on a shared interest that can be a conduit for cancer-related conversation and, therefore, gender and age-appropriate support.
Being able to offer such targeted proactive wellbeing and psychological support programmes would be incredibly beneficial to our young male patients. The clinical psychologists would be with our young male patients through every step of their cancer journey, helping them deal with their feelings, learn coping mechanisms and continue to develop their self-identities with as little disruption as possible.
These clinical psychologists would also enable further research into this age group’s psychological support needs across their cancer experience to inform future service development.
1/2/3: Participants in study: Eiser C, Penn A &Katz E (2009) Psychosocial issues and quality of life in young adult cancer. Seminars in Oncology. 36:275-280.