Dr. Abby Rosenberg recently assumed a leadership role in the Adolescent and Young Adult (AYA) Cancer Program at Seattle Children’s Hospital. She is also a researcher in Seattle Children’s Research Institute’s Center for Clinical and Translational Research. Dr. Rosenberg happens to love to write, so she’ll be contributing to On the Pulse from time to time. Below, she talks about her own experiences as a teen, and what it’s like for teens with cancer to balance those struggles while battling a serious illness.
It is with excitement and some nervousness that I begin my role as the new medical leader of our Adolescent and Young Adult (AYA) Cancer Program at Seattle Children’s Hospital. Why am I nervous? I love working with teens and young adults. But, I also remember my own adolescence and young adulthood. It wasn’t easy. I was socially awkward. Painfully insecure. A little bit lonely. I was a good student, a decent soccer player, and (unfortunately) an inconsistent friend. I wanted desperately to fit in, but never quite did. I believed that each boyfriend was “the one”…until suddenly he wasn’t. I fought with my mother constantly; I wanted her to be my friend and never would have admitted that I really needed her to be my mom. I couldn’t wait to move out, to be independent, to prove to the world that I was somebody.
Adolescence and young adulthood is a period of life that is supposed to be characterized by struggle. Maybe that sounds melodramatic, but I think it’s true. It is the time when we develop our self-identities. Our independence. We navigate peer relationships. Romantic relationships. Family and community roles. We begin to set our educational, vocational, and other life goals. We take on real responsibilities. Put bluntly, we grow up.
Now imagine throwing cancer or serious illness into that mix. These patients face all of these normal challenges plus the big one of having to cope with their illness. Suddenly their self-identity is threatened. They are rarely able to be fully independent (no cancer patient is, no matter how old). Peer and family relationships change (for better or worse), romantic relationships become additionally hard. Imagine how cancer affects all the normal insecurities, social milestones, and that sense of “I can do anything” that is so pervasive among teens and young adults.
It turns out that teens and young adults with cancer have not seen the same improvements in survival that have been described in younger pediatric or older adult patients. One explanation is that they have distinct cancer biology. Another is that these developmental challenges make cancer that much harder to beat. We think that providing a medical home that not only understands, but also meets these needs, may improve the odds and enable more teens and young adults to conquer their cancers.
When I started my oncology training here at Seattle Children’s, I expected to see the adolescent and young adult patients struggling. They proved me wrong. Working with these patients over the past five years, I have seen evidence of extraordinary resilience. In fact, I was so inspired (and surprised) by this resilience that I started to study it, with the hope that I could some day teach it. I’ve been interviewing a group of teens and young adults for the past year and a half. And yes, they do tell me it is hard. But they also tell me what they have learned – about themselves, about what they think matters in life. Here is an example:
“My story is still being written. I think I’m gonna’ be a different person…still the same in some ways, but all this changes you. You value life more. You realize not to waste it. And that seems like a gift.”
So, it is because of these exceptional adolescents and young adults that I look forward to my new position on our team. My goals for our program are to continue to provide state-of-the-art, excellent medical care, while also seeing the whole adolescent or young adult person and providing the psychosocial supportive care that will enable that person to thrive.
Thanks for welcoming me, and stay tuned!