When Cancer Isn’t the Only Battle: Disability, Chronic Illness, & Mental Health

Cancer rarely shows up alone.
For many young adults, it lands in a body that was already managing autoimmune disease, chronic pain, fatigue syndromes, disability, mental health conditions, or invisible illness long before the words “you have cancer” ever entered the chat.

So when cancer enters the picture, life does not politely pause.
You are still juggling appointments, medications, flares, side effects, work expectations, relationships, and whatever scraps of energy you have left. People may call you “strong,” but what you might actually feel is tired, frustrated, overstimulated, and wildly unseen.

And if you have ever thought, Why does this feel harder for me than it seems for everyone else? you are not imagining it.

The overlap between cancer, disability, chronic illness, and mental health creates real, measurable stressors that most people, and honestly many providers, do not talk about enough.

The Mental Health Toll of the Both and

Living with both cancer and chronic illness means your body is constantly negotiating with itself. Fatigue, pain, brain fog, and treatment side effects blur together until it is hard to tell where one condition ends and another begins.

From a clinical perspective, this overlap often leads to:

  • Medical burnout, or emotional exhaustion from years of appointments, self-advocacy, and system navigation

  • Hypervigilance, where you are constantly monitoring symptoms, flares, or changes

  • Identity grief, or mourning past versions of yourself while trying to survive the present

  • Chronic stress activation, where the nervous system stays stuck in fight or flight, worsening pain, fatigue, sleep issues, GI symptoms, and mood

You might notice feeling detached or numb, angry at your body, ashamed for needing help, guilty for resting, anxious before appointments, or quietly sad without knowing exactly why.

Many people minimize their pain because they are afraid of being labeled difficult, dramatic, or non-compliant. Those labels cause real harm, especially for young adults, women, people of color, LGBTQIA+ folks, and people with invisible disabilities who are already less likely to be believed in medical settings.

Here is the truth. Your symptoms do not need to be extreme to be real.
You deserve care that sees the full picture, not just diagnoses in isolation.

When the System Is Not Built for Complex Bodies

Healthcare systems are not designed for overlap. Full stop.

You might have specialists who do not communicate with each other, treatment plans that contradict one another, insurance that covers one diagnosis but ignores the rest, intake forms with no space for nuance, or providers who treat mental health as optional.

Clinically, experiences like ableism, medical gaslighting, and accessibility barriers are strongly associated with increased anxiety, depression, trauma responses, and healthcare avoidance. Research from DREDF highlights how these systemic failures directly contribute to mental distress for disabled and chronically ill people.

If you feel more anxious, shut down, or emotionally exhausted after medical interactions, that is not a personal failure. That is your nervous system responding to repeated invalidation.

And there is hope. Support exists when it comes from communities, therapists, and organizations that understand what it means to live in a body that does not follow the rules.

Finding Support That Actually Gets It

Healing does not mean fixing what is “wrong.”
It means creating safety, relief, and meaning within the reality of your body.

Disability-affirming and chronic illness-informed mental health care often focuses on:

  • Body neutrality and acceptance
    Separating your worth from productivity, wellness, or symptom control.

  • Energy pacing and boundaries
    Planning life around realistic energy limits to reduce flares and burnout.

  • Medical trauma recovery
    Processing fear, anger, grief, and exhaustion from years of care systems that missed the mark.

  • Self-advocacy
    Building confidence and language to communicate your needs clearly with providers.

The right therapist will honor your lived experience, not try to cure it.

Resources for Chronic Illness & Disability Mental Health

These organizations offer validation, education, and community for people balancing illness, disability, and mental health:

Center for Chronic Illness
https://thecenterforchronicillness.org
Provides virtual support groups, education, and resources for people managing chronic illness. Many programs are free and facilitated by professionals who understand both the mental and physical toll of long-term health conditions.

Chronic Illness Hotline
Call or text 512-288-8488
Peer-to-peer support run by people with lived experience of illness and disability. Sometimes you just need to talk to someone who truly gets it.

Disability Rights Education and Defense Fund (DREDF)
https://dredf.org
A national leader in disability rights advocacy offering education, policy work, and resources to help people understand their rights and access equitable healthcare.

Pain Connection (U.S. Pain Foundation)
https://uspainfoundation.org/pain-connection
A national network of peer-led support groups for individuals living with chronic pain and their caregivers, along with education and advocacy resources.

Practical Ways to Support Your Mental Health Right Now

You do not need a perfect plan. You just need permission to start.

  • Honor your pacing
    Rest is not laziness. It is symptom management.

  • Use adaptive tools
    Mobility aids, accessibility devices, and energy-saving hacks are forms of self-respect, not surrender.

  • Create emotional accessibility
    Let your people know what kind of support you need, whether that is quiet presence, distraction, or help with logistics.

  • Connect with peers
    Disability-affirming communities can reduce isolation in ways even excellent medical care cannot.

  • Seek professionals who get it
    Use directories like Inclusive Therapists or TherapyDen to find providers experienced in chronic illness and disability-informed therapy.

You Deserve a Life That Fits You

Living with cancer and chronic illness or disability does not make you broken. It makes you complex, adaptive, and worthy of care that honors that complexity.

You do not have to prove your pain.
You do not have to perform gratitude.
You do not have to make others comfortable at your own expense.

Healing is allowed to look unconventional.
Rest is allowed to be productive.
Joy is allowed to exist alongside pain.

If you are ready to explore resources that support your whole self, body, mind, and everything in between, visit our Disability, Chronic Illness, & Mental Health Resource Directory for peer support groups, advocacy networks, and organizations that speak your language.

Because your story does not end with a diagnosis.
It expands from it. 💛

Ask Perrie: More Than Just Tired

Dear Perrie,

I am a few years out of active treatment, and I still have significant post-treatment fatigue. Not looking for strategies to combat fatigue, but more on how to explain it to other people that my “tired” (bone-deep exhaustion) is different than other people’s “tired.” It’s hard, because I also look physically well now and I’m able to “function” well. Advice needed, Perrie!!

Dear More Than Just Tired,

First, I want to validate that your experience makes sense, and you are far from alone in this. So many young adults I talk to share this exact tension: they look “functional” (especially as young adults). Some may even have a habit of pushing through chronic symptoms so they can still participate in regular life, but end up crashing later. This all happens while carrying bone-deep fatigue and the internal battle of managing capacity as an adult. That’s a lot. 

One tool that can really help put language to this is Spoon Theory. If you’re not familiar, it’s a way of describing energy as a limited number of “spoons” you start the day with. Every task (like getting dressed, working, socializing, even thinking through something emotional) costs a spoon. Using this framework with others can sometimes help them visualize what it’s like to balance capacity while living with chronic fatigue. 

So, instead of saying “I’m tired,” you might say: “I only have a certain number of spoons each day, and I have to choose carefully how I use them.” Or “If I spend my energy here, I might not have enough left for something later. I’ve found that language like this can sometimes help ‘normies’ understand that chronic fatigue isn’t about willpower or effort, it’s about capacity. In my personal life, I’ve even set up a system at home so my husband knows my spoons/capacity that day. I’ll write on the whiteboard or text him how many spoons I have, which helps us adjust our schedule accordingly. 

It may also help to pair Spoon Theory with language such as “dynamic disability” and “invisible illness”. Dynamic disability means your abilities are not fixed. Your capacity can shift day to day or even hour to hour, so what feels manageable one day may feel impossible the next. Invisible illness means what you’re experiencing may not be obvious to others. You might look “fine” while your body is working overtime just to function. Together, these terms can help explain why chronic fatigue is so hard for others to see or understand and help to reinforce your limits when discussing your fatigue with others. 

Lastly, it may also be supportive to get concrete about what support actually looks like. People often want to help, but don’t know how, having never lived through cancer or chronic fatigue. You might say something like, “It helps when plans are flexible,” “I may need to cancel at the last minute,” “Offering options instead of expectations makes things easier,” or “Low-energy time together still means a lot to me.” These types of statements set expectations and communicate directly the type of support that feels most helpful for YOU. You might need to practice these statements on your own at first, and that’s okay! I’ve been known to have a mirror conversation or two to help myself practice naming my needs.

All that said, there is a hard truth we can’t avoid when communicating our needs: Even the best explanation won’t make everyone understand.

You can do your best to explain your experience. You can offer tools to understand. You can be vulnerable and honest. But you cannot control whether someone truly gets it. What you can control is how you care for yourself in response. That’s where boundaries come in. That might sound like, “I need to head out early so I don’t overdo it.” “I can’t commit to that right now.” “I need a slower day today.” Try not to over-explain, and try not to apologize for having real limits! Boundary work is often easier said than done, because we then have to sit with someone’s uncomfortable reactions to our boundaries. I recommend checking out Nedra Glover, a licensed therapist and author who discusses boundary-setting extensively, as a tool for support. 

And as a side note, if you do share vulnerably (which is always optional) with someone and take the time to explain your fatigue, your limits, your reality, and they dismiss it, minimize it, or continue to expect more from you than you can give… that’s important information about the relationship. Don’t get me wrong, some people will meet you there. They’ll adjust expectations, move plans around, respect your limits, and truly care about your capacity. They’ll make a real effort to accommodate your needs and still include you. These types of relationships are worth their weight in gold. And still…. others won’t. Part of navigating life after cancer is learning to invest your energy in the relationships that can honor your reality, not fight against it.

There is also something really powerful in your question. I can tell that you are learning how to listen to and honor your body, name your limits, and advocate for yourself in ways most people never have to. This work is hard, but it’s absolutely vital in reconnecting with yourself after an experience like cancer. I’m really proud of you for doing the hard things! 

With you in it,
Perrie 🌵

Ask Perrie is Cactus Cancer Society’s advice column for the questions that young adult cancer doesn’t come with instructions for. Community members submit anonymous questions, and Perrie offers thoughtful guidance, perspective, and practical ideas for navigating life during and after cancer.

SUBMIT YOUR OWN QUESTION

AYA Awareness Week: What We’re Still Missing

April 6th through April 10th is Adolescent and Young Adult (AYA) Cancer Awareness Week, a time dedicated to bringing attention to the unique realities of people diagnosed with cancer between the ages of 15 and 39, a group that often falls in between pediatric and older adult care and is frequently overlooked in research, resources, and support.

According to the National Cancer Institute, about 89,000 young people in this age range are diagnosed with cancer each year in the United States, accounting for about five percent of all diagnoses.

What’s less often talked about is that for some cancers, rates are actually rising in younger generations. According to the American Cancer Society, colorectal cancer in people under 50 has been increasing by about 2–3% each year, even as rates decline in older adults. It has also become one of the leading causes of cancer-related death among young adults, with about 1 in 5 new cases now diagnosed in people under 55.

The National Cancer Institute notes that young adults are also more likely to be diagnosed at later stages, in part because symptoms are often dismissed or attributed to less serious conditions. And this trend isn’t limited to one type of cancer. Research highlighted by the National Institutes of Health shows that several cancers, including breast, pancreatic, kidney, and colorectal, are increasing in younger generations, pointing to a broader shift in cancer trends.

So yes, awareness matters. But awareness alone doesn’t change what it feels like to be dismissed in a doctor’s office, or to navigate disability, fertility, identity, and everything in between. Recently, our Rooted Voices Advisory Board came together to reflect on AYA Awareness Week. We asked a simple but honest question: What’s really needed in the AYA space with all that is going on the world today? What emerged was thoughtful, direct, and deeply grounded in lived experience.

Here are a few of the themes that came forward.

Being taken seriously, earlier

Many young adults shared how difficult it can be to get answers when their concerns aren’t taken seriously. Being told you’re “too young,” reassured too quickly, or asked to wait it out can delay diagnosis and add another layer of stress to an already overwhelming experience.

Several board members described having to push for testing or advocate more strongly than expected, especially when symptoms were initially minimized. Over time, this can create hesitation. People begin to question their own instincts, wonder if they’re overreacting, or delay speaking up again, even when something still feels off.

Board members also pointed to the need for stronger provider training in bedside manner, clearer guidance for young adults on when and how to advocate for additional testing, and clinical environments where concerns are met with curiosity instead of dismissal. Small shifts in how concerns are received can make a meaningful difference, not just in outcomes, but in how safe and supported someone feels seeking care.

Turning advocacy into something tangible

Accessible education around prevention and early detection, including HPV vaccines, pap smears, mammograms, and genetic testing, was also highlighted as an ongoing need. Without clear, centralized information, many young adults are left to piece things together on their own or learn about options later than they should.

That same gap shows up in how we talk about self-advocacy. It’s often encouraged, but not always explained in a way that feels usable in real moments of care.

Board members expressed interest in more concrete, shared tools, such as a toolkit or living resource document that young adults can return to and build on over time. This could include language for how to approach second opinions, guidance for navigating pushback or uncertainty, and clear next steps when care is denied or delayed.

Tools like this can help make advocacy feel more possible, especially in moments when it’s hardest to know what to say or do.

Making space for grief in all its forms

Grief showed up in many different ways in this conversation. Not only in response to loss, but in the ongoing, layered ways it can exist alongside a cancer experience. Changes in identity, plans, relationships, and sense of certainty all carry their own forms of grief. They identified a need for ongoing spaces to process grief, community-based ways to remember and honor those who have died, and support that acknowledges grief as an integral part of the experience, not something separate from it. 

Making resources easier to find and use

A number of participants reflected on how difficult it can be to find and navigate available resources. They shared that finding information and resources about fertility preservation and storage, financial assistance and grants, insurance navigation and appeals, and workplace and school accommodations has been challenging. In many cases, resources do exist, but they are scattered or not clearly communicated. There is a strong desire for more centralized, easy-to-understand information that young adults can actually use in real time.

Expanding what support can look like

Support groups can be meaningful, but they may not meet every need. Young adults are often navigating multiple layers of experience at once, and many are looking for support that feels more tailored and reflective of who they are. This includes identity-affirming spaces, creative and flexible ways to process and connect, and broader representation across cancer types, including rare diagnoses. Support is most effective when it reflects the complexity of the people it’s meant to serve.

What We’re Doing (and Still Learning)

At Cactus Cancer Society, AYA Awareness Month is not just about visibility. It’s about listening and responding.

Many of our programs are shaped directly by conversations like this:

  • Creative spaces like The Inner Canvas, where grief and identity can be explored without pressure
  • Programming that centers lived experience alongside professional insight
  • CE Programs where providers can learn more about how to effectively support YAs with cancer 
  • Ongoing efforts to make resources more visible, usable, and relevant, including our recently updated resource section 

And we know there is still more to build.

Awareness Isn’t the End Goal

AYA Awareness Month matters. Awareness is only the beginning. What young adults are asking for is care that is informed, accessible, and responsive to the reality of their lives.

Part of that is in the small moments. Like being listened to, being taken seriously, having access to information that’s actually clear and easy to find, knowing what questions to ask, and feeling supported enough to ask them.

It’s also in the way support shows up over time. Not just at diagnosis, but in the in-between, in the long-term, and in the parts that don’t always get talked about. We’ll keep listening. And we’ll keep building alongside this community.

Got feedback you want to share with us on what you think the YA Cancer Community needs? Reach out to us at info@cactuscancer.org 

Ask Perrie: Reclaiming Your Voice

Dear Perrie,

How do you advocate for yourself at doctors’ appointments and hospitals when you have been failed by the medical system before? (ie. missed diagnosis and now new problems are arising….)

Dear Reclaiming Your Voice,

This is such an important question, and I’m so glad you asked it! The truth is that many young adult cancer survivors experience medical mistrust. In the U.S., it’s not uncommon to encounter providers who are burnt out, overworked, and treat patients like numbers rather than people. Missed diagnoses, medical gaslighting, and difficulty trusting the system again are, unfortunately, experiences I have heard from many other young adult cancer survivors.

Despite that, we still have to advocate for ourselves. Recognizing and validating the real barriers and emotions that might get in the way is an important first step. Pushing through with a toxic positivity mindset isn’t very sustainable and can often leave folx feeling even more frustrated than before.

If you find yourself shutting down during appointments, you may need a way to come back into your body and stay present, using tools like mindfulness, fidgets, note-taking, or asking for follow-up appointments. If you find yourself overwhelmed, triggered, or angry in these appointments, you may need to practice deep regulation and communicating your concerns, even when big feelings are in the room.

A helpful tip, in any situation, is to start keeping an organizational system. You likely have access to a virtual chart, and if so, I would practice reviewing your medical notes, labs, and visit summaries before appointments. I’ve recommended to people in the past to have their own medical binder or notebook. But really, you can grab any piece of paper or even the notes section of your phone and jot down your thoughts and the top 5 questions you want to address in your next appointment. Organizing yourself this way can help you stay grounded in what is most important to cover in your appointments, even when you are feeling overwhelmed, scared, or tapped out. 

It can also be incredibly supportive to bring someone with you to appointments when possible. Having a support person can be another great grounding tool and a way for someone to have your back when you need to speak up for yourself. If it’s not possible to have a support person, you could also ask permission to record doctors’ appointments so you can listen back to them later. Recording offers a way for you to review information and return to it, a helpful strategy if it takes time for you to process information. 

It’s also completely okay to ask your provider to slow down. If something is confusing, or they are using a term you don’t understand, it’s okay to ask, “Can you explain that another way?” or “Can you walk me through your thought process as to why this test is the best option, or this other option isn’t a good idea?” Asking providers to clarify their reasoning and thoughts can help you to better understand your care and give you the opportunity to notice if your concerns are being taken seriously. If you find that you are consistently being dismissed, even after you’ve spoken up, then it might be time to pivot.

An important part of self-advocacy is remembering that seeking a second opinion or switching providers is not offensive; it is an act of prioritizing your needs. After all, this is your health! This is a normal and reasonable part of medical care for young adults with cancer or complex medical histories. Seeking another perspective or giving yourself permission to find a new doctor with whom you develop a better relationship does not mean you are difficult; it means you are taking your health seriously. 

Finally, I want to acknowledge that rebuilding trust in medical spaces can take time. If you find that you are still struggling, I want to gently encourage you to reach out for therapy, community support, or other spaces where you can process these experiences. Medical trauma is real, and you deserve support in navigating the impact it may have had on your relationship with healthcare. Advocating for yourself does not mean you have to be perfectly confident or fearless. Sometimes it simply means showing up, asking the question anyway, and reminding yourself that your experiences in your own body matter.

You deserve to be heard. You deserve to be believed. And you deserve care that takes you seriously.

In your corner,
Perrie 

Ask Perrie is Cactus Cancer Society’s advice column for the questions that young adult cancer doesn’t come with instructions for. Community members submit anonymous questions, and Perrie offers thoughtful guidance, perspective, and practical ideas for navigating life during and after cancer.

submit your own question

Ask Perrie: Got Big Questions

Dear Perrie,

How do we cope with the major fear of recurrence for the rest of our hopefully long lives?

How do we choose a career where we do not want to waste our time and be fulfilled, but also gives us the stability and health benefits, especially after experiencing such a traumatic part of our lives?

Dear Got Big Questions,

I’m going to do my best here to be a supportive place to land with these concerns, because they are some heavy and really common concerns among YA cancer folks. First, I want to name something important. Fear of recurrence is a huge part of young adult cancer. So much so that research consistently identifies it as one of the top three long-term aftereffects experienced by AYA survivors. I share that not to make it feel inevitable, but to normalize the experience. You are not alone in this fear, and many struggle to navigate it. 

When you’ve lived through something as traumatic and life-altering as cancer, it makes sense that your brain and body remain alert to the possibility that it could happen again. Your mind is trying to protect you! The tricky part is that this protective system sometimes stays on high alert long after treatment ends (or longer than necessary). 

Navigating fear of recurrence will look different for everyone. For some people, it means working with a trusted therapist who understands cancer survivorship. For others, it means finding community spaces where they can talk openly with people who truly understand the experience. And for many others, it takes space and time (ugh, I know, I know….time?!?) for healing as your mind, body, and soul adjust to your reality. 

Here are a few approaches that I’ve found personally and professionally helpful in dealing with fear of recurrence: 

Let the feeling exist.
Trying to force fear away often makes it louder. Acknowledging that fear is present can sometimes soften its grip. For many people, fear of recurrence does not completely disappear; it softens with time and grows quieter with experience navigating it. I don’t say that to scare you, but to name a truth that many experience: Sometimes the work becomes less about getting rid of fear and more about learning how to let the fear exist without letting it run your life. You see, the more we try to avoid fear, the bigger it can become. You might experiment with gently allowing yourself to be scared while still doing the important things in your life. You might even try practicing being with the fear in small increments on purpose. Yes, I know that sounds a little strange, but stay with me. The more you practice letting the feeling exist, the easier it can be to navigate when it inevitably knocks on your door. 

Bring yourself back to what you actually know to be true.
Fear has a way of pulling our minds into imagined futures. When that happens, try to anchor yourself in the present moment. What do you know to be completely true right now? Right now, you are here in this moment. Right now, you are living your life inside of trauma or new symptoms. Right now, you are doing your absolute best to cope. Bringing your brain back to the current moment is not only an exercise in reeling your thoughts in, but an act of mindfulness. The practice of paying attention to the current moment, on purpose, without judgment. Mindfulness has been shown, across a multitude of studies and cultural practices, to be a cornerstone of resilience and psychological health. When you notice your brain in future-tripping land (as I lovingly call it), try to see if you bring it back to what’s right in front of you through art, music, or another novel experience. It should help take the temperature down! 

Additionally, if you are unsure what symptoms should prompt a call to your oncologist, ask them directly. Having that information can be incredibly grounding. Keep a list of those symptoms somewhere accessible (looking at you, iPhone notes app) so when your brain starts spiraling, you have something concrete. Sometimes that reminder helps us see that our mind is trying to protect us from a future that has not arrived.

Give the fear somewhere to go.
Talking about it with trusted people, journaling, creative expression, therapy, or support groups can help move fear out of your head and into a space where it can actually be processed. Giving your body an opportunity to release some of that energy can be really important for your nervous system and overall mood management. Things like movement, physical activity, grounding exercises, or emotional processing in safe spaces are all ways to help your nervous system move through fear instead of holding it alone. Give yourself and your body an opportunity to chew through the feelings by finding which activities work best for you. 

Your second question about choosing a career after cancer is another really big one. Choosing a career that balances your needs is already a complicated process in young adulthood. When cancer enters the picture, those decisions can start to feel even heavier. It makes sense that you might feel overwhelmed or even frozen when trying to choose something that is both meaningful and stable. Cancer often changes our relationship with time. Suddenly, the idea of wasting time can feel terrifying. There can be pressure to find work that feels deeply fulfilling while also making sure you have stability, health insurance, and enough flexibility to take care of your body.

The truth is that most people build meaningful lives in layers rather than through one perfect decision.

Give yourself some grace to make the next best choice you can in this moment, and maybe even some permission to change your mind later. As you continue to grow as a human, your needs and priorities may shift or evolve. That may mean a professional pivot somewhere down the road, and that is okay (and to be expected, growing and changing is so so human). 

Some tough love here: you do not have to solve the rest of your life today, even if your brain is trying to convince you that you should. 

If you still find yourself feeling stuck on the career piece, it may be helpful to work with a career coach, academic advisor, or another professional who can help guide you through what matters most to you right now. Sometimes, simply exploring your options with someone who understands the process can relieve some of the pressure to find a path that checks every box all at once.

The fact that you are asking these questions tells me you are paying close attention to the life you want to build. That kind of reflection can feel heavy sometimes, but it can also lead to a life that feels deeply intentional. What a wonderful paradox. 

Wishing you courage as you keep asking the big questions,
Perrie




Ask Perrie is Cactus Cancer Society’s advice column for the questions that young adult cancer doesn’t come with instructions for. Community members submit anonymous questions, and Perrie offers thoughtful guidance, perspective, and practical ideas for navigating life during and after cancer.

SUBMIT YOUR OWN QUESTION

We’re Turning 11 — And You’re Invited 🎉🌵

Eleven years ago, Cactus Cancer Society launched as a nonprofit with a simple but radical belief: Survival is insufficient.  Young adults facing cancer deserve more than survival.  They deserve connection, creativity, and community. Since then, thousands of young adults have joined us in art workshops, writing workshops, book clubs of all varieties, LEGO-building sessions, and brave conversations where anxiety lessened, isolation softened, and voices were validated, uplifted, and empowered. This year, we’re celebrating 11 years of impact in the most “Cactus” way we know how: an all-day celebration of creativity, community, and connection. We have 4 ways we can celebrate together!

1. Join the Birthday Celebration

At the heart of it all is our online birthday celebration, a 5-hour creative fundraiser happening Saturday, April 18th (9 am–2 pm PT / 11 am–4 pm CT / 12 pm–5 pm ET). Throughout the day, you’ll join four live, hour-long art tutorials led by Cactus Cancer Society staff. These sessions are welcoming and low-pressure, whether you’re brand new to art or ready to try something different. You’ll explore creative drills in the Constraints Lab with Lauren Morales, LCSW; design exotic monster plants with Aerial Donovan; paint watercolor landscapes with Mallory Casperson; and close with origami lotus flowers. We’ll also announce the Young Adult Advocate of the Year (YAAY), close out the birthday auction, and spend time in real connection with community. This isn’t just a virtual event. It’s a space to make something, feel something, and be part of something.

Ticket Options:

  • $50 — Live Event Access
    Full access to the 5-hour celebration, including all tutorials and the award presentation

  • $75 — Live Event + Bonus Creative Guide (PDF)
    Includes a beautifully designed guide with prompts, supply lists, and ways to keep creating afterward

  • $150 — Live Event + Guide + Supply Box
    Includes everything above, plus a curated supply box with over 25 materials (valued at $200+) so you can follow along in real time

  • $250 — Birthday Champion
    Includes everything above, plus recognition during the event as a Birthday Champion supporter

Every ticket helps fund free creative coping programs for young adults navigating cancer. Get your ticket 

 2. Bid in the Birthday Auction

In the days leading up to the celebration, we’ll host an online art auction featuring work by members of our young adult cancer community. Each piece carries its own story, moments, and meaning beyond the canvas. This is art supporting art. Every bid helps us continue offering free, creative coping programs for young adults impacted by cancer. The auction will close during the live celebration, so join us to catch the final moments and celebrate alongside the artists.

More details coming soon! 

 3. Give a Birthday Gift

If attending isn’t in the cards for you, you can still be part of this. A birthday gift directly supports free creative programs, peer connection, and survivor-led spaces for young adults facing cancer. It helps ensure that someone logging in from an infusion chair, from recovery, or from a moment of uncertainty finds a place where they can exhale and be met with care.

Give a birthday gift 

 4. Support YAAY (Young Adult Advocate of the Year)

This year’s Young Adult Advocate of the Year candidates are thoughtful, driven individuals working to change what support looks like for young adults with cancer. Over the coming weeks, supporters will “vote” with their dollars to help select this year’s advocate. It’s not just a competition. It’s a way to uplift voices, share stories, and fund programs that make a real difference.

Learn more & support a candidate

Thank You For Being Here 

This celebration is about more than a milestone. It’s about everything that has been built over the past eleven years, the art made in hard seasons, the conversations that helped someone feel seen, the moments where isolation softened just a little. It’s about what happens when creativity becomes a coping tool, and community shows up in real ways.

However you choose to take part, whether you join us live, bid on a piece, support an advocate, or give what you can, you are part of what makes this possible. We’re so grateful you’re here, and we can’t wait to celebrate together.



Through the Lens: Young Adult Cancer Survivors Share Their Stories in a National Photo Exhibit

Cancer stories are often told in tidy arcs or in medicalized language. Diagnosis. Treatment. Ring the bell. Survivor. Move forward.

Young adult survivors, patients, caregivers, and co-survivors know it rarely works that way.

Life within and after cancer can be messy, quiet, complicated, funny, exhausting, beautiful, and uncertain all at once. It can mean navigating work, school, parenting, and relationships while balancing chemotherapy, surgery, or radiation. It can mean celebrating no progression of disease while still carrying the burden of scanxiety and frequent oncology appointments. It can mean holding grief and gratitude in one hand or rebuilding a sense of identity when the person you were before cancer feels lost. 

The Through the Lens: Life Beyond Young Adult Cancer Photovoice Exhibit invites the public into those realities. This exhibit is part of the Through the Lens national campaign, a creative and research initiative developed by the School of Social Work at Colorado State University and curated by members of the Serious Illness and End-of-Life Narratives Lab alongside the Through the Lens Young Adult Advisory Board.

Through the Lens features artwork from 16 young adult cancer survivors across the country, bringing together photography, personal narratives, paintings, and poetry that explore what survivorship actually looks like for young adults. Instead of statistics or medical explanations, these stories come directly from the people who have lived them. The result is an exhibit that feels less like a gallery and more like a collection of lived, tender moments, showcasing the art and perspectives of young adults with cancer. 

When Survivors Hold the Camera

At the heart of this project is a creative storytelling method called photovoice. Photovoice invites people to document their own lived experiences through photography, poetry, art, and narrative. Instead of having their stories interpreted by researchers or clinicians, participants choose the moments, objects, and images that best represent their lives. For young adults navigating cancer, that kind of storytelling can be deeply powerful. It allows survivors to reclaim authorship of their experiences and share perspectives often overlooked in traditional cancer narratives. Through their art, they advocate for equitable cancer care for young adults. 

The goals of the exhibit reflect that intention.

The project seeks to increase awareness of the psychosocial impact that young adult cancer can have on identity, relationships, and developmental milestones. It amplifies the wisdom of survivors as they navigate meaning-making and rebuilding purpose. And it highlights the complex uncertainty many young adults carry long after treatment ends.

The Stories Behind Art

Credit: Colorado State University, Photovoice Exhibit Artist: Tabitha

Walking through the exhibit means stepping into deeply personal moments.

Some images capture the intensity of treatment. 

One artist shares a self-portrait taken beside a bedside table overflowing with prescription bottles and scattered medications. The photograph reflects the exhausting routine of managing symptoms and navigating a flood of treatments while already living with chronic illness.

Some photographs hold quiet spaces for reflection. 

Credit: Colorado State University, Photovoice Exhibit. Artist: April

One survivor shares images of Lake Michigan, a place she drives to on difficult days to sit with the water and reset. 

Several artists explore grief and legacy. 

Credit: Colorado State University, Photovoice Exhibit. Artist: Aerial

One photograph shows a shoreline once shared with both of the artist’s parents, who passed away from cancer. In a second image, the landscape remains the same, but the figures are gone. The absence speaks as loudly as their presence once did.

Across the exhibit, there is a shared honesty that many young adult survivors will recognize immediately. Life after cancer does not follow a single narrative. One of the most powerful elements of the exhibit is its honesty in portraying the emotional terrain that young adults often navigate after treatment. Several artists describe the feeling of living with a shadow that never quite lifts. Even on days when life feels joyful or ordinary, there can still be a quiet awareness of follow-up scans, lingering side effects, and the possibility of recurrence.

Others explore the complicated process of rebuilding identity. Who are you after cancer? How do you integrate the person you were before diagnosis with the person you have become through the experience? These are questions many survivors continue asking for years.

The exhibit does not attempt to resolve those questions. Instead, it creates space for them to exist. It offers room for these experiences to be seen, held, and empathically witnessed. In many ways, the artwork gently turns the question back toward the viewer.

Will you bear witness to the truth of our experiences?

Creativity as a Way Through

Many of the artists describe creativity as part of their healing process.

Photography, painting, and storytelling offered a way to slow down and reflect during recovery. One artist shares how creating art helped quiet the judgmental voice that often demanded perfection, allowing space to simply exist.

Another artist describes photography as a way to document moments during treatment that felt surreal or impossible to explain. Capturing those moments created a form of proof that the experience was real, something they could return to later to better understand what they had lived through.

Creative expression does not erase the hardship of cancer. But it can offer language, especially when words fall short, for emotions that are difficult to name. For many young adults with cancer, art becomes both a coping tool and a form of meaning-making in its own right.

The Team Behind Through The Lens

The Through the Lens intervention and national photo exhibit were developed by a team of researchers and oncology social workers at the School of Social Work at Colorado State University, dedicated to amplifying the voices of young adults living with cancer.

The project is led by Dr. Jen Currin-McCulloch, an Associate Professor of Social Work at Colorado State University. Her career has focused on oncology and palliative care, with a particular interest in the ways people find hope and meaning while living with serious illness.

Through her clinical work in hospital settings, Dr. Currin-McCulloch often met young adults navigating cancer who shared that medical conversations rarely included the parts of life that still brought them joy or purpose. That observation became the spark for creating a space where young adults could explore those questions together.

See the Exhibit in Fort Collins

The Through the Lens: Life Beyond Young Adult Cancer photo exhibit will be on display in Fort Collins, Colorado, this April.

Exhibit Hours
April 8 to April 12
12:00 PM to 6:00 PM MST

Reception
Saturday, April 11
3:00 PM to 5:00 PM MST

Location
Center for Creativity
200 Mathews St
Fort Collins, CO 80524

Visitors are invited to explore the artwork, reflect on the stories behind the images, and engage with the many ways young adults navigate life after cancer.

Organizations interested in bringing the traveling exhibit to their own community can inquire through the Through the Lens website or contact Dr. Jen Currin-McCulloch at Colorado State University at jen.currin_mcculloch@colostate.edu or call (970) 391-4941. 

What It Means to Witness

Many young adult cancer survivors spend years explaining their experiences to people who have never lived through them. This exhibit offers a different invitation.

Instead of simplifying those stories, Through the Lens allows them to exist in their full complexity. Through the lens of these artists, we are invited not just to look, but to truly see what life beyond young adult cancer can hold.

To learn more, please visit: Colorado State University Photovoice Exhibit

When Coping Gets Complicated: Substance Use & Addiction

Let’s be honest, cancer can push you to your limits. Between the fear, pain, fatigue, and endless “unknowns,” it’s no wonder so many people turn to whatever helps them get through the day. Maybe that’s a nightly drink to take the edge off. Maybe it’s pain medication that slowly became part of your routine. Maybe it’s something else entirely.

If that sounds familiar, you’re not alone and you’re not a failure for coping the best way you could at the time.

The truth is, substance use among people affected by cancer is more common than most realize. Research shows that young adults who’ve experienced cancer or trauma are at higher risk for developing patterns of problematic use (NIDA, 2020). Sometimes it starts as symptom relief; sometimes as a distraction from the emotional weight. But when that coping starts to feel like control is slipping, it’s a signal for compassion, not shame.

Coping, Not Character

Substance use is often misunderstood as a moral issue, but really, it’s a coping strategy, one that might have helped at first but now feels harder to manage. For many survivors and caregivers, it’s not about “getting high” or “checking out”; it’s about quieting the storm inside.

You might recognize yourself in one (or more) of these:

  • Feeling dependent on substances to sleep or calm down

     

  • Needing more of something to feel the same effect

     

  • Worrying about how much you’re using, but feel scared to stop

     

  • Hiding your use from people you love

     

  • Feeling guilt or shame, but not sure what to do next

     

If you’re nodding along, please know that this isn’t a moral failure. It’s a human response to extraordinary stress. Healing starts with curiosity, not self-judgment.

The Link Between Cancer, Pain, and Substance Use

Cancer and its treatments can cause chronic pain, fatigue, and insomnia. These are all major triggers for substance use. Prescription opioids, sleep aids, or even cannabis can provide relief, but they also come with risk. When your pain is both physical and emotional, it’s easy for the boundaries to blur.

That’s why trauma-informed addiction care is so important for survivors and caregivers. The right provider won’t shame you for how you’ve coped, they’ll help you understand why and offer healthier ways forward.

Therapies like Motivational Interviewing (MI), Acceptance and Commitment Therapy (ACT), and Harm Reduction approaches focus on meeting people where they are, not demanding perfection or abstinence. 

Finding Help That Feels Safe

Support doesn’t have to mean rehab or labels. It can start small. It can be a conversation with your doctor, a text to a helpline, or joining a harm-reduction group online.

Here are some trusted, nonjudgmental resources that offer information and support:

HAMS (Harm Reduction for Alcohol) — hams.cc

A supportive online community for people who want to reduce, moderate, or quit drinking. No judgment, no pressure — just practical tools and harm-reduction education.

Moderation Management — moderation.org

A non-abstinence-based peer program offering group meetings, online forums, and self-assessment tools for people seeking to cut back on alcohol.

Partnership to End Addiction — drugfree.org

Resources, education, and family support for young people and loved ones navigating substance use or recovery.

SAMHSA National Helpline — findtreatment.gov | 1-800-662-HELP (4357)

A 24/7, free, and confidential treatment referral and information service in English and Spanish. Great starting point for finding local or virtual programs.

SMART Recovery — smartrecovery.org

A science-based recovery community using cognitive-behavioral tools and group support for people seeking to change their relationship with substances.

Harm Reduction: Meeting Yourself with Kindness

Harm reduction means focusing on safety and self-compassion, not punishment. It’s about making small changes that lower risk while respecting your autonomy. That might look like:

  • Tracking your use without judgment

     

  • Setting limits that feel doable

     

  • Choosing safer methods or times

     

  • Pairing use with mindfulness, hydration, or nourishment

     

  • Talking to a doctor or therapist before quitting suddenly

     

If you relapse or slip, that doesn’t erase your progress. Healing isn’t about “getting it right”; it’s about staying connected to your own humanity.

Reaching Out Without Shame

Talking about substance use can feel scary, especially in cancer communities where vulnerability already runs high. But connection heals! Whether it’s a friend, a peer mentor, or a helpline counselor, telling someone “I’m struggling” is a powerful act of courage.

If you’re unsure where to start, Cactus Cancer Society’s Mental Health & Peer Support Resource Hub includes harm-reduction and recovery organizations that approach healing with compassion and inclusion.

You deserve care that doesn’t judge you.

You Are Not Alone

Recovery, whatever that looks like for you, doesn’t have to mean perfection. It can mean curiosity, self-respect, and a little more freedom each day.

If you’re coping in ways that no longer feel like support, reach out. There are people who get it and want to help you find your footing again.

You are not “too far gone.” You are not broken. You are doing your best, and that’s where healing starts. 💛

Ask Perrie: Waiting for the Other Shoe to Drop

Hi Perrie,

I’m about to turn 30 in two weeks, and I’ve been in remission from stage 3 triple-positive breast cancer for two and a half years now. I always struggled with taking care of myself before cancer, and now in survivorship, I struggle with the fear of losing my job due to the chronic issues I have now. I was fired while in active treatment at a different job, so it’s hard not to think it could happen again for something as minor as me having to call in sick two days in a row. Do you have any advice on how to handle that fear or advice on how to better advocate and take care of myself? 

Thank you

Dear Waiting for the Other Shoe to Drop,

Survivorship is full of polarities. There’s a push of “you should be all better now” and a pull of “I’m anything but better now.” Let’s make space for where you really are. I’m hearing that you’re juggling chronic illness, maybe even chronic pain, while also trying to take care of yourself, be an adult, pay bills, and show up as an employee. That’s a lot, and I’m probably only touching the surface!

Job insecurity carries real risk, and I don’t want to diminish or invalidate that, especially since you’ve already lived through losing a job during treatment. At the same time, I can hear how the fear of it happening again is starting to get in the way of day-to-day things like taking breaks when you need them, calling out sick, or advocating for yourself.

Giving yourself permission to take care of your body starts from within, and that often begins with self-compassion. You mentioned that caring for yourself was already hard before cancer entered the room. Survivorship can be an opportunity to gently renegotiate that relationship with yourself. Developing more self-understanding and compassion may help you rebuild trust in your own needs and limits.

If you’re open to exploring this, I’d recommend looking into the work of Kristin Neff, who researches and teaches self-compassion. Her workbook, guided meditations, and free online resources can be a helpful starting place: https://self-compassion.org/. Practicing self-compassion regularly can slowly help retrain your brain to respond with kindness toward yourself in moments of overwhelm instead of criticism or fear.

Speaking of fear, what you’re describing can also be deeply connected to anxiety. Your brain is doing what brains do best: trying to predict outcomes in order to keep you safe. The trouble is that sometimes that protective system goes into overdrive. Which, let’s be real, makes sense inside of cancer because you’ve really been through it! 

When you notice fear (whether that’s job loss or any other kind) rising, I’d encourage you to approach it with curiosity rather than judgment. That might sound counterintuitive, because most of us want to avoid fear as quickly as possible. But curiosity can help you gather important information about what you actually need in those moments.

For example, you might notice that fear shows up physically, maybe your breathing gets shallow, or your body feels restless. In that case, regulating your body through breathing or grounding exercises might help. Or maybe fear pulls you into spiraling thoughts and worst-case scenarios (honestly, relatable). In those moments, it may help to gently redirect your thinking or talk through those fears with someone you trust.

And if the fear continues to feel overwhelming, working with a qualified therapist can help navigate those patterns.

As far as advocacy goes, I want to say this clearly: advocating for your needs isn’t selfish. It isn’t a sign that you’re unreliable. It’s part of taking care of yourself so that you can keep showing up in your life and work.

If workplace accommodations might be helpful for you, I also want to point you toward a nonprofit called Cancer and Careers, which provides excellent guidance on navigating employment after cancer. They offer resources on things like intermittent FMLA, flexible work arrangements, and understanding your rights in the workplace: https://www.cancerandcareers.org/en/at-work/back-to-work-after-cancer

The truth is that we live in a culture that often prioritizes productivity and hustle over wellness and balance. Protecting your health may sometimes mean learning how to ask for flexibility or support.

At its heart, a lot of what we’re talking about here is rebuilding trust with yourself. Survivorship, and maybe even this upcoming 30th birthday, can be an invitation to try something new: listening to your body and honoring its limits, even when fear tells you there might be consequences.

You deserve a life that includes stability, self-compassion, and room to heal at your own pace.

Standing with you as you learn to take up space,
Perrie

Ask Perrie is Cactus Cancer Society’s advice column for the questions young adult cancer doesn’t come with instructions for. Community members submit anonymous questions, and Perrie offers thoughtful guidance, perspective, and practical ideas for navigating life during and after cancer.

submit your own question!