Ask a Cactus: Guys Edition Introduction

This is our first video in our Ask a Cactus Series: Guys Edition. Please meet Bryan and Kyle! They are guys in our Cactus Cancer Society community and here to answer a range of questions you may have about the experience guys have in the young adult cancer space. If you’re a guy looking for a sense of “I feel that way, too,” a caregiver to a guy with cancer, or anyone else – they’re here to bring you the truth of their experiences.

Check out this video to meet our experts, Bryan and Kyle!

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Back to School: September 2026

It’s September! The start of the school year is here and that means it’s time for kids to learn, but what about adults? We don’t have any curriculum or teachers to teach us, we’re adults – we need to teach ourselves. However, how do we figure out what we should learn or what we even want to learn?  One thing to do is think about school – what did you like? Did you like Math? English? History? Science? Maybe art, gym, health, or one of those other “specials” in school (At least that is what those subjects were called when I was in school)? We all liked at least something at one point – what was yours?

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You Get a Say: Shared Decision-Making and Biomarker Testing in Young Adult Cancer

As a young adult cancer survivor, I remember how quickly treatment started moving and how much information I was expected to absorb along the way. There were appointments, new medical terms, treatment decisions, and a parade of acronyms, all arriving while I was still trying to wrap my head around the fact that I had cancer at 30.

If you have ever left an oncology appointment wondering what just happened, what half of those words meant, or whether you were supposed to have an opinion about the plan, I promise you are in very good company.

Young adults are often making cancer decisions while also thinking about fertility, work, school, finances, relationships, mental health, and plans for the future. Those parts of our lives do not become less important when cancer enters the picture. They often become even more important.

You deserve to understand your options and have a meaningful voice in what happens next. That is where shared decision-making comes in.

What Is Shared Decision-Making?

The National Cancer Institute defines shared decision-making as a process in which a patient and health care professional work together to decide on the best plan of care.

Your care team brings medical knowledge, clinical experience, and information about the potential benefits and risks of each option. You bring knowledge about your own life. You know what matters to you, how your body is feeling, what you are worried about, which side effects feel manageable, and what you need treatment to make room for.

Shared decision-making means receiving information in language you can understand, having time to ask questions, and being treated as an active participant in your care. You can ask your provider to explain something again, write it down, discuss another option, or take time to think. You can bring someone you trust to an appointment or request a second opinion.

This kind of partnership can be especially helpful when your care team is considering whether additional testing could provide useful information about your cancer. Biomarker testing is one example of a decision you may want to discuss together. It may offer clues about your cancer and possible treatment options, but whether testing is useful depends on factors such as your cancer type, stage, and treatment history. Your goals and priorities can then help guide the decisions that follow.

What Is Biomarker Testing?

Biomarkers are genes, proteins, gene changes, or other substances that can provide information about a cancer. They may help your care team better understand your cancer’s subtype, how it behaves, or whether it is likely to respond to a particular treatment.

You may hear biomarker testing called molecular testing, tumor profiling, somatic testing, genomic testing, or genetic testing of the tumor. Depending on your cancer and the purpose of the test, a laboratory may examine tumor tissue collected during a biopsy or surgery, blood, or another bodily fluid.

Examples of biomarkers include HER2 in breast, stomach, and some lung cancers; EGFR and ALK in lung cancer; tumor changes involving BRCA1 and BRCA2 in several cancer types; KRAS in colorectal, lung, and pancreatic cancers; and IDH in gliomas.

Biomarker testing may help identify a targeted therapy or immunotherapy, rule out treatments that are unlikely to help, clarify information about your cancer, or determine whether you may qualify for a clinical trial.

It is also important to understand the limits of biomarker testing. Its usefulness depends on your cancer type, stage, treatment history, and the biomarkers researchers currently understand. Testing may identify a treatment option, provide information that doesn’t change the current plan, or produce an uncertain result. A biomarker result can be important information without providing every answer.

Bringing Biomarker Testing Into the Conversation

If biomarker testing may be relevant to your cancer, ask your care team how it could inform your treatment options. You can also ask what the test examines, what sample is needed, how long results may take, what it may cost, and whether waiting for results could delay treatment. When the report is available, ask your oncologist to explain what it means for your care.

Questions to consider:

  • Has my cancer been tested for biomarkers, and can I have a copy of the report?
  • What did the test find, and does it change your recommendation?
  • Could the results identify a treatment or clinical trial?
  • What are the test’s limitations?
  • How might each option affect my fertility, energy, cognition, sexual health, work, or quality of life?
  • How much time do I have to decide?
  • What other options should we discuss?

You do not have to ask everything at once. Choose the questions that matter most, and bring a support person to take notes if helpful.

Help Us Color in the Gaps in AYA Cancer Care

At Cactus Cancer Society, we create spaces where young adults can talk honestly about what cancer care is actually like. We want to know how conversations about shared decision-making and biomarkers felt from your side of the exam room.

What did you understand? What felt confusing? What do you wish someone had explained differently? What helped you feel heard?

These questions will be part of our next four-week Creative Arts Book Club, Hue’s in the Moment?

Together, we’ll work through Into the Moment: A Journal and Coloring Book to Inspire Mindful Creativity by Dani DiPirro. Each online session will include coloring, journaling, grounding activities, creative connection, and good conversation with fellow young adult cancer patients, survivors, and thrivers.

During the final 30 minutes of each session, we’ll hold a compensated focus group about shared decision-making and biomarker education in young adult oncology. You do not need to have a particular biomarker, receive biomarker testing, or arrive with expert knowledge. We want to learn from a wide range of young adult cancer experiences.

As both a young adult cancer survivor and a clinician, I know these conversations can bring us back to decisions, questions, and moments that felt deeply personal, confusing, or vulnerable. I am sincerely grateful to everyone willing to share those experiences. Your perspective matters, and we will treat it with the care it deserves.

Who: Young adult cancer patients, survivors, and thrivers ages 18–45
When: Tuesdays, September 15, September 22, September 29, and October 6
Time: 5–7 p.m. PT / 6–8 p.m. MT / 7–9 p.m. CT / 8–10 p.m. ET
Where: Online via Zoom
Compensation: A $10 Amazon gift card for each focus group session attended, with $50 total for participating in all four sessions, plus a free copy of Into the Moment

REGISTER FOR HUE’S IN THE MOMENT

This season of Creative Arts Book Club is sponsored by Daiichi Sankyo (DSI), a pharmaceutical company focused on oncology. Focus group feedback will be shared with DSI in de-identified form, which means participants’ names and identifying information will not be included.

This information is intended for educational purposes and is not a substitute for personalized guidance from your health care team. Whether biomarker testing is appropriate depends on your individual diagnosis, treatment history, and circumstances.

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

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!

Ask Perrie: Stuck In the Freeze

Dear Perrie,

Ever since cancer, I’ve been paralyzed by procrastination. There are so many things that need to be done that I just can’t do any of them. The phone calls, bills, having to talk to people about why the statement I got is wrong- it’s all too much. How do I move past this? I need to deal with these things head-on, but can’t bring myself to do any of it. 

I’m tired and overwhelmed.

Dear Stuck in the Freeze,

First, I want to name that what I’m hearing in your question isn’t just procrastination. Yes, you might be avoiding important tasks, but when we’re in fight-or-flight mode (fight, flight, freeze, or fawn), our nervous system sometimes tries to protect us from overwhelm by doing exactly what you described: freezing.

When that happens, it can become hard to think clearly. You might avoid tasks, numb out, or feel like you aren’t even fully present when these things are being discussed with you. That doesn’t mean you’re lazy or failing; it means your nervous system has been under a lot of pressure (and like….duh, Perrie….. Cancer is hard!)

So my guidance for moving through this starts with something simple: notice the freeze. The more awareness you can bring to those moments when you feel yourself shutting down, avoiding, or checking out, the easier it becomes to gently move through them. The first step really is awareness, as they say. 

You might start paying attention to how your body, thoughts, and emotions show up when you’re facing these tasks. Do you feel tension? Brain fog? A sudden urge to walk away or hide under your covers? Slowing down and getting curious about those reactions can help you respond with a little more compassion toward yourself.

From there, this becomes a divide-and-conquer situation. We’re not meant to handle hard things (or heal) alone. If you have access to a support system (friends, family, church members, online cancer buddies, etc.), consider reaching out for help. There’s no shame in letting someone shoulder a bit of the burden.

For example, someone might help organize bills into a spreadsheet, sit with you while you make calls, or help you figure out where to start. Sometimes just having another person nearby can make a task feel far less overwhelming.

If you don’t have that kind of support available right now, you might ask your medical team about connecting with a social worker or nurse case manager. Many oncology teams or insurance plans can help connect patients to someone who can assist with billing issues, financial programs, or simply advocate on their behalf. Having a professional in your corner can make a huge difference.

And finally, when in doubt: one call at a time.

Big mountains look impossible when we try to climb them all at once. Instead of focusing on every task waiting for you, see if you can bring your attention to the next smallest step. Just one. Giving yourself permission to handle the rest later (and maybe even tell yourself that’s a problem for future me!) can lower the overwhelm enough for your brain to move forward with one time. Do that practice enough and you might find that you’ve completed 3-5 next steps!  

You don’t have to solve everything today. One step is still movement.

Rooting for you,

Perrie

SUBMIT YOUR OWN QUESTION

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.

Cancer Didn’t Come With Instructions. Ask Perrie.

Young adult cancer comes with pamphlets. Port scars. Schedules. Acronyms. Follow-up appointments. 

It does not come with instructions.

There’s no chapter on how to tell someone your diagnosis, how to handle the grief that comes, or what to do when your family and friends feel like they don’t understand. There isn’t an appendix on dating while bald, marriage while sick, or how to navigate cancer ghosting. You won’t find a flowchart for “Why am I angry even though I’m alive?” You won’t find an FAQ for how to handle caregiving without burning out. And trust me when I say there isn’t a secret footnote explaining why your body feels unfamiliar or why losing your hair feels so emotional. 

And yet, the questions keep coming.

At Cactus Cancer Society, we hear them all the time. In DMs. In workshops. In the pause before someone says, “Okay, this might sound weird but…”

It’s not weird. It’s young adulthood colliding with cancer. And that’s complicated stuff. So I’m making space for the questions that don’t fit neatly into a medical visit, the ones you Google at 2 am, or that you feel scared to say outloud. 

I’m Perrie (okay, it’s me, Lauren Morales, the Senior Program Coordinator writing under a pseudonym!), a licensed clinical social worker and young adult Hodgkin Lymphoma survivor who has spent years working alongside young adults impacted by cancer. I’ve sat in hospital rooms, on both sides of the chair. I’ve been in the infusion rooms and support groups. I’ve also helped support folks throughout their treatment and in the post-treatment “WTF just happened” space. I’ve heard the questions people whisper and the ones they laugh off (I’ve had them myself…..) And I know how isolating it can feel to carry them alone.

Ask Perrie is Cactus Cancer Society’s new advice column for young adults navigating every phase of the cancer experience, from diagnosis to treatment to survivorship to recurrence, and for co-survivors walking alongside them. This isn’t therapy. It’s perspective. Context. Language for the things that feel hard to name. Honest, thoughtful responses grounded in real, lived, and professional experience.

This is where you can ask questions like:

I’m surviving, but I am so sad, and everyone keeps just telling me to be grateful. Does that make me ungrateful?
Is it bad that I can’t listen to my friends complain about “normal” things anymore?
How do I date in this body, and when do I know I’m ready?
Why does everyone think I’m strong when I feel completely and totally exhausted?
How do I deal with my friend ghosting me since I told them I was diagnosed?
How do I support my partner/family member without disappearing myself?
Who even am I now?

Each month, Perrie will answer submitted questions with nuance, compassion, and the occasional gentle reality check. Because you deserve answers that treat you like a whole person, not just a diagnosis. Questions will then be posted online in our blog, socials, and newsletter. 

Submit your question anonymously here.

Cancer didn’t come with instructions. Let’s write some together.

Support Our 2026 Young Adult Cancer Advocate of the Year Candidates!

Support Our Young Adult Cancer
Advocate of the Year Candidates!

Cactus Cancer Society is so proud to introduce the 2026 Young Adult Cancer Advocate of the Year (YAAY) candidates!  These passionate, driven individuals are not only raising awareness, but making a tangible impact in the lives of young adult cancer patients, survivors, and caregivers. 

Over the course of nine weeks, these inspiring candidates will raise critical funds to fuel and sustain creative coping programs that combat the loneliness, fear, and uncertainty of a cancer diagnosis. But they can’t do it alone. This is where YOU come in!

Every dollar you donate is a vote for the advocate you believe deserves the prestigious title of Young Adult Cancer Advocate of the Year. More importantly, your contributions directly fuel Cactus Cancer Society’s life-saving programs – proven to reduce loneliness, anxiety, depression, and psychological distress for young adults facing cancer. Who will take home the title of Young Adult Cancer Advocate of the Year? That’s up to you! Casting your vote today and help shape the future for young adults facing cancer!

SUPPORT A YAAY CANDIDATE NOW!