Early-onset cancers rising, survival rates too: how 2 young Hong Kong women beat cancer

“[The doctors] said that if I was extremely aggressive, that I could fight this and win,” she shared in an interview.

I was shocked because I was young, physically active and led a healthy lifestyle, and had no family history of cancer

Angie Yan, cancer survivor

The diagnoses of both women add to an alarming trend of early-onset cancer – cancer cases diagnosed in people from 14 to 49 years. Globally, between 1990 and 2019, early-onset cancer cases increased by about 79 per cent overall, according to a study published in September 2023 in the journal BMJ Oncology.

There are many risk factors for cancer, the biggest of which is advancing age, with most cancers diagnosed in people aged 65 years or older. This is why young cancer patients are jolted when they learn they have the disease.

To be diagnosed at the stage when one is about to start a career or family and still has much to accomplish in life can be difficult to process.

Yan, an accomplished trail runner, takes part in the Mount Fuji 100 event in Japan in April. Photo: The North Face

Just ask Angie Yan. In 2015, at the age of 24, Yan was diagnosed with Hodgkin lymphoma, a form of blood cancer.

She had no symptoms; while training for a half-marathon, she was struck by a van. She did not fracture any bones, but an observant orthopaedist found a pinball-sized lump under her collarbone and referred Yan to a surgeon, who later broke the news to her.

“Initially I was shocked because I was young, physically active and led a healthy lifestyle, and had no family history of cancer,” shares Yan, who is now 33 and works as an in-house legal counsel at an international advertising, media and communications company in Hong Kong.

“I was also worried, because I’d just started my career after years of study and training. I was afraid I’d fall behind my peers, who were all equally ambitious.”

Yan takes part in the Mount Fuji 100 race, in which she came third. Photo: The North Face

Sandy Yeung was diagnosed with breast cancer in 2019 after noticing a lump in her right breast.

Then 27, the Hong Kong-based private tutor was distressed upon receiving the news. She was one semester away from completing her university degree and wondered how her diagnosis would affect her career path.

Her parents, who planned to retire after she graduated, kept working so that they could help finance her medical treatment, which cost HK$500,000 (US$64,000).

While early-onset cancer cases are on the rise, the upside is that survival rates for these young patients are higher than for older patients. This is because young patients are more open to seeking treatment at an early stage, when their symptoms have first appeared or before the disease has spread through the rest of their body – and early treatment often results in a better outcome.

Yan with her mother at Maggie’s Cancer Caring Centre in Hong Kong. Photo: Angie Yan

Young patients are also more likely to be able to tolerate aggressive treatment regimens, like surgery, chemotherapy and radiation. This may significantly improve their chances of survival.

Yan and Yeung came to terms with their diagnoses relatively quickly.

Yan was told her treatment was straightforward with a survival rate close to 80 per cent. She had 12 sessions of chemotherapy over five months and had white blood cell booster injections whenever her white blood cell count fell too low.

There was hope for Yeung, too. She had chemotherapy, followed by a total mastectomy and breast reconstructive surgery, and finally, radiotherapy. Then she had traditional Chinese medicine treatments.

I’ve realised the importance of being optimistic when faced with things I can’t control. If I have to deal with them anyway, why not do it with a positive attitude?

Angie Yan, cancer survivor

While both women endured disruptions to their lives and the side-effects of their treatments, which ranged from pain, dizziness and nausea to fatigue, stomach upsets and insomnia, they overcame these challenges and are now in remission and living healthy lives.

This year, Maggie’s Cancer Caring Centre invited Yan to be an organising committee member for its annual fundraising event, Move for Maggie’s.

Phoenix Ng is a social worker and case manager of the Hong Kong Anti-Cancer Society’s Jockey Club Cancer Survivorship Care Project. Photo: Hong Kong Anti-Cancer Society

While she was undergoing chemotherapy and radiotherapy, Yeung managed her anxiety with drawing and art on the recommendation of Phoenix Ng, a social worker who was part of her support network.

Ng is case manager of the Hong Kong Anti-Cancer Society’s Jockey Club Cancer Survivorship Care Project. Young cancer patients often struggle to accept that they have the disease, he says. Confronted by their mortality, they wonder if they will get to fulfil their dreams. They also worry about the potential impact of chemotherapy on their fertility.

Many cling fast to the hope that they will recover, actively pursuing treatment and making post-recovery plans, such as travelling or accomplishing another goal.

Whatever their prognosis, Ng says that it is crucial for all cancer patients to acknowledge their emotions, learn to express their feelings – through mindfulness practices and art therapy, for instance – and ask for support.

I was distressed when I saw the scars on my breasts and around my waist, but then a friend pointed out that the scars were evidence of my determination to survive

Sandy Yeung, cancer survivor

Dealing with cancer has not only given Yan and Yeung a greater appreciation for life and good health; it has also taught both women about themselves.

“I’ve also learned to live in the moment and to embrace changes as they come. And prioritising my fitness and well-being helps me feel more at peace and in control of my life.”

Ng recommends cancer patients acknowledge their emotions and learn to express their feelings – such as through art therapy. Photo: Shutterstock

Yeung completed her degree but, because of her physical condition and a delay in her graduation, has yet to find a job. Still, she maintains a “positive outlook”.

After her surgery, Yeung also discovered a toughness she never knew she had.

“I was distressed when I saw the scars on my breasts and around my waist, but then a friend pointed out that the scars were evidence of my determination to survive,” she shares.

“Her words encouraged me to keep going with an even greater strength. Now, when I look at my scars, I am reminded of my courage.”

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