Dr Lieu on Early-Onset Cancer Recognition and Care

In this episode of Community Corner, Christopher H. Lieu, MD, professor of medicine at the University of Colorado Cancer Center, discusses clinical considerations in the evaluation and management of cancer in younger adults, with a focus on improving timely diagnosis and coordinated care.

Dr Lieu highlights that community oncologists and primary care clinicians are increasingly encountering younger patients with malignancies such as colorectal, breast, and gynecologic cancers. A key message is the importance of not dismissing persistent or concerning symptoms based on age alone. While many symptoms will ultimately be benign, ongoing or evolving presentations should be followed closely and re-evaluated over time. He stresses the need to maintain malignancy within the differential diagnosis to reduce the risk of delayed identification, particularly when initial evaluations are unrevealing.

Once cancer is diagnosed in a younger patient, he emphasizes the urgency of coordinated, multidisciplinary care. Ideally, patients should have streamlined access to surgical, medical, and radiation oncology, potentially in a single coordinated visit through multidisciplinary clinics. Early integration of supportive services is essential, including oncofertility counseling for fertility preservation, social work involvement to address psychosocial needs and financial strain, and referral to genetics and hereditary cancer services given the higher likelihood of inherited risk in early-onset disease.

These principles aim to help clinicians shorten time to diagnosis, coordinate complex care efficiently, and address the unique psychosocial and long-term survivorship needs of younger patients across care settings.