When Amber Masso was 19, she was getting ready to start her sophomore year at Texas A&M University, and her worries were very similar to those of her fellow students -- school, tuition, work and where to live next year.
But things changed dramatically the day she took her brother to their family physician for his sports physical and she asked a casual question about a golf-ball sized mass above her collar bone.
Later that day, she got the news that the lump was lymphoma.
"I couldn't deny what I was looking at. I remember thinking, 'Well, what the heck am I supposed to do about school and work? How do I tell my mom? What was I going to do to be strong for my parents?'" she told ABC News.
For the next six months, Masso underwent chemotherapy and radiation. She completed her courses online and moved back with her parents. Now, at age 26, she works with children and adolescents living with the disease.
But while much progress has been made in the field of cancer prevention, diagnosis and treatment as whole, these same trends are not evident in cancer among young adults. The National Cancer Institute reports survival rates in young adults have not improved significantly over the years, and a new study by researchers at the Centers for Disease Control and Prevention found that young adult and adolescent cancer survivors are at higher risk for developing chronic diseases, engaging in risky health behaviors such as smoking and having mental health problems.
The study authors analyzed data from the 2009 Behavioral Risk Factor Surveillance System, a nationwide, ongoing phone survey that monitors risky behaviors and health problems.
They compared data from 4,054 adolescent and young adult survivors with more than 300,000 people who never had cancer and found that more young cancer survivors smoked, were obese, had chronic medical conditions such as hypertension and asthma and also suffered from more mental health problems.
"I think it illustrates that this population, which is already vulnerable because of their prior cancer, is continuing to engage in behaviors that lead to long-term outcomes, which can lead to problems down the road for them," said Dr. Eric Tai, the study's lead author and a medical officer with CDC's Cancer Prevention and Control division.
There is evidence from other studies, the authors wrote, that certain risky behaviors such as smoking and drinking may be linked to an increased risk of secondary cancers later on.
Significantly more young cancer survivors also reported having heart disease, high blood pressure, asthma and diabetes compared with those with no cancer history.
"This is consistent with late effects of cancer treatment, including cardiac and pulmonary complications, among childhood cancer survivors," they said.
Tai added that young survivors struggled much more with their psychological well-being, which suggests they may benefit from counseling and care that revolves around promoting healthy behavior after cancer.
They may also benefit from interventions that address their risky behaviors, such as smoking cessation programs.
Masso learned from her own experience that finding inner strength can help in the battle to survive and thrive.
"The one area that I didn't have a lot of growth in was self advocacy. I was always the quiet one and going through what I went through helped me tremendously in the area of self-confidence and advocating for myself," she said.
She also encourages others to reach out and find support, such as through social media.
"You can actually form and become part of a community you can relate to," she said. "You need to realize that 'I do need help. I do need support.