On a 'Re-Mission' to save lives of kids with cancer

— -- Although Rashida Wilkins is only 18, she has already weathered eight years of cancer therapy, including four brain surgeries, six weeks of radiation and nearly two years of chemotherapy.

She knows she should follow her doctors' advice. Yet Wilkins, like many teens with cancer, has at times deliberately stopped taking pills that are vital for her health.

Of all cancer patients, teenagers are the least likely to consistently follow their care plans, says Steve Cole, associate professor at the University of California-Los Angeles School of Medicine.

Unlike smaller children, teens are often responsible for taking their pills, Cole says. But unlike older adults, they may not believe their conditions are really life-threatening. A few weeks or months after these young patients leave the hospital, the threat of cancer may seem distant, while side effects such as acne and weight gain remain painfully visible.

"Teenagers see themselves as invincible," says Karen McKinley, a social worker at Children's Hospital of The King's Daughters in Norfolk, Va., where Wilkins was treated. "They do risky things. They drive fast. They don't want to do anything that makes them look different. And we make them look different. We make them lose their hair. We give them steroids that make them look puffy."

Wilkins, of Norfolk, says she stopped taking daily thyroid medications — required because radiation damaged her thyroid — because she felt better. She resumed taking her pills earlier this year — a few months after she stopped — after she began feeling run-down.

Teens' reluctance to follow their care plans could partly explain why survival gains for young adults have lagged behind those of other age groups, says Anna Franklin of the Children's Cancer Center at Houston's M.D. Anderson Cancer Center. Other factors also may hurt their survival. Young adults also are less likely to have insurance or to join clinical trials. Their tumors also may be biologically different from more common cancers.