When I Got Aggressive Cancer At 29, I Couldn’t Believe What My Friends Began To Imply About My Diagnosis
I sit cross-legged on my couch, trying not to throw up.
After several rounds of a terrible chemotherapy regimen, I packed a simple lunch of plain white pasta, but now I find myself in a tug of war against debilitating nausea. I know I’ll feel better if I eat… I just need to convince myself to take a bite.
My phone rings and breaks my concentration. I looked at the caller ID and expected it to show one of the usual suspects: my oncologist’s secretary, the hospital billing department, or perhaps my health insurance company. Instead, a friend’s name lights up on my screen. “I’m relieved,” I reply.
“Emma!” my friend announces. “I hope I’m not disturbing you, but I just read an article about pasta on the Internet. Did you know that it fuels the growth of cancer? I wanted to warn you so you can avoid it!”
I look at the food in front of me. It was all I could bear to think about eating a second ago. Now this is clearly cancer fuel.
“This was the evening after my first chemotherapy session in December 2018,” the author writes. Courtesy of Emma Vivian
When I was diagnosed with aggressive breast cancer at age 29, I had no idea that people would have so many opinions about my disease or share them so freely. Friends, family, and even strangers began asking me conflicting questions:
Had I eaten too much red meat?
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Too much sugar?
I… God forbid! – are you chronically stressed?
Each question carried an unspoken implication: If I had done this or avoided that, I would never have gotten cancer. I rationalized that people didn’t want to hurt my feelings. It was natural to expect a concrete reason for a healthy young person to suddenly face a life-threatening illness, right? I too was worried that I might have done something wrong. But when I asked my oncologist, he assured me that nothing I did could have caused my disease.
We know that some risk factors are associated with a higher chance of getting cancer, but only some of these are under our control. Not much more. Environmental hazards and genetic predisposition also have an impact on our chances of getting cancer. As much as we might wish otherwise, avoiding known lifestyle risk factors does not protect a person from cancer.
Still, it became increasingly difficult to listen to my doctor’s voice of reason while enduring what felt like widespread social judgment. I found myself avoiding social situations for fear of being questioned about the occasional glass of pinot noir or scoop of chocolate ice cream I enjoyed.
The author is at Haleakala in Maui, Hawaii, a month before her first surgery in May 2019. Courtesy of Emma Vivian
I wasn’t the only one subjected to these unwanted comments. An acquaintance asked my mother if I eat too much meat. After learning that I had been vegan for years, the woman completely changed her mind and said I was eating too much soy!
On a different occasion, when I was visiting family in England, a neighbor waved at us to say hello.
“You look good Emma!” He said to me before turning to my mother.
“This is all your fault, you know, Jane! You must have passed on the genes.”
Another common view I heard was that cancer results from unresolved trauma or repressed emotions. Numerous people have suggested that I read Bessel van der Kolk’s book “The Body Keeps the Score.” Although it does not focus primarily on cancer, it suggests that trauma and chronic stress can weaken the immune system and increase the production of stress hormones, leading to an increased risk of disease. It was more difficult to oppose this point of view, not only with others, but also with myself. I had spent years on and off antidepressants and struggling with mental health issues. Sometimes I was convinced that it must have affected my body.
Still, I can’t help but think that if anxiety caused cancer, all my friends would be at the vaccination center with me.
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Other judgments I experienced centered around how I chose to treat my cancer. I received emails from people trying to persuade me not to undergo chemotherapy, claiming it was unnecessary. Old acquaintances from college (people I hadn’t spoken to in years) were sliding into my DMs and casually asking about my health before suggesting I take their miraculous herbal supplements or invest in antioxidant mushroom powder.
It hurt me that people wanted to make money from my illness. And instead of feeling supported, I was wasting my already limited energy trying not to anger misguided advice givers and snake oil salesmen.
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The author at his last chemotherapy session in April 2019. Courtesy of Emma Vivian
Once, when I was in the emergency room with a fever, a nurse tried to persuade me not to receive radiation therapy.
“Just look inside,” he warned. “I had a girlfriend who was exposed to radiation and it caused her breasts to harden. You don’t want that at your age.”
Also Read: If I Had Listened to My Doctor, I’d Be Dead Right Now
Barely covered by a thin hospital gown, I felt exposed. Radiation wasn’t even part of my treatment plan!
Victim blaming is an unfortunate byproduct of the just world fallacy; this is a common cognitive bias that leads people to perceive the world as fundamentally fair, a place where good begets good and where being “bad” leads to negative consequences. Because of our typically chaotic existence, we seek order and predictability to use as a psychological band-aid.
I realized that people are not only interested in my health, but also in their own health. They apparently believed that if they could identify the reason why I was getting sick, consciously or unconsciously, perhaps they could avoid the same fate.
Since my diagnosis, I have spent years organizing meetings with other young people with breast cancer. Time and again I hear my own experiences echoed among my peers. At this point, I’ve lost count of how often I’ve had to reassure a newly diagnosed person that they’re not responsible for getting sick.
Tragically, I also lost several friends to metastatic breast cancer. These were women who did their best to treat their illnesses. They ate healthy, homemade, organic meals, got plenty of exercise, and avoided alcohol. Some attended community support groups, while others attended spiritual healing retreats. Some took supplements, vitamins and herbs, while others participated in clinical trials. Each received every possible medical treatment.
Now every time I hear someone repeating the same tired cancer myths, I get angry on behalf of my friends and all the people who have lost their lives to cancer.
If it were as simple as limiting risk, my friends would still be here.
Statistics show that young adults are more likely than ever to be diagnosed. Cancer has increased rapidly, especially among young women. Diagnosis rates in women under 50 are now 82% higher than their male counterparts. Various theories have been put forward for this alarming increase, including modern diet, exposure to antibiotics, microplastics and artificial light, but for now no clear answer has been found.
Some oncologists say the cancers they see in their young patients defy explanation and affect people who are much more health-conscious than previous generations. Researchers at Memorial Sloan Kettering Cancer Center I’m even researching the idea. Environmental exposure or multiple exposures that have been present since the mid-20th century may be partly to blame.
If these rising diagnosis rates are related to the increasingly toxic world we live in, then the sad truth is that we have limited power as individuals. We cannot protect ourselves against environmental impacts, many of which are not fully understood. You can cut out all the candy and plastic Tupperware you want, but you can’t change the air quality in your hometown.
The author with her dogs, Flynn and Suki, in May 2025. Courtesy of Emma Vivian
My community work has taught me that the emotional needs of someone with cancer are as diverse as people. So if you’re not sure what to say or not say to someone with cancer, I think it’s best to ask what kind of support they need. If they want your opinion on cancer prevention, they’ll probably ask for it. Otherwise, please trust that their oncologist will handle the necessary work.
My cancer is now in remission and I have thicker skin. I’ve learned that not everyone knows how to talk to someone who is sick, and that even the most misinformed advice often comes from people who believe they are helping. Even so, I wish people would spend less time policing my plate and more time providing emotional support.
I look forward to the day when a newly diagnosed person suddenly won’t find themselves responsible for disclosing their illness. “Why did this happen to you?” Instead of asking when? just “How can I be around you?” They hear the question.
So please don’t ask me if I still drink wine.
You probably won’t like my answer.
Emma Vivian is a writer living in Los Angeles. he writes Optimism Initiativesa Substack about staying hopeful in a complex world, and is currently working on a memoir about surviving breast cancer in her 20s and losing her childhood best friend to the same disease. You can find it at: emmavivian.com.
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