In a conversation with CancerNetwork®, Shari Goldfarb, MD spoke about key developments and challenges regarding the treatment of younger populations with breast cancer. Key areas across the field included the rising incidence of disease, including HER2-positive and triple-negative subtypes; expanding opportunities for clinical trial enrollment; and preserving fertility among patients undergoing treatment, among other focuses.

Although it’s not entirely clear why breast cancer diagnoses are becoming more common in younger groups, Goldfarb noted that a combination of genetic and environmental factors may be driving this increase. Beyond facilitating yearly mammograms among average-risk individuals starting at age 40, she said that knowing one’s family history and genetic risk may also inform personalized screening approaches.

Goldfarb also described how patients in their 20s to 40s may be underrepresented in breast cancer clinical trials due to enrollment criteria typically requiring postmenopausal status, which may be amended by expanding eligibility to patients who receive medically suppressive therapy. The conversation also touched upon providing supportive care for younger patients with breast cancer, as Goldfarb emphasized prompt fertility consultations following diagnosis for patients who desire to have children as well as other services related to integrative medicine and social work.

Additionally, Goldfarb reviewed strategies for mitigating chemotherapy-induced alopecia, highlighting how modalities like scalp cooling may reduce hair loss and improve hair regrowth. In the end, she noted the importance of employing a multi-disciplinary approach to ensure whole-person care and meet the emotional and psychological needs of patients who undergo treatment.

“Patients should always advocate for themselves…If something is different in your body, you should make sure to bring it to a doctor's attention,” Goldfarb stated. “[Patients should] make sure they get imaging or a biopsy if they need it. [They should not] wait because early diagnosis helps with finding things at an earlier stage and [yielding] better prognosis.”

Goldfarb is an assistant attending physician specializing in breast cancer at Memorial Sloan Kettering Cancer Center.

In this episode recorded at the 2026 American Psychosocial Oncology Society (APOS) annual meeting, Daniel C. McFarland, DO, sat down with Kelly Irwin, MD, to address one of the most challenging topics in oncology: suicide risk. The conversation aimed to equip oncologists with the tools and confidence to navigate the emotional complexities of cancer care.

Key Discussion Points:

• Understanding the Risk: Patients with cancer experience more than double the risk of completed suicide compared with the general population. The risk is highest during the first month following a diagnosis—a 12-fold increase in some studies—and remains elevated for the first year.
• Identifying High-Risk Factors: Beyond a prior suicide attempt (the No.1 risk factor), specific contributors include advanced-stage disease, financial distress, and cancers that impact core identity or physical function, such as head and neck or pancreatic cancers.
• The Power of Asking: Both experts emphasized that a clinician asking about suicide does not increase the risk. Irwin advises clinicians to trust their instincts and use a continuum of questioning, starting with general feelings of hopelessness and moving toward specific plans and access to "means" (such as firearms or medication).
• The "Don’t Worry Alone" Rule: Irwin urged clinicians never to handle these concerns in isolation. She recommended involving social workers, nurses, and family members, noting that in life-threatening situations, clinician-patient confidentiality (HIPAA) can be "broken" to ensure safety.
• Relieving Suffering and Building Connection: The primary goal is to make the "unbearable bearable". Irwin highlighted that even small, non-transactional gestures—like a "thinking of you" message—can significantly decrease suicide risk by reinforcing a patient's sense of belonging and mattering.

Available Resources:

· National Mental Health Hotline: Call or text 988

· Connect with a crisis counselor: Text HOME to 741741

· Samaritans Hotline and Website: (877)870-4673; https://samaritanshope.org/our-services/24-7-helpline/

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being a psycho-oncology editorial advisory board member for the journal ONCOLOGY®. Irwin is an instructor in psychiatry at Harvard Medical School and a faculty psychiatrist at the Massachusetts General Hospital (MGH) Cancer Center and MGH Schizophrenia Program, where she founded the Cancer Prevention Program.

In a conversation with CancerNetwork®, Julian Hong, MD, MS, discussed considerations for optimizing care among patients with mental health disorders (MHDs) who are undergoing treatment for cancer. He spoke in the context of a study he and coauthors published in Cancer, which showed that patients with cancer and a mental health condition experience an increased risk of all-cause mortality.

Specifically, findings from the study demonstrated that early MHDs conferred a heightened all-cause mortality risk in the initial 12 to 35 months of cancer diagnosis (HR, 1.51; 95% CI, 1.47-1.56). This trend diminished over time, with gradually reduced risks observed from 36 to 59 months (HR, 1.17; 95% CI, 1.11-1.24) and from 60 to 120 months after that initial period (HR, 0.95; 95% CI, 0.89-1.01). Furthermore, the risk of all-cause mortality was even higher for patients with an early MHD and receipt of psychotropic medications at 12 to 36 months (HR, 2.67; 95% CI, 2.52-2.83), 36 to 60 months (HR, 1.25; 95% CI, 1.07-1.46), and 60 to 120 months (HR, 1.01; 95% CI, 0.82-1.25).

“We’re…trying to combine different types of data to identify earlier mental health diagnoses. Even what can feel like small amounts of time—weeks and months—can make a huge difference for people who are going through these conditions,” Hong stated regarding the next steps for research in the field. “It’s one thing to help identify some of these issues and some of these implications of different conditions, but at the end of the day, the goal is to intervene on these things and do a better job of taking care of patients.”

Hong is an associate professor of radiation oncology in the Baker Computational Health Sciences Institute at the University of California, San Francisco (UCSF), and head of Artificial Intelligence at UCSF Helen Diller Family Comprehensive Cancer Center.

Reference

Ganjouei AA, Zack T, Friesner I, et al. Association of mental health disorders and all-cause mortality for patients with cancer: large-scale analysis of University of California Health System data. Cancer. 2026;132(5):e70254. doi:10.1002/cncr.70254