Maintaining agency during adolescent cancer: Retrospective narratives among young adult survivors - A qualitative content analysis.

Objective: A cancer diagnosis during adolescence can disrupt psychosocial development, autonomy, and everyday social life. This study retrospectively described young adult cancer survivors' experiences of coping with cancer and efforts to maintain personal agency and active involvement during treatment. Methods: This qualitative study (2024-2025) was conducted in eastern Iran using conventional content analysis. Fifteen young adult cancer survivors were recruited through purposive and snowball sampling methods. Participants aged 18-29 years had been diagnosed with cancer between the ages of 11 and 18 years. All had completed treatment at least two years before participation. Data were collected through in-depth semi-structured interviews and analyzed using the approach described by Graneheim and Lundman. Results: Analysis generated four main categories and 14 subcategories: sustaining hope despite suffering, maintaining control under illness constraints, managing social relationships, and managing life responsibilities. Participants retrospectively described coping as an active and ongoing process to sustain hope, preserve a sense of agency, maintain social connections, and uphold continuity in everyday life despite treatment-related challenges. Conclusions: Young adult survivors portrayed their adolescent cancer experiences as involving active engagement with the psychological, social, and practical challenges of illness. These findings highlight the importance of recognizing adolescents as active participants in their cancer care and supporting their involvement, communication, and psychosocial needs throughout treatment.