Where cancer is concerned, it’s safe to say there’s no such thing as good timing. But having a life-threatening disease in your 20s carries a special set of psychological and social challenges. It defies our very definition of what ought to be. Youth and health are supposed to be synonymous. If only I could sue my body for breach of contract with the natural order of things.

Cancer magnifies the in-betweenness of young adulthood: You’re not a child anymore, yet you’re not fully ready to live in the adult world, either. After my diagnosis, as I get sicker, I increasingly rely on my parents to take care of me. But at the same time, I’ve had no choice but to grow up fast. Daunting questions that most of my peers won’t have to consider for many more years have become my urgent, everyday concerns: How will I hold onto health insurance if I’m unable to work? Will I be able to have children? How long will I live?

Even inside the hospital’s oncology ward, being a young adult with cancer can make a person feel like a misfit. I’m usually the youngest patient on the floor. Young adults might just be oncology’s “tweens” — too old for the paediatric cancer floor but equally out of place in an adult oncology unit. I’m not suggesting that it’s worse to be young and sick, but rather that young adults with cancer are a less visible demographic, swept up in the mix of adult cancer statistics.

A 2009 report from the United States Department of Health and Human Services presents a shocking reality: Despite great strides in treatment for most cancer patients, adolescents and young adults ages 15 to 39 have seen little or no improvement in cancer survival rates for decades. The report describes how survival rates have “been hampered because cancer risk and adverse cancer outcomes have been under-recognised in this population.” It points to the fact that health care providers are often not on the lookout for cancer in this age group.

Nine months, eight hospitalisations and seven treatments later, I’m realising that age is an inextricable component of how we experience cancer.

Cancer has forced me to pause my life at a time when my peers are just beginning theirs. For my friends, most of them young adults in their 20s, this is an exciting time as they look forward to starting new jobs, traveling the world, going to parties, dating and finding love, and all the rest of the small and big milestones that are part of early adulthood.

Like my peers, I have yet to fully define who I want to become. But as a young cancer patient, it’s difficult to see ahead when I’m fighting for my life. I don’t know what the future holds. I just know I want to be there.

Last spring, I found out I had Cancer. Before the horror of the news even had time to sink in, I had to absorb a second shock: The chemotherapy treatments that could save my life would also make me infertile.

Leukemia is an emergency, and oncologists are the first responders: They are trained to beat cancer; everything else must take a back seat. It was only after I asked about fertility that the doctors told me about the available options.

This is one of the challenges of being  young with cancer. In many ways, I am still a child myself, relying on my parents to take care of me. But I have an adult disease. Most patients with my type of cancer, a form of acute myeloid leukemia, are long past their childbearing years. While my oncologists are intent on saving my life — and I am forever indebted to them for this — preserving my chance to be a father some day just didn’t seem to be on their radar.

A few days after my diagnosis, I was sitting at the table at home. I should have been savouring my last days before a long hospitalisation, but I was agitated from the fertility drugs. I looked across the table at my mum, and here we were, considering the benefits of freezing sperm. It was awkward territory.

A social worker cautioned me, citing the unforeseeable legal and emotional obstacles that could arise down the road. But how could I plan to have a child with anyone when I didn’t even know if I was going to survive myself? I put off the decision as long as possible, but now a nurse was waiting for my answer, and I had to decide in minutes. With some hesitation, I told them to freeze my sperm.

In most doctors’ offices, it’s hard to know why the stranger next to you is there, but everyone is in this waiting room for the same reason. No one is talking, but everybody seems to be sizing one another up.  I am wearing my uni sweatshirt emblazoned with “Class of 2012,” and I am feeling out of place. I am only in my 20s, with only one thing to do today. And now I  am looking at my shoes.

The timing in all of this, like everything else these days, is out of sequence. But this is my new reality as a young adult with cancer. And although I’m not planning for a child anytime soon, preserving my ability to have children feels like my only lifeline to an uncertain future. All of us are together and alone in this room. Hoping for life.