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We’d love to know a bit about you
NAME
WHAT ARE YOUR PRONOUNS?
He/Him
She/her
They/Them
HOW DID YOU FIND OUT ABOUT US?
Social media
Website search
Another young adult living with cancer told me
Friends/family
Healthcare professional told me
Another charity signposted me to Trekstock
Young Lives vs Cancer
Teenage Cancer Trust
Ellen MacArthur Trust
Macmillan
ANY OTHER CHARITY/NAME OF HEALTHCARE PROFESSIONAL
WHAT TYPE OF CANCER WERE YOU DIAGNOSED WITH?
brain tumour
breast
colorectal
bowel
cervical
skin cancer
thyroid
testicular
neuroendocrine
sarcoma
bone cancer
leukaemia
lymphoma
other types of blood cancer
womb
kidney cancer
IF NOT LISTED PLEASE STATE TYPE OF CANCER
WHAT’S YOUR AGE
18-20
20-24
25-29
30 -34
35-40
WHAT’S YOUR CURRENT TREATMENT STAGE
Just diagnosed
In treatment
6 months or less since finishing active treatment
6 -12 months post active treatment
12-18 months post active treatment
2 years +
I was diagnosed in childhood or as a teenager
Incurable yet treatable (long term treatment)
Watch and Wait
WHERE DO YOU LIVE?
London
South East
East Midlands
Yorkshire & Humber
Scotland
Ireland
Northern Ireland
South West
North West
East of England
West Midlands
North East
Wales
WHAT IS YOUR ETHNICITY
English / Welsh / Scottish / Northern Irish / British
Irish
Gypsy or Irish Traveller
Any other White background
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed / Multiple ethnic background
Latin American
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background
African
Caribbean
Any other Black / African / Caribbean background
Arab
Other
PLEASE STATE IF NOT LISTED
HOW WOULD YOU LIKE TO HEAR FROM US
(required)
Please tick a checkbox
Email
Through our regional whatsapp group
Newsletter
Share your story
PLEASE ENTER YOUR EMAIL
Please enter a valid email address
If you’d like to be added to your regional WhatsApp group, let us know your mobile number?
WHAT AREAS WOULD YOU LIKE SUPPORT?
Meeting other young adults with cancer
Psychological wellbeing
Nutrition
Physical Activity (exercise)
Finances
Work issues
Getting back into work
Sex and relationships
Coping with menopause
LGBTQI+ and cancer
Meeting other men with cancer
Friendships and cancer
Thinking about fertility
Living well with incurable cancer
Cancer and being from BAMER community
Parenting with cancer
If you ticked psychological support we’d love to know what you mean by this
Just meeting others who understand
Formal support ie. counselling or time with a psychologist
I struggle with anxiety and want help coping with this
I struggle with the fear of recurrence
I am struggling with feelings of being alone
I want to know ways to help improve my mental health
If you want support around getting active - https://www.trekstock.com/intreatmentorfinishedexerciseprogramme
Check out our resources on the subjects that matter to you: https://www.trekstock.com/Pages/Category/practical-information-for-young-adults
If want support with what to eat - https://www.trekstock.com/foodandcancer
WE KNOW YOU ARE SO MUCH MORE THAN YOUR CANCER SO TELL US WHAT MAKES YOU TICK?
Exercise
Food
Fashion
Books and films
Walking
Water sports
Cooking
Nights out with friends
Anything else
TELL US MORE
Let us know any ideas on events you would like us to offer
This data will be used for internal monitoring & will occasionally be anonymised & used for promotion. All data will be treated as strictly confidential & subject to the provisions of the Data Protection Act 1998. Please indicate if you’re happy for your
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