Across all age groups, cancer affects relationships with family and friends; challenges one's sense of independence; disrupts goals, aspirations, and achievements; alters one's body image and integrity; and poses existential challenges about the world and one's place in it. When diagnosed with cancer, adolescents and young adults (AYAs) in their 20s and 30s face unique challenges compared with younger children and older adults. Understanding how cancer-related challenges manifest needs and desires for psychological and social support services throughout a continuum of care may help clinicians improve cost-effective quality care and patient outcomes. This article provides a context for understanding the experiences of AYAs with cancer and highlights key domains of psychosocial need in this population. (JNCCN 2012;10:1151-1156)