Health: Why on earth is Mum so worried?: Teenagers with cancer need specific care and attention. Celia Hall reports on a new helpline

MATTHEW MARTIN, 17, is a qualified football referee. He has played in every position on the football field and has a roomful of trophies to prove his successes. He has, in addition, eight GCSEs and has just swapped his motorbike for a car. He plans to take a degree in physical education and become a PE teacher.

But before he can take his A-levels he has to overcome a different kind of hurdle. Next month Matthew will have a bone marrow transplant for his acute lymphoblastic leukaemia, which was diagnosed when he was 10 years old.

Matthew, from Weston, Southampton, is a modest and self-composed young man, not one to make much of the setbacks he has experienced. Wise, perhaps, beyond his years, he says that the worst times were when he was 14.

'I was diagnosed about eight years ago but I don't remember a great deal about that. I had radiotherapy for six months and then blood tests for another 18 months.'

But about three years later, just as medical staff were thinking he could be clear, a football in the chest resulted in a hair-line crack to a rib, which would not heal. This time Matthew had chemotherapy which caused him to lose his hair, a hateful experience for anyone but especially difficult to cope with at 14. 'That time I found the leukaemia was a bit of a problem,' he said. His mother, Carolyn, says that her son lost his self-confidence for six months or so and would not return to school until his hair had grown again.

Matthew says that his mother sometimes drove him crazy by being too protective. 'We lived in a flat on a fifth floor at that time and she would not let me go in the lift with other people in case they gave me a cold. She used to ask everyone else to get out.'

A more recent relapse, in November last year, has meant more chemotherapy and put Matthew on the bone marrow transplant list. Now a matched donor has been found.

Matthew's experience has encouraged 100 students at Itchin College, the sixth form college he attends, to put themselves forward for the national register of people willing to donate their bone marrow.

Mrs Martin, a single parent, is full of admiration for her son. 'He is so positive that he carries me through. He says I used to fuss too much, but I don't think I was that bad. I was so scared that he would catch viruses.

'On the other hand, I have said yes when he has wanted to do dangerous things. He has gone parasailing and water-skiing and he did have a 50cc motor bike. I never thought I would agree to that.'

Matthew and Carolyn Martin have been able to benefit from the far-sighted approach of cancer paediatricians and nurses at Southampton General Hospital, where he has been treated.

Margaret Evans, a Macmillan nurse and lecturer, was among the first to realise that teenagers with cancer have separate needs. A teenage day room and a teenage ward are special features of the children's cancer unit at the hospital.

'So much has changed. Fifteen to 20 years ago cancer in young people was only seen as a life-threatening illness. Today 50 to 60 per cent of young people survive so that we have to change the way we look at their psychosocial care. We are talking about a group of young people who are planning for the future. On the whole they cope incredibly well,' she says.

The Cancer Relief Macmillan Fund, which specialises in cancer care in hospital and at home, today launches a service aimed at 13 to 20-year-olds. A free and confidential 'MAC Help Line' has been set up for teenagers with cancer who can, if they wish, be put in touch with others in their area.

Robert Souhami, professor of oncology at University College London Medical School, says that while cancer is rare in children, affecting one in 1,000 or about one in 2,000 teenagers, after accidents it is the biggest killer of the young. He is in charge of the 10-bed teenage unit which opened at the Middlesex Hospital, London, in 1990, the first such unit of its kind.

'The point is that there is nothing different as far as the management of the cancer goes, from a medical point of view, between children and young adults,' he explains. 'But in teenagers the disease is appearing at a very important time in their life.

'They have precious little in common with tiny tots or with middle-aged or elderly people with cancer on an adult ward. On an adult ward the staff have little experience in dealing with children so it may well not be an appropriate place either.

'You might ask why we should single out this age group and not 30 or 40-year-olds. Teenagers have particular problems. They are growing fast, they may be in the middle of exams, they are having to make some very important decisions.

'Although the fear of death and illness is seen as an adult fear some of these young people can feel very vulnerable. They are hovering on the edge of childhood. At times they may want to be grown-up but at others they may want a lot of support from their parents.'

Professor Souhami acknowledges that specialist teenage wards can have some drawbacks, since the patients are old enough to appreciate that one of their group may be dying and since teenagers are not always 'sweetness and light'.

'There are advantages and disadvantages. But teenagers tend to be very positive and live for the present. They understand if one of their number wants to be quiet,' he says.

The new MAC Help Line, with Phil Collins as its patron, will tackle the questions that teenagers want to ask but feel they cannot.

The leaflet that goes with the service says that being told there is every hope of a cure does not necessarily stop the questions: 'Why me? How long will the treatment take? Why on earth is Mum so worried? Is everybody telling me the truth?' These secret fears can now be shared.

MAC Help Line: Monday to Thursday: 9.30am to 5pm (answering machine at other times): 0800 591028.

(Photograph omitted)