Purpose To compare and contrast the issues raised in narrative data gathered from parents of teenagers and young adults with cancer with interview data gathered from young adults being treated for cancer. Methods A narrative correspondence method elicited contributions from the parents of 28 young adults with cancer. In-depth qualitative interviews were undertaken with 28 young adults in treatment for cancer or soon after their treatment. Key results The secondary analysis of the two data sets illuminates contrasting familial perspectives. While some of the topics raised by parents are also addressed by young people, their perspectives differ thus offering a ‘mirror image’ of the same issue. The contrast in priorities can contribute to stress within the family and can increase the danger of conflict over key decisions that may impact upon the health of the young adult with cancer. Conclusions If the potential conflicts are anticipated and understood and as a consequence handled with skill by professionals in the setting of care, this can benefit family relationships which can be thrown into crisis by the illness. It is thus important that a model of care that incorporates such an understanding is widely implemented in order to mitigate the negative impact on family dynamics when cancer is diagnosed in young adulthood.