Adolescents and young adults (AYAs) are at a critical juncture in their lives, often pursuing education, starting careers, forming relationships and gaining independence. Cancer disrupts these pivotal life transitions, causing significant emotional and psychological stress. Advocacy plays a crucial role in promoting awareness, access to care and support for AYAs with cancer. This paper aims to identify and examine the potential barriers to access to cancer treatment and advocacy among AYAs with cancer in Africa. A selective literature review was conducted to provide a foundation for the discussion. The search involved databases such as PubMed, Scopus and Google Scholar, using keywords such as ‘AYAs,’ ‘cancer,’ ‘advocacy,’ ‘Africa,’ ‘barriers’ and ‘factors.’ Relevant articles were selected based on their relevance, recency and quality, focusing on empirical studies and seminal and theoretical papers. Drawing from existing literature, expert opinions and case studies, several key barriers are explored, including social and cultural stigma surrounding cancer, limited access to health education and support services, economic constraints and inadequate healthcare infrastructure. Sociocultural norms and taboos can lead to a lack of open dialogue about cancer, hindering advocacy efforts. Furthermore, poverty and financial constraints often impede access to treatment and support resources, limiting opportunities for AYAs to engage in advocacy initiatives. Inadequate healthcare systems, lack of specialised care facilities and limited training for healthcare professionals also pose significant challenges. This paper highlights the urgent need to address these multifaceted barriers through collaborative efforts involving healthcare providers, policymakers and community organisations. Recommendations are provided for developing culturally sensitive advocacy programs, improving health literacy and strengthening healthcare infrastructure to empower AYAs with cancer and amplify their voices in Africa.