NCCN Guidelines for Patients
: Caring for Adolescents and Young Adults
Part 4: Navigating the treatment process
Like consolidation therapy, maintenance therapy is given
after successful primary treatment to keep the cancer from
coming back. Unlike consolidation therapy, maintenance
therapy can be taken for years and typically uses relatively
low doses of targeted therapy, chemotherapy, or immune
therapy. For example, if you have been treated for breast
cancer, your doctor may recommend maintenance therapy
with a drug that interferes with estrogen—a hormone that
some forms of breast cancer need to survive.
Second-line therapy (and beyond)
If cancer does not respond to initial therapy—or reappears
after a period of remission—it’s time for second-line
therapy. Some people may have many remissions and
recurrences, and require third, fourth, or even more lines
of therapy. Treatment options in these situations may
include another round of the therapy used initially, surgery,
radiation therapy, immune therapy, targeted therapy,
chemotherapy, or a combination of all the above.
If there are no evidence-based recommendations for
second-line (or later) treatment for the cancer you have,
you may be enrolled in a clinical trial of an experimental
When treatment results in remission (or no evidence
of disease) you’re on your way from cancer patient to
cancer survivor. Life as a cancer survivor will not be quite
the same as life before your diagnosis. Cancer and its
treatment can’t help but leave their mark—on your body,
on your emotions, and on your mind. Dealing with these
effects can be a challenge for even the most hardy of
According to recommendations from the Institute of
Medicine, every cancer patient should have a survivorship
care plan that includes guidelines for monitoring and
maintaining health in the months and years post-treatment.
Moving Beyond Treatment
, will include detailed
information on survivorship issues, including how to
ensure you have the information and support you
need to make the transition to the brave new world
of cancer survivorship.
You may hear these words as you go through
treatment. All of them mean that the cancer is
growing in some way. Recurrence or relapse refers
to cancer that shows up after the cancer has been
in remission for a while (usually a year or more).
Progression is when the cancer spreads or gets
worse with no period of remission in between.
Recurrence (or relapse) vs. progression