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NCCN Guidelines for Patients


Adolescents and Young Adults with Cancer, Version 1.2017


Navigating the treatment process

Who is on my treatment team?

cancer treatment. And this type of care can start early

on in your cancer journey.

Survivorship care

When treatment leads to remission (or no evidence of

disease) you are now moving into follow-up care. This

is also known as survivorship care, although many

patients refer to themselves as survivors from the

time of diagnosis.

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, and

your mind. Dealing with these effects can be a

challenge for any cancer survivor.

According to recommendations from the Institute of

Medicine, every patient with cancer should have a

survivorship care plan that includes guidelines for

monitoring and maintaining health in the months

and years after treatment. Part 8,

Moving Beyond


, has detailed information on survivorship


Recurrence (or relapse) vs. progression

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.

Progression is when the cancer spreads or gets

worse with no period of remission in between.

End-of-life care

Sometimes cancer keeps progressing despite

everyone’s best efforts. When remission or cure is

no longer possible, the next step is end-of-life care,

which is designed to keep patients comfortable and

help make the most of the time remaining.

Although it’s natural to want to avoid thinking about

death, most cancer experts suggest completing an

advance directive, to plan for end-of-life care, sooner

rather than later. Doing this will give you one less

thing to worry about. An advance directive does not

mean you have given up. However, it ensures that

your treatment team and your loved ones understand

what you want.

Who is on my treatment team?

To get the highest level of care possible, it’s helpful

to work with a medical team that looks at the whole

picture. It is good to find a doctor who will not only

care for your physical health, but also can help you

with the emotional effects of dealing with cancer.

Hospitals and cancer centers with AYA oncology

programs typically have a team of specialists who

can work with you to get the help you need. If you are

being treated at a facility that does not offer support

services, the following information can be helpful for

building your own team of professionals. This team

can help you during the treatment process.

Some members of your treatment team will be with

you throughout the cancer journey, while others will

only be there for parts of it. Key players are likely to



A primary care practitioner

(family doctor,

internist, or general practitioner) handles

medical care that isn’t related to the cancer.

This person should be kept up-to-date on

your cancer care and receive notes on your



A medical oncologist or hematologist

specializes in the systemic treatment of

cancer. This person will be the one who

prescribes chemotherapy. Often, he or she

will also lead the overall treatment team and

keep track of tests and exams done by other