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.
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,
, 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.
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
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