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NCCN Guidelines for Patients


Adolescents and Young Adults with Cancer, Version 1.2017

Surgery can be:


Open where the surgeon makes a large

incision and takes out the tumor and some

surrounding tissues or lymph nodes.


Minimally invasive where small cuts are made

rather than a large one. A thin, lighted scope

(laparoscope) is inserted and the surgeon

uses tools for the surgery.

Other surgery done before or after treatment:


Restorative (or reconstructive) surgery to

repair damage caused by other cancer

treatments. The most familiar example of this

kind of surgery is breast reconstruction, in

which a surgeon restores the appearance of

the breast after the removal of breast cancer.


Preventive (or prophylactic) surgery to remove

tissue that carries a high risk of becoming

cancer, such as precancerous polyps in the

colon. Preventive surgery can also be done

for people with genetic mutations that put

them at risk for certain cancers.


For example, a woman with cancer in

one breast who has the gene mutation

associated with a high risk for breast

cancer may choose to have her

healthy breast removed (prophylactic


Many techniques are used for surgery and can be

talked about with a surgeon. Each surgery is carefully

planned by your surgical team, which includes the

surgeon, anesthesiologist, and nurses. A patient

having surgery has a risk of infection and may

experience pain. The medical team takes time to plan

ahead and give support after surgery. Follow-up care

is necessary for healing. You need to know when you

can return to normal activities and your diet.

Radiation therapy

Radiation therapy uses high-energy particles or rays

to kill cancer cells. It can also damage the cells’ DNA

so they can no longer grow or divide. Radiation is

given over a certain period of time planned by the

radiation treatment team. This type of treatment is

given to cure cancer and as a supportive treatment

to help ease discomfort or pain. It can also be given

before, during, or after surgery to treat or slow the

growth of cancer.

There two main kinds of radiation treatment:

External beam radiation

uses a machine outside of

the body to aim radiation at the cancer. It is planned

to treat a certain area of the body where cancer can

be found.

Internal radiation

is when radiation in placed inside

the body as a solid like seeds or capsules, or it can

be given in liquid form.


The solid form is called brachytherapy and

would be placed in a specific area in or

around the cancer.


The liquid radiation can be given through an

IV (intravenous) into a vein to find cancer cells

in the body. This would be a systemic form of


The radiation oncologist and other treatment staff

take time to plan the treatment that is right for you.

Even with planning, the radiation can harm healthy

tissue near the cancer. Side effects like fatigue or skin

irritation can happen.

Radiation is given at different doses and schedules.

External radiation can be given once, for days, or

even weeks, so planning time off from work or school

is important. Any concern about the schedule or side

effects can be discussed with your doctor before you



Understanding your treatment options

What are local treatments?