NCCN Guidelines for Patients
Adolescents and Young Adults with Cancer, Version 1.2017
Moving beyond treatment
Will the cancer come back?
Late effects on fertility
Many cancer treatments damage cells in the testicles
and ovaries and can lead to problems with fertility. In
men, treatment-related infertility is often temporary.
That is rarely the case with women. In fact, women
may develop premature ovarian failure months or
years after treatment is over.
These uncertainties make it important that you get
regular checkups to determine if you are still fertile,
and that you use birth control if you don’t want a
child in the near future. If you’re a woman and are
still having periods, you may want to ask your doctor
whether the treatment you received is associated with
an increased risk of delayed premature failure.
Will the cancer come back?
Sometimes a few cancer cells manage to survive
despite everyone’s best efforts to destroy them. Over
time, these cells can divide and spread, leading to a
return (recurrence) of the cancer. Recurrences can
The same place as the original cancer (local
The same general area as the original cancer
A completely different part of the body (distant
recurrence or metastasis).
Recurrences are scary and frustrating but you do
have options. Advances in cancer treatment have
made it possible to cure many local and regional
recurrences, and even a distant recurrence can
sometimes be successfully treated or kept in check
for years. The exact treatment for the recurrence will
be based on the same factors that were considered
after your first diagnosis, including clinical trials.
Give yourself permission to express your feelings and
reach out for help. Above all, use your valuable time
and energy to move forward not backward. This time
around you have quite a few advantages that you
didn’t have when you first were diagnosed.
You know more. The first time out, everything
was a surprise. Now, you have experience.
You’ve built relationships. If you’re being seen
by the same treatment team, you also have
the advantage of working with people you
already know and trust.
You know what works for you. Instead of
trial and error, you can draw on your first
experience when making decisions about
dealing with side effects, planning your life,
and making use of support services.
Use the lessons learned during your first round of
cancer to help with decision making and take control
of the situation.
For more on navigating life
after treatment, check out:
The Essential Handbook to Life After
(New York, NY: Marlowe &
Written by psychologist and cancer
survivor Michael Feuerstein and social
worker Patricia Findley,
offers 7 distinct steps
to help survivors chart the course of
their post-treatment life.