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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.


Part 3.

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

happen in:


The same place as the original cancer (local



The same general area as the original cancer

(regional recurrence).


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 &

Company, 2006).


Written by psychologist and cancer

survivor Michael Feuerstein and social

worker Patricia Findley,

The Cancer

Survivor’s Guide

offers 7 distinct steps

to help survivors chart the course of

their post-treatment life.