11 Tips to Back Tips to Treatment

Advocate to Manage Day

for Your School Side Style
Care pg. 28 Effects pg. 21
pg. 3 pg. 10

's G u i d e t o
A Teen
EVERYTHING
CANCER

The Ultimate Teen Guide

to Self-Advocacy and Self-Care
During and After Treatment
Le tt e r
FROM LLS
The Le
ukemia
Society
& Lymp
(LLS)
homa

Being a teen can be tough. You’re juggling school, friendships,

family and more. Throw cancer into the mix? Ugh!

You’re right—it’s not fair.

IT’S OKAY TO BE ANGRY, SAD, SCARED OR A MIX

OF MANY EMOTIONS.

Here’s the good news:

Even when faced with a situation outside of your control,

such as cancer, there are things you can do to take care
of yourself to feel more in control. By reading this magazine,
you’ve taken a step toward doing just that.

You have people on your team who you can ask for help. Check
out page 4. Other teens have been through similar experiences.
Read Julian’s and Annabel’s stories starting on page 22.

Many resources exist that can provide you with support and
empower you. Take advantage of them.

Illustrations by Honor Hingston-Cox

I D YO U THERE ARE AN ESTIMATED

D

54,888
W?
K NO

PEOPLE YOUNGER THAN 20 YEARS OLD EITHER LIVING WITH OR

IN REMISSION FROM BLOOD CANCER IN THE UNITED STATES

Source: Facts 2022-2023. The Leukemia & Lymphoma Society.

Contents BLOOD CANCER 101
Blood cancers affect the
bone marrow, blood cells,
lymph nodes and other parts
of the lymphatic system.
Leukemia, lymphoma, multiple
myeloma, myelodysplastic
2 Emergency Plan syndromes (MDS) and
myeloproliferative neoplasms
3 11 Tips to Advocate for Your Care (MPNs) are all types of
blood cancers. Blood cancers
4 Who’s on My Team? affect people of all ages,
races and sexes.
6 Staying Well During Treatment

8 Caring for Your Hair, Skin, Nails, and Mouth & Teeth

10 Tips to Manage Side Effects

11 Managing Pain Try the

12 Why Am I So Tired? Very Berry
cipe
Smoothie re
13 Nutrition: Fuel Your Body on page 7!

14 Puberty and Cancer: What You Need to Know

15 Fertility: What You Need to Know

16 Movements: You Can Do These Anywhere!

18 Q+A with a Social Worker

Hear from
s,
20 Friends young adult l,
A abe
n n
Julian and
een
21 Treatment Day Style who have b .
are
where you
22 Survivor Stories Teens, ask your
parents or guar
25 Quiz: Which Hospital Snack Are You? dian
for permission
26 Mental Health before visiting
websites
27 Body Image & Self-Esteem or resources.

28 Back to School

30 Tough Stuff

31 Getting Ready for Adult Health Care Want more resources?

Visit [Link]/teens
32 After Treatment or scan the QR code
for more from us and other
trusted organizations!
Support for this publication provided by
Servier Pharmaceuticals
 IN AN

EMERGENCY
WHEN EMERGENCY,
IN D
CALL 9 OUBT,
11.

PLAN
If yo ua
with frie re hanging ou
nds t
friends , make sure yo
know to ur
alone
ency, either when you are
parent/
guardia call your
If you experience an emerg you nee d to know in an em n and/or 9
rdian present, 11
or without your parent or gua
erg
ne or kee p a are una ency if you
tion in your pho ble to d
what to do. Save this informa purse). o so
(for exa mple, in your backpack or yourse
lf.
printed copy with you

m below:
ptoms require a trip to the emergency room? List the
What signs and/or sym

else) call in an emergency?

Who should I (or someone

Parent or guardian

Name:

Phone number(s):

Name:

Phone number(s):

ter
Hospital or treatment cen
center:
Name of hospital or treatment

Phone number:

Other emergency contact

Name:

Phone number:

SET UP AN “IN CASE OF EMERGENCY” (ICE) CONTACT ON YOUR SMART PHONE

Most smart phones allow you to pick a contact in your phone (such as a parent or guardian) as your
emergency contact. In case of an emergency, a friend, a bystander or first responder can call your
emergency contact without needing your phone’s password. To find instructions on how to set up an ICE
contact, search online for “how to set up ICE on an iPhone or Android” (depending on your type of phone).

2 [Link]
 7. Always ask questions.
11 y o ur b od y and your heal
th—

10 TIPS TO
It’s answers.
you deserve

8. Talk to your parent or

guardian if you feel
as though you are not
being heard by your
doctor. If the problem
continues, ask your
parent or guardian
to consider changing
to a different doctor
that’s a better fit for you.

9. Be honest with members of your healthcare

team. Talk to them about mental health,
tobacco, vaping, drugs, alcohol or sex. All of

ledge
these can affect your overall health, and some
1.  earn about your diagnosis
L n ow
K er! of them can affect your cancer treatment. If
i pow
and treatment options. it’s uncomfortable talking openly about these
s topics in front of your parents, tell them so.

2. Ask
Then, tell the members of your healthcare
if your cancer center team that you want to speak to them privately.
has a program or resources

10. insurance
for teens or young adults.
Ask your parents to explain your health
plan. They may be handling it now,
3. Tasakeprescribed.
your medications exactly
Do not take
but it’s important for you to learn how it works.

more or less. Do not take any

new medications, including 11. Omembers
n the day that you turn 18 years old, the
of your healthcare team will ask
over-the-counter medications, you to make your own medical decisions
without checking with your and sign consent forms for your treatments.
healthcare team. If you want to, you can sign papers giving
members of your healthcare team permission

4. Dtheyon’tcanmissbeappointments.
to continue to talk to your parents about your
Even though
medical information.
upsetting, frustrating or even
boring, they are important.

Survivorship Workbook
5. Follow your doctor’s instructions.
Doing things that your doctor has
for Children
and Adolescents
told you to avoid can be dangerous
Working with your parents
for you. Your treatment may not
and members of your
work as well, or you may have
healthcare team, use the free
serious side effects.
LLS workbook Navigating
NAVIGATING LIFE
DURING AND AFTER
A BLOOD CANCE
R DIAGNO SIS CHILDR EN &
ADOLESCENTS
Support for this publication
provided by

Life During and After a

6. Know your medical history and

keep records. Every doctor you will
Blood Cancer Diagnosis
to collect all the important information you
see in the future will need to know will need as you move through diagnosis
about your diagnosis and treatment. and treatment into follow-up care.
Visit [Link]/SurvivorshipWorkbook
Tip: Many doctor’s offices offer to learn more.
online patient portals where you can
view your medical records and more.

A TEEN’S GUIDE 3
 2
1 3

PEDIATRIC ONCOLO
GIST
OR HEMATOLOGIST
-
ONCOLOGIST
SKILLS /
PEDIATRIC
IAN Oncologist: Diagnosin
g and treating ONCOLOGY NURSE OR
children and teens who
have cancer NURSE PRACTITIONER
Hematologist-Oncolog
SKILLS / many
ist: Diagnosing
and treating children and SKILLS /
and treating teens who have
Diagnosing d teens blood cancer or other blo Treating people who have can
cer
children an od disorders
illnesses in ie n ts to o ther (Giving chemo , drawing blood,
g pat
and referrin supplying snacks, wiping tea
rs …
cialists Experiencing side effect
medical spe s?
TIP Let your oncologist kno
w.
and more)

ician is your Got questions? Oncology

Your pediatr P).”
provider (PC nurses have answers.
T IP “primary care TIP

5
4 6

IALIST
CHILD-LIFE SPEC

SOCIAL WORKER SKILLS /

teens and their REGISTERED DIETITIAN
Helping children,
SKILLS / cancer
families cope with
Talking to teens and the SKILLS /
ir families
about their emotional Helping people improve their food
and
practical needs and find Do you need help choices and learn about nutrition
ing them rents?
support services talking to your pa
ild -lif e sp ecialist
TI P Let yo ur ch
be the refere e.
Social workers can Dietitians have the best ideas
connect you with other for snacks, even ones that
TIP teens in cancer treatm TIP can taste good when you
ent.
don’t have any appetite.
 7

TEACHER AND
LOR
GUIDANCE COUNSE
SKILLS /
w and
Helping teens learn, gro
navigate schoo l 8
to
Worried about returning
to your tea cher
school? Talk
TIP or guidance cou nse lor.

PARENT
AND TR S, GUARDIAN
U ST E D S
ADULTS,
SKILLS / LLS
COMMUNITY
Caring a
bou
9 and givin t you, supportin
g guidan
ce
g you,

At this one-stop
virtual meeting place,
Rememb
T IP er,
go to the you can always
m and as
you can talk with other
k for help
. patients and get the latest
blood cancer resources
and information.
FRIENDS
Share your experiences
SKILLS / and with other patients
be yourself
Letting you and caregivers and
making you
laugh
SUPPO
10 get personalized support
ORGANIZA RT from LLS staff.
TION S
s SKILLS
If you can’t se
e your friend
s.
/
t in other way Providing p
often, connec r ideas! and assistan
rograms, re
sources Visit
T IP See page 2
0 fo
with cancer
ce for famili
es dealing [Link]/community
to join.
Support org
anizations m
offer financi ay
T IP support grou
al assistance
ps, educatio
, People 16 years old and older are
events and nal invited to join LLS Community.
[Link].o m ore. Visit
rg/OHO for Ask your parent or legal guardian
of other he a list for permission before joining.
lpful organiz
Teens, ask ations.
your parent

Like LLS!
guardian’s or
permission
visiting these before
resources.
may also ne You
ed them to
support pro apply for
grams on yo
ur behalf.
STAYING WELL
DURING TREATMENT
Your immune system helps fight illness and infections. Every time you
get sick, your immune system goes to work to help you heal and feel better.
Cancer and cancer treatment can weaken your immune system making
it easier for you to get sick or get an infection.

Ways to Wash your hands with

warm water and soap
Avoid people
who are sick.
Wipe your
cell phone

PROTECT for at least 20 seconds,

especially before eating and You can also use
down with
disinfecting You know
YOURSELF after using the bathroom. hand sanitizer wipes. where
it’s been!

Take care of your Wear a mask in crowds Avoid activities that Take precautions
central line or port, and in waiting rooms. put you at risk for cuts, around pets and animals.
as instructed by your injuries and falls. Ask Let someone else
healthcare team. your healthcare team clean up after pets.
how to care for cuts.

Pets also include the

non-furry kind,
DO YOU KNOW
THE SIGNS AND SYMPTOMS such as lizards. Reptiles
OF INFECTION carry bacteria, too!

☐ F
 ever of 100.4°F ☐ Diarrhea ☐ V
 aginal itching or an
Tell your doctor or greater unusual discharge
☐ A
 burning feeling
immediately ☐ Chills when you pee ☐ Abdominal pain
if you notice ☐ Sweating ☐ A
 cough or ☐ Pain
 or redness
any of these: sore throat near a central line
☐ Redness,
 swelling or
or port
pain near a wound

6 [Link]
Very Berry Smoothie
This refreshing pineapple, banana and berry blend smoothie
has 2½ cups of fruit per serving. Makes two servings.

INGREDIENTS DIRECTIONS
1 cup frozen strawberries 1. Peel and slice the banana.
1 cup frozen raspberries
2. Gather all ingredients
1 cup pineapple chunks and combine in a blender.
1 banana 3. Cover and blend until smooth.
1 cup skim milk
4. Serve right away or pour into
(or almond milk)
ice cube trays and freeze.
1½ cups ice During the week, pop out the
cubes for a quick on-the-go
to either breakfast.
T IP: If you need
weight,
maintain or gain Notes: Get an additional food
instead
use whole milk
group in your smoothie by adding
of full-fat 1 cup of spinach or kale.
or add a scoop
Greek yogurt.
Source: USDA Center for Nutrition Policy and Promotion

WANT MORE RECIPES?

→ Nutrition Education Services Center: [Link]/recipe
→ American Institute for Cancer Research: [Link]
→ Academy of Nutrition and Dietetics: [Link]
→ Cook for Your Life: [Link]/recipes

Smart Snacking

For a filling snack with a lot of

nutrients, combine food groups.
For example, try:
• yogurt and berries
• carrots and hummus
• apple and almond butter
• cheese and whole-grain crackers

Sip water or other

caffeine-free fluids
throughout the day
to stay hydrated.

A TEEN’S GUIDE 7
 Ca r i
FOR
n g
...YOUR ...

HAIR
Cancer treatment can cause hair loss, including
eyelashes and eyebrows. There are people who
lose all their hair, others lose some, and some
people do not lose their hair at all. Most people’s
hair will begin growing back once their treatment
ends. Here are ways to take care of your hair
during (and after) cancer treatments:

• Wash your hair and scalp every 2 to 4 days

with fragrance-free shampoo and conditioner.
Rinse well and pat dry with a soft towel.

• Continue to comb your hair, even if you are

noticing hair loss.

• If you know that your treatment is likely to

cause hair loss, you may find it helpful to get
a short haircut or shave your head before
treatment begins. (Using an electric shaver
instead of a razor will prevent cuts!)

• Use hats, scarves, caps or bandanas

to keep your head warm and protect
your scalp from sunburns.
s
• Use mineral oil or coconut oil Resource
W igs
to moisturize the scalp, especially for Free
if it’s dry.
ove
Locks of L
[Link]
locksoflov
• W
 ear a wig if that feels right for you. • Do not put hair in tight braids, cornrows or
You can even try a new hair color or style. ponytails. They can cause breakage. Do not
hare
• Avoid perms, chemical relaxers, Hair We S use clips or ties that hold the hair tightly.
s h a re .org
permanent hair dyes and bleach, hairwe • You can use a make-up pencil or brush
all of which may damage the hair ids to draw on eyebrows or fill in brows (or use
and irritate the scalp. Wigs for K temporary eyebrow tattoos).
id s .org
wigsfork

8 [Link]
 MOUTH & TEETH NAILS SKIN
• Brush your teeth and tongue at least • K
 eep your nails clean, dry, and short • T
 ake a warm (not hot) bath or shower
twice a day with toothpaste and a because nails may darken, crack every day. Use unscented soap or
soft-bristle toothbrush. or become brittle from treatment. body wash. Avoid bubble baths–they
can irritate the skin.
• A
 sk your healthcare team if you can • Try not to bite your nails or pick at cuticles.
floss. If your blood counts are low, • Pat skin dry with a towel. Don’t rub.
flossing may increase the risk of • Skip manicures and pedicures at salons.
bleeding or infection. If it’s safe to do • Use unscented lotion for dry skin.
• D
 on’t apply fake nails. They can
so, floss gently every day. damage your natural nails and increase • Use lip balm on dry or chapped lips.
• Braces may need to be removed before the risk of infection.
• A
 void direct sunlight. Use a broad-
treatment to reduce the risk of infection. • S
 oak hands in a natural oil, such as spectrum, water-resistant sunscreen
• R
 inse your mouth with plain water olive oil, to help moisturize. with a sun protection factor (SPF)
or a mixture of ¼ teaspoon of baking of 20 or higher. Reapply sunscreen
• A
 sk your healthcare team about nail every 2 hours.
soda and ⅛ teaspoon of salt in 1 cup polish. Nail polish can strengthen
of warm water. and protect the nails. However, check • If you use acne medication or washes
• T
 ell your healthcare team if your with the members of your healthcare on your skin, ask your healthcare team
gums bleed or if you see white patches team before painting your nails, if it’s safe to continue using these
in your mouth. because they may want to be able to during treatment.
see your nail beds to check your blood
• Avoid smoking, vaping and chewing circulation. Nail polish can also interfere • D
 o not pick at your skin or pop pimples.
tobacco, all of which irritate the mouth with the clip that is put on your finger This could cause an infection.
and increase the risk of other diseases. to check oxygen levels in your blood. • If you shave, use an electric shaver,
• If you are removing nail polish, use an instead of a razor, to prevent cuts that
oily polish remover to prevent drying. could get infected.

• T
 o protect your toenails, wear
comfortable, loose-fitting shoes with
cushioned socks.

Eyebrow Tutorial
Use an eyebrow pencil within a shade or two of your hair color.
If you have light hair, a slightly darker pencil may work best. If you
have dark hair, a slightly lighter pencil may work best. You can
also ask an employee for help at a store that sells makeup or at
the makeup counter in a department store or drugstore.


1 Use the pencil to mark the start of the brow,
the arch and the end of the brow.


2 Using the marks as a guide, fill in the brow with light,
hair-like strokes, tapering towards the end.


3 Blend with the spoolie brush. (Most eyebrow pencils
have a spoolie brush on the non-pencil end.)

Drawing on brows takes practice. Don’t worry about the brows

looking exactly the same. Natural brows do not match exactly.

You can also try other products such as brow powders,

gels, pomades or stencils.

A TEEN’S GUIDE 9
 TIPS to manage
side effects
the
<< worst!

sensitivity to smells dry mouth

> L
 ay off the perfume and air > Stock up on sugar-free gum,
fresheners. (You smell fine!) candy and popsicles.
>  cold or room temperature
Eat > Keep lip balm handy.
foods. Hot foods can be smelly. > Drink water throughout the day.
> Use cups with lids. > Pucker up with tart foods,
such as lemonade or sour candy.

mouth sores
nausea
>  inse your mouth often with a mixture
R
of ¼ teaspoon of baking soda and > Eat small meals throughout the day.
⅛ teaspoon of salt in 1 cup of warm water.
> Snack on dry, bland foods such as
> Brush your teeth and tongue with a soft
crackers, toast, cereal, or pretzels.
toothbrush. (No one wants bad breath!)
> Avoid foods that may trigger nausea
> Suck on frozen fruit or popsicles.
such as fried and spicy foods.
>  hoose soft, bland foods that won’t be difficult
C
to chew and that won’t irritate your mouth. >  ginger ale, ginger candy
Try
(Put down the tortilla chips and hot sauce!) or ginger tea.
> Stay sitting upright after eating.
> 
Don’t skip meals. An empty stomach
may make nausea worse. Yuck!
diarrhea
> Wear comfy, lose-fitting clothing.
> 
Drink clear liquids such as water > If you do throw up, sip water, ginger ale
and sports drinks to stay hydrated. or a sports drink to stay hydrated.
> 
Avoid foods that can make
diarrhea worse such as high-fiber
foods, raw fruits and vegetables,
spicy foods, fatty foods and milk. constipation
> Eat foods that are easy to digest
such as white rice, applesauce, > Eat more foods with fiber
bananas, and cooked, soft vegetables. such as whole fruits, vegetables,
beans, and whole grains.
> Drink plenty of water.
> Try plum or prune juice.
Always tell your healthcare team if you
> Be physically active to get
experience any side effects. things moving ...
There may be medications that (You know what we mean!)
can help you to deal with them.

>> WANT MORE TIPS? Visit [Link]/booklets and filter by “Side Effect Management.” <<

10 [Link]
MANAGING PAIN
A cancer diagnosis does
not necessarily mean
you will have pain. But,
hands or feet (neuropathy),
mouth sores, skin irritation,
or pain due to a surgery or
Ask the members of
your healthcare team
to explain the sorts of pain
Whenever you are
experiencing pain, tell
your parents or guardian
it’s possible that you may procedure (for example, or discomfort you may and members of your
experience some pain. a port placement or bone experience and how healthcare team right
marrow biopsy). such experiences would away. You are never
Pain may be short lived be managed. bothering them when you
(acute) or continue longer The type of pain and its tell them you have pain.
(chronic or persistent). intensity depends on PAIN CAN BE They want to help you.
the diagnosis, treatment MANAGED.
Some people with a cancer and the individual person’s NO PAIN SHOULD
diagnosis experience pain. response to treatment.
The pain may be bone or
GO UNTREATED
joint pain, tingling in the OR IGNORED.

MEDICATION

MASSAGE
REST

BREATHING Managing pain can

EXERCISES sometimes be like
solving a puzzle. A
STRESS
combination of things
MANAGEMENT
may work best for
you, and it may take
time to find the pieces
that fit the best.

MEDITATION OR
GUIDED IMAGERY PHYSICAL
THERAPY
ART
THERAPY

A TEEN’S GUIDE 11
Soo o o o o TIRED?
WHY AM I Do you always want to take a nap? But then, when it’s
bedtime, do you find it hard to fall asleep or stay asleep?
Do you feel as if you don’t have the same energy levels
as you did before cancer?

Sleep is important for both physical

and mental health. However,
many teens with cancer struggle
with fatigue or sleep problems.
Talk to
healthc
about w
manage
your
are team
ays to
fatigue.

Tips To Fight Fatigue Super Sleep Habits

Eat frequent small meals and snacks Go to bed at the same time every night.
throughout the day to maintain energy levels.
 o something relaxing before bedtime.
D
Drink water and other non-caffeinated liquids Take a warm bath, read, do some journaling,
throughout the day to stay hydrated. Dehydration meditate, or listen to calming music.
can make you feel tired.
Keep your bedroom cool, quiet and dark.
Stay active. Being physically active during
 void caffeine (coffee, soda) at least 6 hours
A
the day can give you more energy and help you
before bed.
sleep better at night.
 top using screens at least an hour before
S
Keep daytime naps short,
bedtime. This includes cell phones, computers,
30 minutes or less.
tablets, hand-held video games and televisions.

BE KIND
TO YOURSELF.
You may not have
the energy to do
all the things you
did before your
cancer diagnosis.
That’s okay!
Set realistic
goals. Focus on
the things that
are the most
important
to you. Ask
for help when
you need it.

12 [Link]
 Make at l
ON: ea s t
FUEL
ITI
N UTR 2/3
of
y ou
r
YOUR BODY
m

ea
lp
lan
Nutritious foods give your body the

tf
energy it needs to recover from

ood
treatment, but during cancer treatment,

s.
you may not always feel like eating.
(Thanks, chemo. ) Or, you may
have cravings. (Thanks, steroids. )
Treatment may make food taste different.
Even your favs may not seem appealing.
When you are in the thick of treatment
or dealing with side effects, don’t stress
about eating the “right” or “healthiest”
foods. Eat foods that sound good
to you. When you feel well,
eat a variety of nutritious
and delicious foods.

Wash fruits
and veggies
before cutting Try
and eating! plant proteins
Choose
whole grains— such as beans,
Avocado,
a great source peas, nuts
olive oil and
of energy! and tofu.
nuts are good
sources of
healthy fat!

Eat a variety
of colorful
vegetables and LIMIT THESE FOODS
fruits for the
Fried food Red meat Salt Processed
most beneficial such as such as such as meats such
nutrients. chips steak and table salt as hot dogs
and fries hamburgers and most and bacon
packaged
foods

Keep It Clean High-Risk Foods

• Wash your hands before • Close the refrigerator door! If you are at risk of infection due to low
cooking or eating. Keep cold foods and leftovers cold. white blood cell counts, you need to avoid
foods associated with foodborne illness
• Keep raw meat away from • Check the expiration date. (food poisoning). A few examples include
all other foods and surfaces.
sushi, undercooked meat, raw or runny
• Cook meat, chicken, fish, If a food looks, eggs, cookie dough with raw flour and/or
eird,
eggs and leftovers all the smells or tastes w eggs, and unpasteurized foods. Ask your
way through. throw it aw !ay healthcare team for nutrition guidelines.

Want more nutrition information? Visit [Link]/booklets to view the free LLS booklet Nutrition Handbook.

A TEEN’S GUIDE 13
 b e r t
Pu Cancer y&
What You Need to Know

As you probably learned in a health class (or during an awkward conversation with
a parent), during the preteen and teenage years, people go through many physical and
emotional changes. An increase in the production of sex hormones prepares the body You might
for adulthood and for the ability to create a baby. This time in your life is called “puberty.” cringe
at the thou
ght of talk
Honestly, your body is going through a lot of crazy changes. You are going through to member ing
s of your
puberty and undergoing cancer treatment, both at the same time! It’s normal to feel healthcare
team about
uncomfortable, confused or annoyed by this onslaught of changes. Remember, puberty, pe
riods, or se
they are nothing to feel embarrassed about. Easier said than done—but it’s true! medical prof x, but
essionals ta
One thing to keep in mind, cancer treatment can sometimes delay or interrupt puberty. about this lk
kind of stuff
the time. It all
Talk to your parents, guardian or your healthcare team if you have questions ’s a very n
conversation or m al
or concerns about puberty. for them.

Periods & Cancer: What You Need to Know

• If you have a period, cancer treatment may interrupt or stop your cycle. Even if this happens,
you may still be able to become pregnant if you are sexually active. Pregnancy during
cancer treatment is often not safe for the pregnant person or the fetus.
• If you have a low platelet count, your period may be heavier
than usual. Use pads or absorbent underwear during your period,
as tampons can cause small tears to your vaginal walls.
• If you have a low white blood cell count, use pads
or absorbent underwear during your period, as tampons
pose a risk for infection.

Ask your healthcare team what to expect and

let them know about any changes you experience.

14 [Link]
FERTILITY:
WHAT
YOU
NEED
TO
KNOW

As a teen, you may not H

 ow does cancer pregnancy), and carry and
deliver healthy children. Note:
know yet if you would treatment affect fertility?
like to be a parent in Some people do so by Even if you have been
Cancer treatment can taking steps to preserve
the future. That’s okay. told cancer treatment
damage organs that are their fertility before
But because of your may affect your fertility,
part of the reproductive starting a treatment you may still be able
cancer diagnosis, it may system. This can include that may affect fertility. to become pregnant
be something you need the ovaries (where eggs
Remember, there are many or contribute to a
to think about. are stored), the uterus
pregnancy. If you are
(where a fetus grows ways to build a family
and many ways to have sexually active, always
What is “fertility?” and develops) or the
children, whether through practice safe sex. Use
testes (where sperm is
“Fertility” is the ability natural conception, with a form of birth control
made). Cancer treatment
to have a biological child, medical assistance, or to prevent pregnancy.
can also damage the
a child who carries your adoption. When, and if, you Use a barrier method
thyroid or pituitary gland.
DNA (your genetic material). decide to have children (condoms, dental dams)
These organs produce
in the future, consider and to prevent sexual
Cancer treatment can hormones that support
discuss all options. transmitted infections
affect fertility making it growth and sexual
(STIs), also called
either less likely or more development (puberty).
“sexually transmitted
difficult to have a biological What do I need to do?
diseases (STDs).”
child in the future. What else do Ask your healthcare team
I need to know? if your treatment will affect
Many cancer survivors your fertility and if so,
do go on to conceive ask about your options
(become pregnant to preserve your fertility.
or contribute to a

A TEEN’S GUIDE 15
 C A N DO THESE
YOU E!
ANY WHER
1
Cat-Cow a

Start on your hands and knees with

your hands under your shoulders
and your knees under your hips.

Breathe in deeply while bringing

your head and pelvis up (Cow). (a)

Breathe out while arching

your back and bringing your head
and pelvis down (Cat). (b)

Repeat.

2
b
Bird Dog

Start on your hands and knees.

Raise your left arm and right leg

and hold for a few seconds.

Use your abdominal muscles

(abs) to stay balanced.

Switch to the other side.

3
Downward Dog

Start on your hands

and knees.

Move up onto your toes.

Walk your hands out and

push your weight back onto
your feet, bringing your
heels closer to the floor and
bringing your bum into the air.

Try moving from Cat-Cow to Bird Dog to Downward Dog for a simple yoga flow.
16 [Link]
 a

With your parent’s

4 or guardian’s
Tree Pose permission, you can
search online
Start by standing with your arms at your side. for more poses!
Reach down and hold your left foot.

Use your hand to bring your left foot up along your

right thigh. (a) If you find it difficult to balance
or lift your leg, try this instead: Rest the heel of your
left foot on your right inner ankle. (b)

Find your balance by focusing on something

a few feet away from you.

Bring your palms together in front of your chest.

Hold for a few seconds and focus on your breathing.

5 b
Warrior II

Start by standing with your legs further apart.

Bend your left knee at a 90° angle.

Want to take it
Keep your knee over your ankle.
up a notch?
Stretch your right leg out.
Consider adding
Spread out your arms and look light weights to your
at your left hand. movement such as
Hold for a few seconds and focus holding a weight
on your breathing. while doing warrior II
pose or walking.

You can find objects

around the house
6 that you can use
Reclined Spinal Twist as weights, such as
an empty milk jug
filled with water
or a soup can.
Start by lying on your back with your arms out.
Check with your
Bend your right knee and place your right foot doctor to make
on your left knee. sure these
Let you right knee gently fall over to the left side of your body. movements (and
ones like them)
Look at your right hand. are safe activities
Hold for a few seconds and breathe deeply. for you as you
go through
Switch to the other side. cancer treatment.

A TEEN’S GUIDE 17
 Q+A with a SOCIAL WORKER

Do you have a social worker and/or a child-life

specialist as a member of your healthcare team?
Social workers and child-life specialists are
healthcare professionals who can help you (and
your family) to cope with your emotional or practical
needs. They can also help you find support services.
You can always share your concerns with a
social worker or child-life specialist and ask them
for answers if you have questions!

Q. A friend that I met at over your friend’s response

to treatment, and it is not
Q. I will be starting a with others, you may want
to share some details, but
a cancer support group new school next year
isn’t doing well. While I’m your fault. Even though and meeting new people. not all the information.
glad my treatment was this feeling is normal, it can How do I tell people about It is perfectly fine to set
successful, I feel bad for really make you feel sad my cancer diagnosis? boundaries and limit who
them. How do I handle and impact your life. A way Do I have to tell people? you tell and what you tell
these feelings? to help with these feelings them. You can also do this
is to talk about them A . Meeting new people at your own pace, when it
A. It is normal to feel this and process them with who don’t know what feels right to you. You do
way. Sometimes people someone who understands. you’ve been through can not have to tell someone
even give this feeling a Talk to a mental health be anxiety-provoking and about your diagnosis the
name—“survivor’s guilt.” professional, a social make you want to isolate. It first time you meet them.
This can be the guilt, worker or a psychologist, can also be an opportunity Some people find that they
remorse or sadness for example. Consider to experience new things are more comfortable talking
people feel when their sharing these feelings and get to know new about their cancer diagnosis
circumstances seem to be with other members of people. You don’t have to if they have practiced talking
more favorable than those your support group. It is tell someone about your it out with a close friend or
of another person in a important to know that you cancer diagnosis, unless family member beforehand.
similar situation. In reality, are not alone. you want to. If you choose Anticipate that people will
you don’t have control to share this part of yourself have different reactions;

18 [Link]
anticipate that they may ask date reacts negatively, it is They might have some
a lot of questions. It may be not your fault. You are not helpful feedback and ideas
helpful to think through your your cancer diagnosis. You about how to get through
answers. You can also ask are a person with many something like this.
other teen cancer survivors different thoughts, feelings
how they handle telling and interests. People have Q . I am afraid of the
people about their diagnosis. different histories and future. I try to talk to
You can meet other teens encounters with cancer. In my parents about it, but
in a support group or at some cases, you may be they tell me not to worry.
a survivorship camp or able to teach someone what I still worry. I feel pressure
conference. You should it means to be a person to be positive all the time.
know, though, that some with a cancer diagnosis. How can I make them
staff members at school may For example, you may need understand?
need to know about your to explain that they can’t
diagnosis to help support “catch” cancer from you. It A . Many people who
Check Out These
you. If that is the case, isn’t contagious like the flu. have cancer, especially
young people, feel that
Organizations
members of your healthcare In other cases, someone
team, such as a social may not be hearing you. they always have to “stay for Teens and
worker or child-life specialist, You may have to move on. positive.” This can be Young Adults
can help guide you and your It may hurt but, in the long helpful for some people,
parents or guardian about run, anyone you are going to but it is not realistic to
communicating with school allow to have a special place expect you to have a
staff members. in your life must be caring positive attitude all the
and supportive. time. You can still be a
Q . Do I have to tell strong person but feel
someone who I’m dating Q . I won’t be able to sad, angry, anxious and ELEPHANTS AND TEA
or someone I have a go to the prom with vulnerable at times. That [Link]
crush on about my cancer my friends because of is part of being human. Free quarterly
diagnosis? What if it treatment. I feel left It is very normal to worry magazine, digital
changes how they feel out and robbed of the about the future. After all, programs and events
about me? experience. I just want to no one can tell you what
be a teen. What can I do? the future may hold; but
A . Dating can be fears about the future
intimidating no matter your A . This is really hard. It’s can make it hard to live
situation. You don’t have unfair that you have to miss your life in the present.
to tell someone about your the prom while your friends If possible, talk to your
cancer diagnosis, unless you will be having fun. It is so parents about the ways in
want to. (See answer to the difficult to have to prioritize which these worries are
last question.) Keep in mind, your health when you just impacting your life. Ask
though, that if someone will want to be a teen. Missing STUPID CANCER
if you can meet with a
[Link]
be playing a big role in your this experience will be counselor, social worker
CancerCon
life or is someone you will really sad--but try to think or some other mental (annual conference),
be going to for emotional of ways to make it a little bit health professional who events, webinars
support, it’s good to be easier. Can you get dressed can help you to process and list of resources
honest and up-front with up with your friends and your fear. You can also
them. When, and how, you take pictures before the tell a member of your
tell someone is always your prom? Is there something healthcare team that you
choice. When it comes to special you want to do on are afraid of what
dating, some people prefer that night instead? Maybe the future could hold for
to disclose their cancer you can have a party with you. They might be able
diagnosis right away to clear your friends at another time to help you reframe some
the air and get a sense of when you’re feeling better? of your worries, or they TEEN CANCER
whether the other person It’s important to talk to the AMERICA
may suggest someone
is likely to be supportive or supportive people in your [Link]
you can talk to.
not. Some people prefer to life—close friends, family, Stories, videos and
list of resources
wait until they trust someone other survivors, counselor
before they share their or social worker—about
cancer diagnosis. If your how you are feeling.

A TEEN’S GUIDE 19
 FRIENDS
During treatment, you may find that some
of your friends are your biggest supporters.
People who you may not have been close to
before your diagnosis may step up in a big
way to support you and go on to become your
closest friends. You may make new friends
during treatment (for example, meeting other
teens with a cancer diagnosis).

STAYING IN TOUCH FIND YOUR PEERS BEWARE OF

HEALTH INFO
You may not be able to Connect with ONLINE!
spend as much time other teens
with your friends while who have a It’s best to avoid Googling cancer.
you are in treatment. Here cancer diagnosis. Ask With the internet, so much
are ways to stay in touch: your healthcare team how information is available right at our
you can do this. Talk fingertips. But it’s not all reliable
• C
 atch up through video calls
to someone who gets it! information. The best source of
and messaging.
information about your diagnosis
• Send handwritten letters or cards. and treatment plan is your healthcare
• S
 tream a movie or play a team. Members of your healthcare
video game online together. TALKING TO YOUR team can answer your questions
PARENTS OR GUARDIAN and tell you where to find reliable
• T
 rade books, graphic novels,
information if you want to read more.
or comic books. After your diagnosis, does it
• Create music playlists for each other. feel as though your parents
are babying you? Do you
• If your healthcare team approves,
wish they would let you do
let your friend visit you in the WHAT IF A FRIEND
more for yourself?
hospital or at home. GHOSTS ME?
Talk to them. Do it when
you aren’t upset or Some people do not
frustrated. Start by thanking have experience with
SOCIAL MEDIA them for all that they do. cancer or other tough
(Admit it—they do a lot for stuff. (Lucky them.) They may not
Ask your parent or you!) Then name a few know how to cope with your
guardian for permission specific things that you diagnosis. You may find that you don’t
before creating social would like to change. For hear from them as often as you did or
media accounts. Be careful example, “I prefer to clean they feel distant when you do speak
what you post on social media. my room myself.” or see each other. This may leave you
Remember that even a private feeling sad, confused or let down. The
Still struggling to communicate
profile may not be as private as you hard truth is that not everyone knows
with your parents or guardian?
think. Think about your relationship how to handle a cancer diagnosis.
Ask a child-life specialist
with social media. Is it fun? Do People have different experiences
or social worker for help.
you use it to connect with friends? with illness and different fears
They are pros at
Awesome! Or does it make you feel surrounding cancer. Focus on the
navigating tough
bad, anxious or left out? Maybe it’s friends who do stick around or step up.
conversations!
time to take a break from scrolling.

20 [Link]
TREATMENT DAY StYLe
On treatment or appointment days, COMFORT IS KEY.
You can have fun too. Wear your favorite colors A cozy cardigan, zip-up
or prints such as plaid, polka dot, or camo. You can sweatshirt or button-up flannel.
support your favorite team or rock a band T-shirt. Dress in layers!

Loose or Sneakers
V-neck or slippers
T-shirts with a
so it’s hard sole
easier for
members
of your
healthcare
team to
access
your port

Knit hat or scarf to

keep your head warm Socks! Cold toes
Sweatpants, leggings or
are the worst.
even pajama pants

WHAT’S IN MY BAG?
Pack a few key items in a tote, backpack or purse to take with you on treatment
or appointment days. A blanket will you keep you warm in a chilly hospital. A few
favorite snacks and a reusable water bottle will keep you fueled and hydrated.
Hard candy or sugar-free gum can help if your mouth feels dry. Yuck! Take a
phone, tablet, or laptop and headphones so you can listen to music or binge
watch a new show (or a show you’ve seen a million times—no judgment). Don’t
forget a charger—you’ll thank yourself later. For more ways to pass the time, bring
a book, journal or deck of cards. You could even bring homework. (But we don’t
blame you if you don’t.) Add a comfort item, such as a stuffed animal or favorite
pillow. Lastly, toss in lip balm and unscented lotion to soothe dry lips or skin.
A TEEN’S GUIDE 21
SURVIVOR STORIES

Julian's STORY

KEEP SETTING BIG GOALS

I was a 10-year-old kid After almost 4 years of chemo, I was

finally in remission. At this point, I
when I was first diagnosed was a quiet 14-year-old in junior high,
with leukemia. I was a happy, barely starting to build my confidence
energetic kid who loved being back as my hair grew back. I was
outside, and I was a straight-A student. beginning to feel my age again. I spent
However, my whole childhood most of my time in school rather than cancer might be back. I was terrified.
was put on hold once I had cancer. in the hospital, which was a significant My life had just returned to normal. At
Rather than having sleepovers at change of scenery. I was doing well in the age of 16, a bone marrow biopsy
my friend’s houses, I was sleeping school once again. confirmed that my leukemia had come
over at the hospital. It was hard back in full force, and I would need
In high school I joined the cross country to start treatment right away.
losing my energy, smile, confidence,
and track team. I loved running because
and hair as treatment took over
it was always a way for me to let go of all
my life. As a kid, it was hard to truly
the anger, frustration, sadness, and other
understand what was happening A bone marrow biopsy is a
feelings. My confidence grew. During
between getting injections, procedure to remove a small
my sophomore year, I had huge goals—
procedures, chemotherapy (chemo) amount of bone marrow for
I wanted to run a mile in under 5 minutes,
and surgery. All I knew was that
and I planned to take part in a college
testing. Bone marrow is the
everyone around me was crying spongy center located inside
engineering program over the summer.
and sad. I was just going through the bones, where blood cells
the process blindly and trying to Before summer came, I went for a are made.
get better. checkup, and my doctors told me the

THE BLOODLINE
WITH LLS
is here to remind you that after a diagnosis
comes hope.
Listen in as patients, caregivers, advocates,
doctors and other healthcare professionals
discuss diagnosis, treatment, side effects,
resources and more.

⊲ Visit [Link]/TheBloodline
to listen to the podcast.
22 [Link]
Learning that I had leukemia for a second home. My mom stayed with me at the
time was so much more devastating, hospital, and I was grateful to my family
not just because I knew what I had for being so supportive of me. Overall,
to go through but also because it had my transplant went well, and I returned
taken me so long to just feel normal to high school for the second half of my
again. I felt like cancer was putting all junior year.
my dreams and goals on hold.
After my transplant, I was ready to
My doctors told me that I would need make the most of my second chance.
to go through the same treatment I knew I wanted to do something to
that I went through as a kid, another support other patients. I wanted to
4 years of treatment. I started give them hope like my family, friends,
chemotherapy and lost my hair again. healthcare team and others gave to
me. So, I started selling bags of chips.
Soon after I started chemo, my doctors My friends started helping too. With the
realized that my body had built up a money, we made 50 care packages for
tolerance to the treatment, so it wasn’t children in cancer treatment. My senior
as effective. Instead, a bone marrow year, we did even more fundraising. I
transplant would give me the best was lucky to have many great friends
chance of remission. I was admitted who supported me and my mission.
to the hospital for my transplant.
Once I turned 18, I officially founded
the Bags of Love Foundation, an
A bone marrow transplant, also organization dedicated to providing
called a “stem cell transplant,” hope to children, teens, and young
is a procedure that replaces adults affected by cancer. Our
unhealthy bone marrow with programs include care packages,
healthy bone marrow to create scholarships, and financial assistance. Check out Julian’s
new blood cells. As an organization, we have raised over Bags of Love Foundation at
$100,000 for other patients affected
[Link]
by cancer. My ultimate goal is to
First, I went through 1 week of high- provide hope to patients and families to learn more!
dose chemo and radiation to wipe out nationwide.
my bone marrow and prepare me for
my transplant. All I wanted to do was ■ Julian Castaneda, age 22
sleep, and the chemo caused bad In addition to his work with Bags of Love
mouth sores. After the transplant, I Foundation, Julian is also a student at
recovered in the hospital. It was difficult California State University, Northridge
and a Dare to Dream Ambassador for
to spend almost 3 months away from
The Leukemia & Lymphoma Society (LLS).

MEET THE
DARE TO DREAM PROJECT ...
The goal of The Dare to Dream Project
is to transform treatment and care
for pediatric blood cancer.
Visit [Link]/DareToDream to learn more
about what LLS is doing to achieve this goal
and how you can get involved.

FAITH
ALL survivor
SURVIVOR STORIES

Annabel's STORY

CURIOSITY, CONFIDENCE
AND MENTAL HEALTH

During my final year of I am usually a positive, bubbly person,

but cancer treatment is not bubbly or
high school, I felt a lump fun at all. Since I was 18, I was treated at
near my clavicle. I did not have an adult cancer center. I was always the
other symptoms, but I went to my family youngest person there. For treatment,
out was extra dangerous for me so I
doctor to have it checked out. My I got the full package. I did six rounds of
stayed isolated. It wasn’t a nice feeling
doctor thought the lump was a lipoma chemotherapy and 2 weeks of radiation.
to see people going out together
(a non-cancerous tumor) and ordered when I was stuck at home. My family
I had planned to shave my head when
an ultrasound to check it out. I am and friends were my support system.
I graduated school, so I wasn’t too
interested in medicine, so I was curious My relationships with my close friends
worried about the hair loss. I called my
about the diagnostic process. grew stronger. We had weekly, virtual
chemo hairstyle “kiwi hair” because I
During the ultrasound, the ultrasound still had some hair left. I decided I wasn’t check-ins to stay in touch and through
tech took a long time to complete the going to hide, and I lived my “main this learned more about each other. I
scan. She kept adding gel and moving character moment” with confidence. learned to value my close friends more
the wand up my neck. I began to and to filter out other people who don’t
I also lost weight during treatment and matter. I’ve carried that lesson with me.
suspect something was wrong. I had a
then gained it back quickly when my
CT scan (CAT scan) next, and it showed I am now in remission. I am in university,
appetite returned. Other people noticed
multiple growths in my body. My doctor and I am still very interested in medicine.
and made comments. I saw myself in the
didn’t tell me it was cancer at this point, I plan to become a surgeon. Looking
mirror every day. I didn’t really notice the
but in my head, I knew it couldn’t be back, I wish someone had told me to
changes much. When I would see people
anything else. I knew a benign tumor look after my mental health. My doctors
who had not seen me in a few months,
wasn’t going to spread to other places. were really focused on my physical
I could see the shock on their faces. It
I had a biopsy to confirm the health, but mental health is also so
was difficult to deal with. Their reactions
diagnosis—Hodgkin lymphoma. important. Even 2 years later, I am still
and comments made me feel insecure
and bothered me more than I thought processing all of it and dealing with
it would. It’s something I am still working the emotional baggage. My advice to
A lymph node biopsy is a though. It’s a process, but I feel like now anyone diagnosed with cancer is to talk
procedure where a doctor I am much happier with my body, no to a therapist early, or at least soon after
removes either all or part of matter how it looks. I know my body is treatment, if you have the strength.
an enlarged lymph node for so strong because of all that it handled. ■ Annabel Nelling, age 20
testing. Lymph nodes are Annabel is currently studying medicine
After my diagnosis, I was determined
small bean-shaped organs at Tartu University in Estonia and living her
to finish school with my classmates.
that contain white blood Due to the Covid pandemic, everything
best life.
cells, which fight infections. was online, so I was able to keep up
with lessons. School kept me going.
At the time, after my diagnosis, I wasn’t
Staying busy kept me from dwelling on
what was happening to me. I graduated TALK to
worried or depressed. I was interested members of your
on schedule!
from a medical perspective to see what healthcare team
happened next. I approached treatment My social life, however, was put on about your mental
with curiosity and took it head on. hold. Treatment weakened my immune health. Ask for a
system. Especially with Covid, going
referral to a therapist
or counselor. Learn
more about mental
health on page 26.
24 [Link]
 S N ACK

?
ITA L

U
H O S P

O
WHICH

ARE Y Ta ke th is qu iz to
di scover w hi ch
ho sp ita l sn ac k m at ch es yo ur pe rson al
ity.

Where would you go on

What is your a dream vacation?
favorite color?
1 ■ a) Blue ■ a) Mountains

■ b) Yellow 2 ■ b) Beach

■ c) Red ■ c) Amusement park

yo ur favo ri te su bj ect in school?

What is
■ a) English

3 ■ b) Math

■ c) Science

What is your
What do you like to do to
pass the time in waiting rooms?
favorite animal? 5
■ a) Dog
■ a) Read
■ b) Elephant
4 ■ b) Watch videos
■ c) Tiger
■ c) Text friends

Mostly Cs: Ice pop. You are cool—what else is there to say?
Mostly Bs: Cookie. Fun and sweet describes you best. You can make anyone smile.
Mostly As: Apple juice. You are a classic—loyal and dependable. Friends can always count on you.
 Mental health (like phy
sical
health)

is important to your overall well-being.

You may experience feelings of sadness, anxiety, anger, grief or guilt.
These feelings are normal. Most people feel them at some point.
Find an outlet for big feelings such as:
Journaling • Music, drawing or painting • Hobbies such as reading, baking or video games • Walking or being outdoors

ic
Mus

If these feelings begin to be scary or overwhelming, talk to the members

of your healthcare team and your parent or guardian. Ask for help.

Talking to a therapist or mental health professional can be helpful for anyone. A therapist can
provide you with tools that will help you to identify and cope with your emotions in a healthy way.

Visit [Link]/booklets to view the free LLS booklet Managing Stress:

How stress affects you and ways to cope and order the Write It Out journal.

If you are having trouble coping and do not know who Do you feel as th
ough you are
you can turn to for support, dial 988 to talk to a spinning out of co
ntrol?
community crisis center representative. The 988 Suicide & First, close your ey
es, take a few de
Crisis Lifeline is free, confidential and always available. and count to ten ep breaths
slowly. Open your
For the Crisis Text Line, text HOME to 741741. eyes and list and
touch the items ar
ound you.
Next, after you fe
el more grounded
talk to a parent or ,
trusted adult.

26 [Link]
 Use journaling to work
through your feelings.
Respond to these
body image prompts.

☐ L
 ist three or more important
things your body can do.
Example:
My arms can hug my friends.
_______________________

_______________________

_______________________

_______________________

_______________________

_______________________

☐ L
 ist three or more things
BODY IMAGE & SELF-ESTEEM you like about yourself.

Examples:
Almost everyone struggles with body image and self-esteem at Sense of humor, smile
_______________________
some point, but teens who have a cancer diagnosis face the uniquely
awful combo of cancer treatment and puberty. Yikes! Both can change and intelligence
_______________________
how your body looks and feels in a lot of different ways.
_______________________

_______________________
↓↓ WAYS TO FEEL MORE COMFORTABLE IN YOUR BODY ↓↓
_______________________
Wear Stop scrolling Don’t body-
comfortable social media! shame yourself. _______________________
clothes. Don’t let all Ask yourself,
Clothes should those “perfect” “Would I say
fit your body. images make or think that _______________________
Your body you feel badly about someone
does not need about yourself. I love?”
to fit clothes. Besides, they ☐ When do you feel the strongest?
are all edited!
_______________________
Move Treat your Ask friends and
_______________________
your body. body well family members
Stretch, go by eating a not to talk about
for a walk variety of foods, appearance _______________________
or dance. drinking water or body size.
and resting. There are more _______________________
interesting things
to talk about! _______________________

For more writing prompts, visit

Your appearance does not determine your worth.

Gentle
[Link]/booklets to order
Be You do not have to love everything about your body, the FREE Write It Out journal.
but you do need to respect and care for it.
comes
Bonus: it
with yourself Remember, too, that you are not your cancer diagnosis.
ils!
It does not define you.
red penc
with colo
You may be excited, worried or a mix of both of
these feelings about returning to school. If you
have any particular fears or you’re feeling anxious,
talk to your parents, guardian, members of your
healthcare team or a teacher.

Teach Your Classmates About Cancer

By now, you’re the expert! Before you return to school,
it may be helpful for your friends, teammates or classmates
to learn about cancer. (Not the whole school—just close
friends.) A teacher, guidance counselor or other adult can
lead the discussion. You can be part of the discussion or
not. The choice is yours. Your friends care about you and
learning about your experience can help them support you.
An adult you trust or a member of your healthcare team
can help with the discussion and provide information.

Questions, Questions, Questions

Be prepared for questions about your diagnosis. You can
share either as much or as little as you want. Most questions
will be from people who care about you or who are curious
about cancer. If someone asks a question you don’t want
to answer, you can say, “I’d rather not talk about that.
Let’s talk about something else.” If someone persists after
you’ve asked them to stop, end the conversation and tell
an adult about the problem.

Struggling with School Work?

Since cancer treatment, do you find yourself forgetting things?
Is it harder to focus in class? Do your thoughts sometimes feel “foggy?”

You may be experiencing a side effect of treatment that many cancer survivors
call “chemo brain.” Doctors call it “cognitive (thinking) changes.”
Cognitive changes are common, and they can differ a lot from person to person.

If you find yourself struggling with your schoolwork, let your parent, teacher
and healthcare team know. You may benefit from extra support at school.
You may even be eligible for accommodations that are protected by law.

28 [Link]
 S T U D Y T IP S
• S
 tay organized. Find a sys
tem that works for you.
For example, try using a
different color notebook
or folder for each subjec
t.
• Keep track of due da
tes and tests in a digital
or paper planner.

• R
 eview the notes you tak
e during class later the
what you learned. Try to same day to help retain
review your notes or revis
it concepts a few times.
Don’t wait and try to cr
am the day before a test.

• Ask your teacher if you

can record lessons. You ca
n then listen to them lat
er.
• Ask for help. If you ha
ve questions, ask your te
acher. For help studying ,
ask a parent or classmate
to quiz you.

• Set aside time specifi

cally for studying . Try to
study at the same time ev
ery day.
• Create a study space,
such as a desk or kitche
Do not study in the place n table.
where you rest, for examp
le, your bed.
• Put away distractions,
such as your cell phone. Lo
g out of social media.

• Have a snack and beve

rage before studying .

• Take a break and move

around every 30 minutes
(or more often if you need
to).
• Know when to stop. If
you are tired and you’ve
been studying for hours,
aren’t retaining any new you likely
information. It would be be
tter to get a good night
’s sleep.
DID
YOU Scholarships are availabl
e to help cancer surviv
KNOW Visit [Link]/sc
ors pay for education.
holarships to view a pot
ential list.

A TEEN’S GUIDE 29
 TOUGH
STUFF
As a teen, you will need to make ALCOHOL, TOBACCO AND DRUGS
tough decisions—it’s part of reaching
adulthood. You need information to Alcohol and drugs may not mix with your medications or treatment.
Mixing them may make side effects worse, treatment less effective,
make these decisions. This information or cause serious complications. Smoking, chewing tobacco or
(no judgements!) is being provided vaping can also make mouth sores or taste changes worse.
for your safety and well-being. Smoking marijuana can put you at risk for a serious fungal infection.

From health class, you may already know … SEX

■ A
 lcohol, drugs, vaping and tobacco can Cancer treatment can weaken the immune system which puts
increase your risk for disease, such as people at a higher risk of infection, including STIs. Additionally, it can
heart disease, stroke and some cancers. be more difficult to treat or manage an STI during cancer treatment.

■ A
 lcohol and drugs impair your mental and Pregnancy during cancer treatment can be unsafe for both
physical capabilities putting you (and others) the pregnant person and the fetus.
at risk for injury or other dangerous situations. Sexual activities may be unsafe during cancer treatment.
■ A
 lcohol, drug and tobacco use is illegal for For example, a patient who is at risk for bleeding issues due to a
low platelet count may need to refrain from vaginal and anal sex.
people under 21 years old in the United States.
Sexual activities may also be unsafe for your partner if you’ve
■ S
 ex, especially sex without protection, recently received treatment because chemotherapy and other
can lead to pregnancy and sexually drugs can be present in your bodily fluids, including saliva,
transmitted infections (STIs), also called semen or vaginal fluids.
sexually transmitted diseases (STDs).
If you are sexually active, you must:

By now, you may be sick of hearing this, but ☐ Use condoms, or another barrier method, to protect against STIs.
CANCER CHANGES THINGS. You and your peers ☐ U
 se some form of birth control. (Do not make assumptions about
all have issues to deal with, but you have more. your ability to become pregnant or contribute to a pregnancy.)
It is important to keep this in mind when you are
faced with tough decisions. ☐ A
 sk your healthcare team if it is safe to have sex or participate
in other sexual activities.

Talk to your healthcare team about sensitive subjects such as tobacco, vaping, alcohol, drugs and sex. Be honest
about alcohol, tobacco and drug use. Be honest about sexual activity. If you want to talk to members of your healthcare
team without your parents or guardian in the room with you, ask to speak to them privately. u can do this!)
(Yes, yo

30 [Link]
 Adult
GETTING
READY
FOR

HEALTHCARE
As you get older, you will at a survivorship clinic for
transition into the adult specialized care.) You will
healthcare system. Once also need to learn how to
you are 18 years old, you
are legally in charge of
manage your health by
doing things like scheduling
Did You Know?
Cancer treatment can cause side effects that appear after
your own healthcare. Your appointments and getting treatment ends, even years later. These are called “late effects.”
doctors can only talk to you your prescriptions filled. As you get older, you may need special tests or screenings
about your health unless (See “11 Tips to Advocate to check for these late effects. Ask your oncologist about
you give permission for for Your Care” on page 3.) the possible late effects of your treatment and for screening
them to talk to someone Talk to your pediatrician recommendations. When you see a new doctor (even as
an adult), tell them about your diagnosis, treatment and risk
else. If you are still seeing or other members of your
for late effects to make sure you get the tests you need.
a pediatrician as your healthcare team. They can
primary care provider (PCP), help you with transitioning The Children’s Oncology Group (COG) provides guidelines
for monitoring late effects.
between ages 18 and 22, to adult healthcare
you will be moving on to and recommend doctors. • F
 or Healthcare Professionals: Long-Term Follow-Up
seeing a doctor who takes Guidelines for Survivors of Childhood, Adolescent and
Visit Got Transition at Young Adult Cancers
care of adults. (As a teen
cancer survivor, however, [Link] • F
 or Patients and Families: “Health Links,” a set of materials
you may continue seeing to learn more. Visit [Link] to download.
a pediatric oncologist for Check out the Health Links with your parent or guardian.
years after treatment ends Write down any questions you have for your healthcare team.

R I N G )
O LO Teens
L S C S(™and
L K ID
R
ges

FO
s t i me , and pa ids
pas
and treatme
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i v i t y g olo ring p ctivities
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s s your oom or e s , gene y Journ Book.
e r s M g
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t h e b la nk c P ic la n t Co
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 AFTER TREATMENT
What People Think You Do
After Finishing Cancer Treatment

Celebrate

Stop thinking
about cancer

What You Actually Do

After Finishing Cancer Treatment

Eat snacks Ring the bell

Worry about
Experiment with
check-ups
new hairstyles

Manage continuing Go to check-ups

side effects and get
lab work done

Nap Feel
weird

Make jokes about

cancer that
Celebrate your parents don’t
think are funny

Is that pain from

bumping my knee
on the table
or is it cancer?
Miss your favorite
Figure out
nurse
what to do now

Finishing cancer treatment does not mean that your life immediately returns to being exactly the same as it was before cancer.
You will still need to get regular check-ups. You may still have side effects from treatment or need to take medication.
You will be transitioning from seeing members of your regular treatment team to seeing a new team at a survivorship clinic.
You are likely to have new perspectives on a lot of things as well as new goals. You may have emotions that you are either still
processing or need to process. Cancer treatment pulls the rug out from under you. Give yourself grace as you find your
footing again. Ask your parents or guardian and members of your healthcare team for help whenever you need it.
 PROVIDING THE LATEST INFORMATION FOR
PATIENTS & CAREGIVERS

Hodgkin

Want to Learn More About

Lymphoma
PROVIDING THE LATEST INFORMATION FOR
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Blood Cancer and Treatment? Acute

Lymphoblastic
Leukemia PROVIDING THE LATEST INFORMATION
FOR PATIENTS & CAREGIVERS

in Children
Visit [Link]/booklets to view, and Teens
Acute Myeloid
download or order booklets and fact sheets Leukemia
in Children
Revised 2022

about different blood cancer diagnoses and Teens

and treatments.
Revised 2022

Support for this

Visit [Link]/education-videos to
publication provided by

watch education videos about blood cancers,

treatment, survivorship and more.
Revised 2023

This publication is designed to provide accurate and authoritative information about the subject matter covered. It is distributed as a public service
by The Leukemia & Lymphoma Society (LLS), with the understanding that LLS is not engaged in rendering medical or other professional services.
LLS carefully reviews content for accuracy and confirms that all diagnostic and therapeutic options are presented in a fair and balanced manner
without particular bias to any one option.
GAME YOUR WAY
AND GIVE BACK.
Every time you boot up a favorite game,
you could be helping LLS fund groundbreaking
treatments and top-notch care for blood cancer patients
and their loved ones. Turn a family game night
or an afternoon with friends into something bigger—
a chance to change lives.

Help us #TiltCancer!
Visit [Link]/TiltCancer to learn more.

PARENTS AND GUARDIANS:

For more information on disease, treatment, support and resources,

Thank You
to the y
call an LLS Information Specialist at 800-955-4572. oung ad
and tee ults
ns who
make th he lped
is resou
rce
possible
!

3 International Drive, Suite 200, Rye Brook, NY 10573 • 914.949.5213

The mission of The Leukemia & Lymphoma Society (LLS) is to cure leukemia, lymphoma, Hodgkin’s disease
and myeloma, and improve the quality of life of patients and their families. Find out more at [Link].

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