 For example, AYA survivors report that their education, employment, sexual functioning, marriage, fertility, and other life values are impacted by their cancer.Data show that AYA survivors have a much greater risk of getting a second primary malignancy as a side effect of the treatment for their original diagnosis.It is believed that AYAs have a much higher relative risk of developing a second primary cancer because the intensity of the treatment for their original diagnosis, typically including any combination of chemotherapy, surgery, and radiation, is much higher than the level of intensity given to patients over 40.