People newly diagnosed with cancer are often struck by how thoroughly it can weave its way into all aspects of life. Oncologist-author Siddhartha Mukherjee, MD, describes this as entering “cancer world.”

Cancer world is full of ups and downs. Rick George, featured on the cover, is a good example. He developed end-stage liver disease related to hepatitis C and was diagnosed with liver cancer while awaiting a transplant. He bounced back after getting his new liver but later had a recurrence of cancer. As we worked on this story, George had just started a new targeted therapy, his cancer had stabilized and he was feeling great. But as we went to press, we heard he’d developed side effects and was stopping this treatment.

These ups and downs are not always a problem. Targeted therapies and immunotherapies are now being developed so fast that as older drugs stop working, there’s a good chance something new is coming down the pipeline. This beats the usual course during the chemotherapy era, which I remember from my dad’s fight with lung cancer in the late 1990s—lots of downs and not very many ups.

The ups and downs affect not just those living with cancer but also their loved ones. As Lindsay Norris, an oncology nurse living with colon cancer, writes, “normalizing the abnormal” can be one of the most useful steps, especially for kids. For many people, normalizing means maintaining a career. Breast cancer survivor Lisa Vento Nielsen shares tips for going back to work during or after treatment.

Of course, it’s better to prevent cancer in the first place, if possible. As Roger Pebody explains on here, some cancers—like the oral cancer he beat a year ago—are caused by viruses and can be prevented with vaccines. The HPV vaccine, newly approved for people up to age 45, can prevent cervical, anal and oral cancers. The hepatitis B vaccine is one of the surest ways to prevent liver cancer. There’s no vaccine yet for hepatitis C, but treatment with new antivirals cuts liver cancer risk. Researchers are hard at work to find new ways to tip the scales in favor of more ups than downs.