A cancer diagnosis can send your entire life into turmoil, as well as that of your loved ones. Although the prognosis for patients is getting better with more research, the treatment can leave your body permanently changed.
Finding out you have cancer at an early age can change your entire life trajectory, impacting work, relationships, and family plans - a reality that Jaymz Goodman was faced with at just 19-years-old.
His plans to join the Royal Air Force and start his life were turned upside down when a check up for his persistent cough resulted in a diagnosis of T-Cell Acute Lymphoblastic Leukaemia.
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Jaymz, from Shropshire, told The Mirror how alongside his chemotherapy and other cancer treatments, he was suddenly having to confront another unexpected decision - whether or not he wanted children one day.
The now 26-year-old said: "When it started, I didn't know [the impact]. There was no conversation about infertility until I almost signed all of the paperwork to go through it.
"Then it was a very last minute thing where they were like, 'ah, there's a chance that you're probably going to end up infertile during this'. They wanted a sperm sample from me just completely out of the blue just before I started treatment.
"There was an expectation I was going to become infertile."
T-Cell Acute Lymphoblastic Leukaemia is an acute and aggressive form of blood cancer that affects your white blood cells and develops quickly. Although it is rare, it is most commonly found in children, teens and young adults.
In 2015, while completing his A-Levels and undergoing tests to join the RAF, a two month long cough sent Jaymz to the doctors. They discovered an almost 15cm diameter tumour on his lungs, prompting immediate treatment.
In such a "life or death" situation, children were the last thing on his mind - preoccupied instead with staying alive.
At the time, Jaymz was approaching the two-year mark in his relationship with his former girlfriend, and the pair had never discussed the future in terms of wanting children.
The then 19-year-old had vaguely assumed he would follow his parents footsteps with work, a house, and maybe marriage before kids entered the picture in his late 20 to early 30s.
"That was a conversation we never had," he explained. "We were way too young to even consider it but then when handed the forms there was a section on there for on the off chance of my death, do I want to leave my sperm sample available for anyone?
"That's an unbelievably weird consideration at such a young age and in such a young relationship."
Some chemotherapy drugs and radiation treatment can lead to an increased risk of infertility, so before treatment patients will often be asked if they wish to freeze a sperm sample or eggs for future use in IVF.
The ability to do so depends on their age, the type of cancer, and how immediately treatment needs to start. For people with ovaries, freezing eggs is a more complex and invasive treatment so not always possible.
Jaymz shared: "All of a sudden you're thrust into the 'Oh, damn, do I actually want a family? Am I going to be here to have a family?'"
Making such difficult decisions at just 19 forced him to do a "ridiculous" amount of growing up within a short space of time, and by his own admission "pushed [him] away from friends, family and partners."
He mentioned a friend he made during the ordeal, who was not able to save her eggs because she was both too young and her cancer needed immediate treatment - she is now infertile.
"They're focused on keeping you alive," Jaymz said. "It's cure you first, deal with the aftermath later.
"There's still a lot of conversations ongoing around managing care for people past finishing treatments and those after effects versus the immediate issue of keeping you alive. Both are very important in their own ways.
"When I was going through it, there was a lot less discussion about the after effects and about what the considerations would be should you survive because more people do now. Due to more people surviving, there are these implications of long term effects on the person who's been treated."
Trying to stay positive, Jaymz and his friends would joke about the sperm "on ice" and the "hilarious" awkwardness of having to get a sample to freeze. However, the 26-year-old is under no illusions about his time in the Birmingham Children's Hospital.
He shared: "I think the last thing that you're really thinking about in that moment is 'Do I want to have children?' I think it's more like 'What have I not done with my life? What's next and I'm going to still be here in a year'.
"The prospect of having children is definitely something that you think about after the fact."
Almost eight years on from his diagnosis Jaymz is in full remission with his fertility back and has moved to Manchester with his girlfriend.
While kids are still a long way off, he is happy to know that the choice is there regardless and is still glad his younger self made the decision to freeze a sample.
Jaymz advised: "If you have the option to do fertility saving, do it. It's not an option that you should ever take off the table for yourself.
"Be kind to your older self because at some point you're probably going to want to have those conversations even if you don't think about it when you are young. So if you have the option on the table, take it."
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