This study describes a connection between late effects, engagement in major life activities, and self-management strategies in young adult childhood cancer survivors. A mailed survey focused on late effects of pain, fatigue, depression, cognition, memory, and body image distortion and their impact on work, education, independent living, and community and social engagement. Additionally, survivors identified self-management strategies that minimize their late effects. Eighty-eight percent of the 42 responders struggled with at least one of the six late effects. Work and educational pursuits were affected, with memory and fatigue the most intrusive to daily activities. Self-management strategies of sleep/rest, fitness, quiet leisure, and support of family/friends were the most common. Reaching out to long-term follow-up cancer clinics, health professionals, survivors, or community resources were the least employed management strategies. Occupational therapists can look to community models for educating survivors about self-management, and take this opportunity to define new collaborative partnerships with long-term follow-up cancer clinics and community agencies to assist young adult survivors transitioning to adult roles.