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What is preventative chemotherapy? Princess Kate’s cancer treatment explained

PRINCESS Kate bravely revealed she is undergoing “preventative chemotherapy” in a video message on Friday night.

She said her diagnosis was a “huge shock” but said she is in the early stages of treatment and vowed she is “getting stronger every day”.

AFP

Kate Middleton revealed she is undergoing ‘preventative chemotherapy’[/caption]

The Princess of Wales said: “In January, I underwent major abdominal surgery in London and at the time, it was thought that my condition was non-cancerous.

“The surgery was successful. However, tests after the operation found cancer had been present. 

“My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment.”

While it is not clear what cancer she is battling, experts have weighed in to reveal what treatment the princess is likely to be having and what the course might look like.

What is preventative chemotherapy?

Chemotherapy is a type of treatment that involves killing cancerous cells using a variety of drugs.

Chemotherapy works well for testicular cancer and Hodgkin lymphoma, according to Cancer Research UK.

Many people with breast or bowel cancer have chemotherapy after surgery to help lower the chances of it returning.

There are more than 100 different chemotherapy drugs, each with various potential side effects.

While preventative chemotherapy is not a term that is used by doctors, experts believe the treatment Kate is referring to may be adjuvant chemotherapy.


Dr Mangesh Thorat, of Homerton University Hospital, said: “The term ‘preventative chemotherapy’ is not used medically, or indeed in scientific communications.

“Without wanting to speculate, the most likely nature of chemotherapy in this scenario is what is commonly referred to in medical language as ‘adjuvant chemotherapy’.  

“Patients may understand it as ‘preventive chemotherapy’ since the purpose of such treatment is to prevent cancer from coming back, a possibility that exists even in very early stages of cancer.”

When do patients need it?

Adjuvant chemotherapy is used to prevent tumours returning, especially after surgery.

Any cancer cells that are left behind after an operation are attacked by the cytoxic drugs.

Professor Phil Dash, of the University of Reading, said: “When surgeons remove a tumour it is possible that a few cancer cells remain behind and that these could cause the tumour to regrow if not treated. 

“Preventative chemotherapy would be given after surgery to remove the tumour.”

What does it do?

Chemotherapy works by attacking cancer cells wherever they occur in the body.

Professor Lawrence Young, of the University of Warwick, said: “The drugs are used to kill off any cancer cells that might be in the body after removal of the primary tumour.  

“Cancer chemotherapy drugs mostly target rapidly growing cells and will destroy any cancer cells that are remaining in the body.”

Professor Dash added: “Newer types of chemotherapy treatment make use of more targeted therapies which can exploit specific weaknesses in cancer cells in order to kill them.

“Targeted therapies can have fewer side effects but won’t work in all patients as only some tumours will have the necessary weakness.”

How long does preventative chemo take? 

Most chemotherapy patients will receive between three and six months of treatment, but it can be less or more depending on their illness.

Professor Bob Phillips, of the University of York, said: “This is hugely variable.

“Traditionally, patients receive between four and six ‘cycles’ or ‘blocks’ of chemo, with each cycle lasting 21 days and consisting of a day or few days of chemo.

“Then they will receive time for the body to recover from it, while the chemo keeps damaging the cancer cell.

“There are also some which are daily, some which are four-weekly, and some which are two-weekly.”

Do people normally have one or multiple courses?

The number of courses of chemo a patient will undergo will largely be decided based on what type of cancer they have and where it was.

Professor Young said: “This also depends on the nature of the original tumour as detected in tissue after the initial surgery.  

“An incidental finding of cancer during surgery for other conditions is often associated with the tumour being at an early stage when subsequent chemotherapy is much more effective.  

“This is likely to mean that a single course of chemotherapy will be sufficient to ensure that if any cancer cells are present, they will be destroyed.”

What side effects does it have?

Chemotherapy can cause a range of unpleasant side effects, although some can be treated or prevented.

Most pass once treatment stops and it is difficult to predict which ones a patient will suffer.

Professor Iain McNeish, of Imperial College London, said: “It varies hugely on what chemotherapy is being given, which, in turn depends on the type of cancer being treated.

“However, fatigue is the commonest side effect of all chemotherapy.

“Hair loss is not universal – some chemotherapy drugs cause inevitable hair loss, others very little. It is sometimes possible to prevent hair loss using a cold cap.

“Nausea is fairly common, although again it depends on which chemotherapy drug is being given. However, modern anti-sickness medications are usually very effective.”

He added: “Most chemotherapy causes at least some damage to the bone marrow, which can cause anaemia — which can exacerbate chemotherapy-induced fatigue.

“It can also cause low white blood cell counts — increasing the risk of infection — and low platelet counts  —which can increase the risk of bleeding.

“Some chemotherapy drugs can cause damage to nerves in the fingers and toes — usually this manifests as pins and needles or tingling sensations, but it can also cause pain or numbness.”

What is the recovery time after chemotherapy?

Most patients will start recovering from the side effects of chemo within a few months.

Dr Shivan Sivakumar, of the University of Birmingham, said: “The recovery time is usually a couple of weeks.”

Dr Phillips added: “Again, very variable to the person and type of chemo but when all treatment is finished, it can be a few months before the person is back to nearly full strength. 

“Side effects can still be causing problems many years down the line if treated as a child though, for example.”

What are some of the side effects of chemotherapy?

Chemotherapy can cause unpleasant side effects, although many can be treated or prevented, and most will pass once your treatment stops.

They include:

  • Tiedness
  • Feeling and being sick
  • Hair loss
  • Infections
  • Anaemia
  • Bruising and bleeding
  • Sore mouth
  • Loss of appetite
  • Skin and nail changes
  • Memory and concentration problems
  • Sleep problems
  • Sex and fertility issues
  • Diarrhoea and constipation
  • Emotional issues

Source: The NHS

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