Kate Middleton, Princess of Wales, released a video update on Friday, 22 March 2024, revealing her cancer diagnosis, sending shockwaves across the world. The video comes in the wake of several speculations about the 42-year-old’s health following her abdominal surgery in January 2024. Kate disclosed that specific tests done after her surgery showed the presence of cancer, mentioning that she is undergoing preventative chemotherapy.
However, the type of cancer against which she is being treated has not been disclosed.
“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 post-surgery found that 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,” she said in the video.
What is preventative chemotherapy?
The term ‘preventative chemotherapy’ has been grabbing eyeballs post Kate’s revelation, with many trying to decipher what the treatment involves.
According to Dr Radheshyam Naik, consultant medical oncologist, hematologist & bone marrow transplant physician with Sammprada Hospital, Bangalore, preventative or preventive chemotherapy is not the correct medical terminology for the treatment. The medical term is adjuvant chemotherapy, used by organizations like National Health Services (NHS), UK.
He says that adjuvant chemotherapy is a treatment that is done after the primary treatment, such as surgery, radiation, and chemotherapy. It is done to lower the chances of relapse and improve primary treatment outcomes.
“While the tumor is removed through primary treatments, some cancer cells may have spread to other body parts. These cells may be too small to be detected through diagnostic tests. Adjuvant chemotherapy is done to destroy these cancer cells and reduce the chances of relapse,” says Dr Naik.
Dr Naik also sheds light on neo-adjuvant chemotherapy, which is done to shrink the tumor before it is surgically removed.
How common is this treatment?
“Adjuvant chemotherapy is a common treatment method. It is especially opted for in advanced stages, where the cancer has spread to the surrounding lymph nodes and other organs,” says Dr Reshma Purella, an oncologist from Hyderabad.
She explains that depending on the grade and stage of cancer, the chances of relapse can be estimated. If the likelihood of recurrence appears higher, adjuvant chemotherapy is advised. If cancer has been diagnosed at a very early stage, such as stage zero, adjuvant therapy may not be necessary.
She adds that the timing of adjuvant chemotherapy varies depending on factors such as the type and stage of cancer and the individual’s health status. Generally, it is administered within a few weeks to a few months after primary treatment.
What is the duration of adjuvant chemotherapy?
Usually, four to six cycles of adjuvant chemotherapy are required. Each cycle is done once in three weeks. The treatment lasts for up to five months.
“The dose and duration are decided based on whether circulating cancer cells are detected in the bloodstream,” says Dr Naik.
Circulating tumor cells (CTC) are tumor cells that have detached from the primary tumor and entered the bloodstream. They provide important clues about cancer progression. A CTC is associated with cancer containment or remission, and an increase in it indicates cancer progression.
“If there are circulating cancer cells in the blood, then it is an indicator that there will be a recurrence. If no circulating cancer cells are in the blood, the treatment dosage is reduced,” says Dr Naik.
Efficacy of the treatment
According to Dr Purella, the efficacy of adjuvant chemotherapy varies depending on factors such as the type and stage of cancer, as well as individual characteristics. However, numerous studies across different types of cancer have shown that adjuvant chemotherapy can significantly improve survival rates and reduce the risk of cancer recurrence.
“The decision to recommend adjuvant chemotherapy is typically based on a careful assessment of the risks and benefits by the treating oncologist, taking into account factors such as the cancer stage, tumor characteristics, and the person’s overall health status,” says Dr Purella.
Dr Naik says that in some, the cancer doesn’t relapse at all after adjuvant chemotherapy, and in some, it has been seen to prolong the survival rate.
“The treatment may not affect some as the microscopic cancer cells can sometimes be resistant to adjuvant chemotherapy,” adds Dr Naik.
Takeaways
- Preventative chemotherapy, medically known as adjuvant chemotherapy, is a secondary cancer treatment following the first line of treatment that includes chemotherapy, radiation, and surgery.
- The treatment is to improve the efficacy of the primary treatment by reducing the chances of a relapse.
- This treatment helps, especially if the cancer has spread to the lymph nodes.
- The treatment may prolong survival and reduce relapse rates.
