Kate Middleton Is Receiving ‘Preventative’ Chemo — What Does That Mean?
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Catherine, Princess of Wales, says she has started “preventative” chemotherapy to treat a cancer that doctors diagnosed after she underwent abdominal surgery in January. Preventive chemo is often considered once tumors start to grow or spread throughout the body.
The cancer wasn’t suspected before the operation, but tests done afterward found that “cancer had been present,” Catherine said in a video statement. “My medical team therefore advised that I should undergo a course of preventative chemotherapy, and I’m now in the early stages of that treatment,” she said in the video.
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The former Kate Middleton, 42, didn’t share what type of cancer she has, how advanced it is, or any details about the specific chemotherapy regimen she’s undergoing. Many doctors who treat cancer but aren’t involved in her care say that preventive chemotherapy, also called adjuvant chemotherapy, is often used to stop tumors from growing or returning.
What Is Preventive Chemotherapy?
“Adjuvant or preventative chemotherapy is typically given after the cancer is surgically removed,” says Andrea Cercek, MD, a codirector of the center for young onset colorectal and gastrointestinal cancers at the Memorial Sloan Kettering Cancer Center in New York City.
“The reason it is given is because the stage of the disease suggests there might be some microscopic cancer still remaining in the body, and the point of the chemotherapy is to get rid of it,” Dr. Cercek says.
Who Gets Preventive Chemotherapy?
Preventive chemotherapy isn’t typically offered for stage 1 cancers, the smallest tumors that only appear in one area of the body, Cercek says. It’s more routinely used once cancers reach stage 2, when they’re growing but haven’t spread, and for more advanced cases or metastatic cancers that have moved to other parts of the body.
Many types of solid tumors, such as breast and colon cancer, may be treated with preventive chemotherapy after surgery, says Aditya Bardia, MD, MPH, a professor and the director of translational research integration at the UCLA Health Jonsson Comprehensive Cancer Center in Los Angeles.
“The goal is to mop up any residual cells and treat micro-metastatic disease to prevent disease recurrence,” Dr. Bardia says.
Abdominal surgery is the initial treatment for several types of solid tumors that might then be addressed with preventive chemotherapy, says Andrea Porpiglia, MD, an associate professor at the Fox Chase Cancer Center in Philadelphia.
“There are too numerous possible cancers to list them all, but several examples include gastrointestinal cancers, gynecologic cancers, and genitourinary cancers,” Dr. Porpiglia says.
A wide variety of medicines in different forms may be used for preventive chemotherapy, but it typically involves up to six months of intravenous (IV) treatments, Bardia says.
What Are the Side Effects of Preventive Chemotherapy?
Side effects can vary, but should be expected, because chemotherapy circulates throughout the body and can impact both healthy and cancerous cells.
“Side effects are dependent on the type of treatment given, but some common side effects include fatigue, nausea, vomiting, anemia, and decrease in appetite,” Porpiglia says. “However, we have excellent medications to combat these side effects and most side effects abate after the treatment stops.”
Patients’ age can play a role in the decision to offer preventive chemotherapy, with the risk of side effects weighed against the potential longevity benefits of stopping the cancer from coming back, doctors say. It’s more common to provide preventive chemotherapy for people who are younger than for elderly patients.
Cancer diagnoses are becoming more common in people who, like Catherine, are under 50, says Kimmie Ng, MD, MPH, an oncologist at the Dana-Farber Cancer Institute in Boston.
“As she is only 42 years old, this is another concerning example of the rising rate of cancer among adults under the age of 50,” Dr. Ng says. “There is an urgent need for research into the causes of this uptick.”
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