What kind of chemotherapy could the Princess of Wales be having?
After a cancer is diagnosed, several treatment pathways follow, including several types of chemotherapy.
“Curative chemotherapy is used on its own without any other interventions, while adjuvant chemotherapy is the type used to reduce the risk of a cancer coming back after treatment,” says Dr Frankie Jackson-Spence, a clinical research fellow of medical oncology at Barts Cancer Institute.
“Neoadjuvant chemotherapy is a term used to describe chemotherapy that is used before another intervention like surgery or radiotherapy to improve the success rate of the later interventions.”
Only after they have been diagnosed with a potentially curative cancer would a patient be given chemotherapy. This would happen either before surgery to improve the effectiveness of it, or after surgery to prevent the cancer returning. This treatment would be used in multiple cancer types, including colorectal cancers and bladder cancers.
Kate, the Princess of Wales, is undergoing chemotherapy. The video announcement came after weeks of speculation spread on social media about her whereabouts and health since she was hospitalized in January for unspecified abdominal surgery. Photo / Kensington Palace
What happens when you have chemotherapy?
If you have a diagnosis of cancer on a biopsy and you have cancer cells that are going to develop, chemotherapy can help improve your outcome. It’s a treatment given through the vein, like an infusion, and works by killing some cancer cells so it can shrink the mass. That, in turn, makes surgery easier.
Sometimes when you have cancer, cancer cells spread from the mass and linger in your blood. They’re often small and hard to detect so won’t be visible on a scan.
“Tests and scans currently available are unable to detect such microscopic spread, and therefore, to improve chances of cure, presumptive treatment of such likely spread is often undertaken – even after the cancer in the solid organ of origin is completely removed,” says Dr Mangesh Thorat, consultant breast surgeon at Homerton University Hospital in London.
Chemotherapy goes all around your body and mops up any escaped cancer cells. That reduces the risk of the cancer coming back after the surgery. There are different types of chemotherapy that work in different ways, but the most common type interferes with the cancer’s DNA so the cancer cells can’t grow.
What are the side effects?
The general side effects of chemotherapy can include fatigue, nausea, vomiting, sepsis, anaemia, constipation and diarrhoea, according to Dr Shivan Sivakumar, associate professor in oncology at the University of Birmingham. He adds: “The recovery time is usually a couple of weeks. How you tolerate chemotherapy is determined by your performance status (known as your baseline health status). The younger you are, the more likely you are to tolerate chemotherapy well.”
How long will you need to have treatment?
How much and how long you’ll need chemotherapy for depends on the type of chemotherapy, the type of cancer and the patient.
“Sometimes we might plan to do three cycles with a patient but actually, if they have quite bad side effects after two rounds, medical professionals might stop it,” says Dr Jackson-Spence. “It changes from patient to patient.”
What can you expect when you go for treatment?
That depends on the stage of the cancer. Dr Jackson-Spence explains that with stage one cancer, medics might treat it with some chemotherapy to prep ahead of surgery to improve the effectiveness.
“In these cases, we use it to boost the chances of success of your main intervention. Then you might expect shorter periods of chemotherapy.” With Stage 4 cancer, medics might do six cycles of chemotherapy if that is the only type of treatment the patient is having, but they might only do three if the patient is having surgery too.
