What kind of chemotherapy could the Princess of Wales be having?
After a cancer is diagnosed, there are several treatment pathways that 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,” explains 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 you have been diagnosed with a potentially curative cancer would a patient be given chemotherapy. Either before a surgery to improve the effectiveness of it, or after a surgery to prevent the cancer coming back. This treatment would be used in several cancer types, including colorectal and bladder cancers.
There are various types of chemotherapy that work in particular ways, but the most common type interferes with the cancer’s DNA so the cancer cells cannot grow. Photo / Getty Images
What happens when you have chemotherapy?
If you have a diagnosis of cancer on a biopsy and you’ve got cancer cells that are going to develop, then 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.
There are various types of chemotherapy that work in particular ways, but the most common type interferes with the cancer’s DNA so the cancer cells can’t grow.
What is preventive chemotherapy?
Sometimes cancer cells spread from the mass and linger in the blood. They’re often small and hard to detect so aren’t always picked up on a scan. To make sure these cancer cells don’t spread, health professionals will give patients a type of chemotherapy called adjuvant chemotherapy. Because chemotherapy is a cancer drug that’s systemic, it goes all around your body and mops up any cancer cells in the body.
“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.
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 for?
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 Jackson-Spence. “It changes from patient to patient.”
What can you expect when you go for treatment?
That really depends on the stage of the cancer. 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 four cancer, medics might do six cycles of chemotherapy if that is the only type of treatment you’re having, but they might do only three if the patient is having surgery too.
