July 13, 2024

“Most patients are cured when early-stage cancers are discovered,” says Yuman Fong, a surgical oncologist at the City of Hope cancer center in Southern California.

Of course, desired outcomes and survival rates depend on a patient’s willingness to follow the treatment recommendations of their doctors—a commitment Princess Kate seems to be exemplifying.

What is preventative chemotherapy?

Cancer is a disease in which a mutation in a cell’s DNA causes it to begin growing rapidly and uncontrollably, interrupting normal functions and putting various bodily systems and organs at risk. These cancer-causing cell mutations can occur sporadically or result from lifestyle or environmental factors such as air pollutants, exposure to too much sunlight, dietary choices, or tobacco use. Research shows that genetics also plays a role in increased risk of certain cancers.

The first thing an oncologist does after cancer has been discovered in a patient is determine the safest and most effective way of killing or removing these rogue cells from the body.

Treatments include surgery, where a cancer mass is removed; radiation in which high-powered electrical or proton beams are focused on cancer cells to kill them; or chemotherapy, in which chemicals insert themselves into the DNA of cancer cells to destroy them.

Chemotherapy induced cell death. Coloured scanning electron micrograph (SEM) of a cultured cancer cell (HeLa) treated with doxorubicin to cause necrosis.

A colored scanning electron micrograph shows a cultured cancer cell after it has been treated with the cancer drug, doxorubicin. Here there are visible signs of impending cell death: a ruptured plasma membrane and visible holes.  

Photograph by STEVE GSCHMEISSNER, SCIENCE PHOTO LIBRARY

Oftentimes, a combination approach is recommended. “The intent of all these treatments is to destroy cancer cells, even when they are microscopic,” says Elena Ratner, a physician and gynecologic oncologist at Yale Cancer Center in Connecticut.

After surgically removing or eradicating the presence of existing cancer cells, follow-up adjuvant treatment can be administered to prevent the cancer from returning, which is what Princess Kate was likely referring to when she said she was receiving “preventative chemotherapy.”

“Adjuvant treatment is given in cancers to help to reduce the risk of recurrence and treat micro-metastatic disease,” says Syma Iqbal, a physician and gastrointestinal oncologist at USC Norris Comprehensive Cancer Center in Los Angeles. After receiving a course of the treatment, she explains, “patients are subsequently monitored with scans to make sure there is not recurrence of the disease.”

What are the consequences of chemotherapy?

Whether a patient is receiving chemotherapy as a way of preventing cancer from returning after a cancer mass has been removed—as seems to be the case with Princess Kate—or as a treatment to target a known presence of the disease, “the same drugs are used,” says William Dahut, an oncologist and the chief scientific officer for the American Cancer Society.

These chemicals are administered orally or intravenously, either through a surgically-installed port or via a new injection site each visit. While the chemicals used are designed to target and destroy rapidly growing cancer cells, “unfortunately, chemotherapy also has an impact on other growing cells in the body, such as hair follicles, lining of the gastrointestinal system, and blood cells,” explains Dahut.


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