What is the ‘preventive’ chemotherapy Princess Kate is receiving?

In a video released Friday, Catherine Middleton, the Princess of Wales, revealed that she has cancer and is undergoing chemotherapy.

While Catherine did not reveal the type of cancer involved, the announcement brings much-needed clarity after weeks of speculation about her condition. But her statement left many wondering: what is the “preventive chemotherapy” she mentioned, and why might a team of doctors employ it?

Dr. Walter Curran Jr., chief of Piedmont Oncology Institute said the term “preventive chemotherapy” is rarely used in the medical community.

He told The Atlanta Journal-Constitution Friday that he believes the term is being used to suggest “there’s no visible evidence of cancer and the goal of chemotherapy is to prevent it from returning and that whatever cancer was there was removed, at least to the greatest degree possible by the surgeon.”

Curran said lots of chemotherapy administered today is delivered “in that spirit.”

For example, if a woman has had breast cancer surgery and there is no evidence of any more cancer in the breast, it’s common for the woman to receive chemotherapy treatment that could be considered preventive.

“In this use of the term, it would be when the cancer has been visibly removed,” he said. “So for a cancer to be visibly removed that’s obviously a better sign that it can be removed and let’s hope that’s truly the case.”

Preventive chemotherapy could last anywhere from four to 12 months, he said.

Middleton, 42, was hospitalized in January for an unspecified abdominal surgery and has not had any formal public appearances since Christmas.

Catherine said Friday it had taken her time to recover from the major surgery before starting the chemotherapy treatment, which she said was in the early stages.

Curran said for a woman of Middleton’s age, he suspects a tumor of gynecological or gastrointestinal origin, which could include everything from ovarian cancer as well as colon, and stomach cancer.

Dr. Sarah Dilley, assistant professor for the Division of Gynecologic Oncology at the Emory Winship Cancer Institute agreed with Curran’s assessment, but noted there’s no way to be sure.

“Preventative chemotherapy is also called adjuvant chemotherapy. I have no idea what Kate has, but we do it in ovarian cancer and uterine cancer, for example. We will sometimes give chemotherapy to prevent it from coming back. So when Kate said ‘preventative,’ that’s what came to mind for me.”

There are many varieties of chemotherapy, and the type administered and the extent of the chemotherapy is based on the type of cancer and the stage, Dilley said.

Brittnay Starks, communications director of Debbie’s Dream, a nationwide support group network for stomach cancer patients, said it’s not uncommon for those who have stomach cancer to undergo chemotherapy “just in case any cancer is still prevalent even after surgery.”

Stomach cancer is one of the deadliest cancers, and the least researched, Starks said. According to the National Institutes of Health, the five-year survival rate for stomach cancer is 36%.

Just as the British Royal Family has asked for privacy, Starks said families she has worked with have reacted the same way. It happened in her own family as well.

Starks said her late godmother “kept it from her immediate family, and even from me. The statistics are very grim – many patients are paralyzed by the fear that they will die. It’s very common that people will not speak openly about it.”

Inpatients and outpatients can interact in designated areas at the hospital during rehabilitation, thanks to the thoughtful design of the facility, like the Integrative Oncology and Survival rehab area.
Miguel Martinez /miguel.martinezjimenez@ajc.com

Credit: Miguel Martinez

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Credit: Miguel Martinez

Stomach cancer screening isn’t recommended by medical organizations in the U.S. because the cancer is not common in the U.S., the American Cancer Society says on its website. But due to this lack of routine screening, most cancers are caught late or when symptoms like nausea, weight loss, abdominal pain, swelling, and heartburn lead people to see their doctors for an endoscopy.

Catherine’s announcement comes a month after King Charles III said he was being treated for an unspecified type of cancer that was discovered while undergoing a procedure for a benign enlarged prostate.

“I think all of us are deeply saddened by the risks to this young woman with young children with the life ahead of her, said Curran. “The encouraging news is that we have made progress against almost every type of cancer and if she truly had a complete surgical removal, her outlook is much better than it would be for people for whom it was not possible. She is young and appears healthy and is far more likely to handle therapy and therefore benefit from it.”

The Associated Press contributed to this article.