The Princess of Wales has started preventative chemotherapy after her doctors discovered she had cancer following major abdominal surgery in January. What is preventive chemotherapy and how effective can it be?
What is preventive chemotherapy?
The treatment, also called adjuvant chemotherapy, consists of a course of cancer drugs given to clear out any cancer cells that may remain in the body after primary cancer treatment, which usually involves surgical removal of a tumor.
Why does it do that?
The therapy aims to reduce the risk of the original cancer returning and spreading. This can happen when cancer cells, which are too small to detect with scans and tests in hospital, remain after surgery. The risk of the cancer returning is usually lower if the cancer is detected at a very early stage, before it has had a chance to spread, but higher if the disease is detected at a later stage or has spread to nearby lymph nodes.
How does the therapy work?
Most cancer chemotherapy drugs target rapidly dividing cells. A typical preventive course of chemotherapy lasts three to six months, depending on the type and stage of the cancer, which is determined by examining the cancer removed during surgery. Occasionally, courses of adjuvant chemotherapy are given over several years.
How many therapy courses do people have?
It depends on the nature of the original tumor picked up after surgery. When cancer is discovered during surgery for other conditions, the tumor is often in its early stages and subsequent chemotherapy is more effective. “This probably means that a single course of chemotherapy will be enough to ensure that any cancer cells are destroyed,” said Prof. Lawrence Young, director of the University of Warwick’s Warwick Cancer Research Centre.
How effective is the therapy?
It is especially effective in breast, colon and lung cancer, but can also be recommended for other forms of the disease. For example, adjuvant chemotherapy is often used after surgery for epithelial ovarian cancer, the most common form of ovarian cancer, because of the risk of the disease returning. Doctors decide whether adjuvant therapy is likely to provide benefit based on the type of cancer, how advanced the disease is, and other characteristics of the tumor.
Are there any side effects?
No chemotherapy is completely harmless. Side effects depend on the specific medications administered, but patients may experience fatigue, nausea, vomiting, diarrhea, an increased risk of contracting infections, and loss of appetite. The side effects arise because the drugs affect not only cancer cells, but all rapidly dividing cells, including hair, bone marrow, skin and the lining of the digestive system. However, the damage to healthy tissues is usually temporary and side effects usually disappear once treatment is over.
Younger people often tolerate chemotherapy better than older patients and experience fewer side effects because of their “greater functional reserves” and the “ability of young tissues to heal more quickly,” says Dr. Mangesh Thorat, honorary reader at Queen Mary University of London. and Consultant Breast Surgeon at Homerton University Hospital. This allows younger people to receive higher doses of the drugs, which are more likely to destroy the cancer cells that remain in their bodies.
How long does it take to recover?
It depends on the patient and the specific medications given, but it can take several months for someone to regain full strength. Because younger people are generally healthier and fitter than older people, their recovery time is usually shorter.