2024-03-25 16:39:00
Catherine Middleton, known as Kate Middleton, Princess of Wales and wife of Prince William, heir to the United Kingdom, put an end to speculation regarding her health last week by announcing that she was suffering from cancer. In a two-minute video to thank her followers on social media for their messages of support, the princess explained that “the analyzes carried out after the operation [de chirurgie abdominale] revealed the presence of cancer. »
“My medical advisors recommended that I begin preventative chemotherapy, the first stages of which have begun. », she adds. No further details have been released regarding the ongoing treatment.
What does “preventive chemotherapy” mean? In what context can this type of support be effective? Here’s what we can say about it.
It is not a cure for cancer
It is now scientifically well established that adopting a certain lifestyle helps limit the risk of developing cancer. Playing sports, adopting a healthy diet, protecting yourself from the sun… all these actions have shown their benefits.
In very specific cases, the administration of certain medications may also be considered. This is for example the case of tamoxifen, which blocks the estrogen receptors that certain cancer cells have. This molecule can be administered to patients whose risk of breast cancer is very high.
The work is also evaluating the benefit of aspirin for people at high risk of developing colon cancer or certain other cancers.
However, in this case, it is not this type of therapy.
How can chemotherapy be preventative?
In the context of the management of declared cancer, preventive chemotherapy refers to the administration of anticancer drugs after suppression of cancer cells. The goal is to prevent the disease from reestablishing itself.
You should know that when a cancer is localized, in other words limited to a given region of the body, and the imaging (scanner) has not revealed any spread to other sites, it is possible to come to cure the disease with treatments such as surgery or radiotherapy.
On the other hand, if the disease was detected after it had spread to other parts of the body, clinicians opt for treatments that will circulate throughout the body. This is the case for chemotherapies (anti-cancer drugs), hormonal treatments, or immunotherapies.
Chemotherapies can also be used via another approach, which involves giving them before or after surgery or radiation therapy. The idea is then to prevent the initial cancer from returning. Indeed, if surgery can eliminate all of the cancer cells, it can also happen in certain cases that cells may have passed into the bloodstream and thus settled in other places in the body.
Administering chemotherapy before or after surgery or radiotherapy kills these cells and limits the risk of the cancer returning.
The effectiveness of this approach has been proven through clinical trials. The relapse rate and survival of patients who underwent surgery only were compared to those of patients who underwent surgery then chemotherapy (when chemotherapy is administered after surgery, it is called adjuvant chemotherapy). The results showed that in the second case the patients were less prone to relapses and survived longer.
How effective is preventive chemotherapy?
The effectiveness of this approach depends on the type of cancer and the type of chemotherapy given.
In the case of colon cancer, considered at high risk of recurrence after surgery (due either to its extent or to this spread to the lymph nodes), the first chemotherapy tested increased the 5-year survival rate by 15%. . In the case of more intensive chemotherapy administration, the chances of survival at six years approach 80%.
This type of chemotherapy is generally administered for three to six months.
How does chemotherapy work?
Many drugs used in chemotherapy stop cancer cells from dividing by attacking their DNA (the genetic material located in their nucleus). To improve their effectiveness, drugs targeting different cell sites can be combined.
Chemotherapy is not selective, in other words it does not only attack cancer cells: it kills all dividing cells.
However, in cancer, abnormal tissue contains a higher proportion of dividing cells than the rest of the body. This means that with each cycle of chemotherapy a greater proportion of cancer cells are eliminated (compared to the collateral damage suffered by healthy cells).
Normal tissues can also “recover” between two cycles.
What are the side effects of chemotherapy?
The side effects of chemotherapy are generally reversible, and are felt in the parts of the body where cells renew themselves the most.
Chemotherapy, for example, disrupts the production of blood cells. However, when the quantity of white blood cells is low, the risk of infection increases. The death of the cells that make up the wall of the intestine results in mouth ulcers, nausea, vomiting and intestinal disorders. Some medications sometimes given during chemotherapy can also affect other organs, for example causing numbness in the hands and feet.
Chemotherapy also causes generalized symptoms, such as fatigue.
Because preventive chemotherapy is administered after all traces of cancer have been removed through local surgery, patients can usually return to activities within a few weeks after the last treatment cycle ends.
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