Catherine, Princess of Wales, has announced she has now completed a course of preventive chemotherapy.

The news comes nine months after the princess first revealed she was being treated for an unspecified form of cancer.

In the new video message released by Kensington Palace, Princess Catherine says she’s focused on doing what she can to stay “cancer-free”. She acknowledges her cancer journey is not over and the “path to recovery and healing is long”.

While we don’t know the details of the princess’s cancer or treatment, it raises some questions about how we declare someone fully clear of the disease. So what does being – and staying – “cancer-free” mean?

What’s the difference between being cancer-free and in remission?

Medically, “cancer-free” means two things. First, it means no cancer cells are able to be detected in a patient’s body using the available testing methods. Second, there is no cancer left in the patient.

These might sound basically the same. But this second aspect of “cancer-free” can be complicated, as it’s essentially impossible to be sure no cancer cells have survived a treatment.

It only takes a few surviving cells for the cancer to grow back. But these cells may not be detectable via testing, and can lie dormant for some time. The possibility of some cells still surviving means it is more accurate to say a patient is “in remission”, rather than “cancer-free”.

Remission means there is no detectable cancer left. Once a patient has been in remission for a certain period of time, they are often considered to be fully “cancer-free”.

Princess Catherine was not necessarily speaking in the strict medical sense. Nonetheless, she is clearly signalling a promising step in her recovery.

What happens during remission?

During remission, patients will usually undergo surveillance testing to make sure their cancer hasn’t returned. Detection tests can vary greatly depending on both the patient and their cancer type.

Many tests involve simply looking at different organs to see if there are cancer cells present, but at varying levels of complexity.

Some cancers can be detected with the naked eye, such as skin cancers. In other cases, technology is needed: colonoscopies for colorectal cancers, X-ray mammograms for breast cancers, or CT scans for lung cancers. There are also molecular tests, which test for the presence of cancer cells using protein or DNA from blood or tissue samples.

For most patients, testing will continue for years at regular intervals. Surveillance testing ensures any returning cancer is caught early, giving patients the best chance of successful treatment.

Remaining in remission for five years can be a huge milestone in a patient’s cancer journey. For most types of cancer, the chances of cancer returning drop significantly after five years of remission. After this point, surveillance testing may be performed less frequently, as the patients might be deemed to be at a lower risk of their cancer returning.

Measuring survival rates

Because it is very difficult to tell when a cancer is “cured”, clinicians may instead refer to a “five-year survival rate”. This measures how likely a cancer patient is to be alive five years after their diagnosis.

For example, data shows the five-year survival rate for bowel cancer among Australian women (of all ages) is around 70%. That means if you had 100 patients with bowel cancer, after five years you would expect 70 to still be alive and 30 to have succumbed to the disease.

These statistics can’t tell us much about individual cases. But comparing five-year survival rates between large groups of patients after different cancer treatments can help clinicians make the often complex decisions about how best to treat their patients.

The likelihood of cancer coming back, or recurring, is influenced by many factors which can vary over time. For instance, approximately 30% of people with lung cancer develop a recurrent disease, even after treatment. On the other hand, breast cancer recurrence within two years of the initial diagnosis is approximately 15%. Within five years it drops to 10%. After ten, it falls below 2%.

These are generalisations though – recurrence rates can vary greatly depending on things such as what kind of cancer the patient has, how advanced it is, and whether it has spread.

Staying cancer-free

Princess Catherine says her focus now is to “stay cancer-free”. What might this involve?

How a cancer develops and whether it recurs can be influenced by things we can’t control, such as age, ethnicity, gender, genetics and hormones.

However, there are sometimes environmental factors we can control. That includes things like exposure to UV radiation from the sun, or inhaling carcinogens like tobacco.

Lifestyle factors also play a role. Poor diet and nutrition, a lack of exercise and excessive alcohol consumption can all contribute to cancer development.

Research estimates more than half of all cancers could potentially be prevented through regular screening and maintaining a healthy lifestyle (not to mention preventing other chronic conditions such as heart disease and diabetes).

Recommendations to reduce cancer risk are the same for everyone, not just those who’ve had treatment like Princess Catherine. They include not smoking, eating a nutritious and balanced diet, exercising regularly, cutting down on alcohol and staying sun smart.

Amali Cooray, PhD Candidate in Genetic Engineering and Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research) ; John (Eddie) La Marca, Senior Research Officer, Blood Cells and Blood Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research) , and Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, WEHI (Walter and Eliza Hall Institute of Medical Research)

This article is republished from The Conversation under a Creative Commons license. Read the original article.

If you buy your olive oil in bulk, you’ve likely been in for a shock in recent weeks. Major supermarkets have been selling olive oil for up to A$65 for a four-litre tin, and up to $26 for a 750 millilitre bottle.

We’ve been hearing about the health benefits of olive oil for years. And many of us are adding it to salads, or baking and frying with it.

But during a cost-of-living crisis, these high prices can put olive oil out of reach.

Let’s take a look at why olive oil is in demand, why it’s so expensive right now, and what to do until prices come down.

Remind me, why is olive oil so good for you?

Including olive oil in your diet can reduce your risk of developing type 2 diabetes and improve heart health through more favourable blood pressure, inflammation and cholesterol levels.

This is largely because olive oil is high in monounsaturated fatty acids and polyphenols (antioxidants).

Some researchers have suggested you can get these benefits from consuming up to 20 grams a day. That’s equivalent to about five teaspoons of olive oil.

Why is olive oil so expensive right now?

A European heatwave and drought have limited Spanish and Italian producers’ ability to supply olive oil to international markets, including Australia.

This has been coupled with an unusually cold and short growing season for Australian olive oil suppliers.

The lower-than-usual production and supply of olive oil, together with heightened demand from shoppers, means prices have gone up.

How can I make my olive oil go further?

Many households buy olive oil in large quantities because it is cheaper per litre. So, if you have some still in stock, you can make it go further by:

• storing it correctly – make sure the lid is on tightly and it’s kept in a cool, dark place, such as a pantry or cabinet. If stored this way, olive oil can typically last 12–18 months
• using a spray – sprays distribute oil more evenly than pourers, using less olive oil overall. You could buy a spray bottle to fill from a large tin, as needed
• straining or freezing it – if you have leftover olive oil after frying, strain it and reuse it for other fried dishes. You could also freeze this used oil in an airtight container, then thaw and fry with it later, without affecting the oil’s taste and other characteristics. But for dressings, only use fresh oil.

I’ve run out of olive oil. What else can I use?

Here are some healthy and cheaper alternatives to olive oil:

• canola oil is a good alternative for frying. It’s relatively low in saturated fat so is generally considered healthy. Like olive oil, it is high in healthy monounsaturated fats. Cost? Up to $6 for a 750mL bottle (home brand is about half the price)
• sunflower oil is a great alternative to use on salads or for frying. It has a mild flavour that does not overwhelm other ingredients. Some studies suggest using sunflower oil may help reduce your risk of heart disease by lowering LDL (bad) cholesterol and raising HDL (good) cholesterol. Cost? Up to $6.50 for a 750mL bottle (again, home brand is about half the price)
• sesame oil has a nutty flavour. It’s good for Asian dressings, and frying. Light sesame oil is typically used as a neutral cooking oil, while the toasted type is used to flavour sauces. Sesame oil is high in antioxidants and has some anti-inflammatory properties. Sesame oil is generally sold in smaller bottles than canola or sunflower oil. Cost? Up to $5 for a 150mL bottle.

How can I use less oil, generally?

Using less oil in your cooking could keep your meals healthy. Here are some alternatives and cooking techniques:

• use alternatives for baking – unless you are making an olive oil cake, if your recipe calls for a large quantity of oil, try using an alternative such as apple sauce, Greek yoghurt or mashed banana
• use non-stick cookware – using high-quality, non-stick pots and pans reduces the need for oil when cooking, or means you don’t need oil at all
• steam instead – steam vegetables, fish and poultry to retain nutrients and moisture without adding oil
• bake or roast – potatoes, vegetables or chicken can be baked or roasted rather than fried. You can still achieve crispy textures without needing excessive oil
• grill – the natural fats in meat and vegetables can help keep ingredients moist, without using oil
• use stock – instead of sautéing vegetables in oil, try using vegetable broth or stock to add flavour
• try vinegar or citrus – use vinegar or citrus juice (such as lemon or lime) to add flavour to salads, marinades and sauces without relying on oil
• use natural moisture – use the natural moisture in ingredients such as tomatoes, onions and mushrooms to cook dishes without adding extra oil. They release moisture as they cook, helping to prevent sticking.

Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.