Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

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Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.”

“My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video.

No further details have been released about the Princess of Wales’ treatment.

But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment.

It’s not the same as preventing cancer

To prevent cancer developing, lifestyle changes such as diet, exercise and sun protection are recommended.

Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at high risk of breast cancer.

Aspirin can also be used for those at high risk of bowel and other cancers.

How can chemotherapy be used as preventive therapy?

In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning.

If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer.

If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate around the body .

The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer coming back. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later.

With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back.

If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer.

How effective is preventive therapy?

The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy.

Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The first chemotherapy tested improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%.

Preventive chemotherapy is usually given for three to six months.

How does chemotherapy work?

Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations.

Chemotherapy is not selective for cancer cells. It kills any dividing cells.

But cancers consist of a higher proportion of dividing cells than the normal body cells. A greater proportion of the cancer is killed with each course of chemotherapy.

Normal cells can recover between courses, which are usually given three to four weeks apart.

What are the side effects?

The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells.

The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection.

Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance.

Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet.

There are also generalised symptoms such as fatigue.

Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.The Conversation

Ian Olver, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide

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

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  • Walden Farms Caesar Dressing vs. Primal Kitchen Caesar Dressing – Which is Healthier?

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    Our Verdict

    When comparing Walden Farms Caesar Dressing to Primal Kitchen Caesar Dressing, we picked the Primal Kitchen.

    Why?

    As you can see from the front label, the Walden Farms product has 0 net carbs, 0 calories, and 0 fat. In fact, its ingredients list begins:

    Water, white distilled vinegar, erythritol, corn fiber, salt, microcrystalline cellulose, xanthan gum, titanium dioxide (color)

    …before it gets to something interesting (garlic purée), by which point the amount must be miniscule.

    The Primal Kitchen product, meanwhile, has 140 calories per serving and 15g fat (of which, 1.5g is saturated). However! The ingredients list this time begins:

    Avocado oil, water, organic coconut aminos (organic coconut sap, sea salt), organic apple cider vinegar, organic distilled vinegar, mushroom extract, organic gum acacia, organic guar gum

    …before it too gets to garlic, which this time, by the way, is organic roasted garlic.

    In case you’re wondering about the salt content in both, they add up to 190mg for the Walden Farms product, and 240mg for the Primal Kitchen product. We don’t think that the extra 50mg (out of a daily allowance of 2300–5000mg, depending on whom you ask) is worthy of note.

    In short, the Walden Farms product is made of mostly additives of various kinds, whereas the Primal Kitchen product is made of mostly healthful ingredients.

    So, the calories and fat are nothing to fear.

    For this reason, we chose the product with more healthful ingredients—but we acknowledge that if you are specifically trying to keep your calories down, then the Walden Farms product may be a valid choice.

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  • Securely Attached – 

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    A lot of books on attachment theory are quite difficult to read. They’re often either too clinical with too much jargon that can feel like incomprehensible psychobabble, or else too wishy-washy and it starts to sound like a horoscope for psychology enthusiasts.

    This one does it better.

    The author gives us a clear overview and outline of attachment theory, with minimal jargon and/but clearly defined terms, and—which is a boon for anyone struggling to remember which general attachment pattern is which—color-codes everything consistently along the way. This is one reason that we recommend getting a print copy of the book, not the e-book.

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  • The 4 Best Stretches To Do Before Bed (And Even: To Do In Bed!)

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    Contrary to the stereotype of early morning yoga sessions, the evening is actually the best time to improve flexibility.

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    The most comfortable yoga session

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    Frog pose:

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    Half straddle stretch:

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    • Keep your lower back elongated while folding forward.
    • Adjust the stretch’s focus by moving towards the middle or towards the extended leg, to stretch your inner thighs more or your hamstrings more, respectively.
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    Tabletop chest stretch:

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      • Cross arms to stretch the ribs.

    Cross-legged forward fold:

    • Start in a cross-legged seated position and slightly shift your hips backwards.
    • Fold forward, allowing the spine to round.
    • Hold for 1–3 minutes, breathing calmly.

    This latter is especially good despite its simplicity, as it provides a deep stretch in the outer hips and lower back.

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    Harvard-trained gastroenterologist Dr. Saurabh Sethi advises:

    Calming it down

    First of all, what it actually is and how it happens: acid reflux occurs when the lower esophageal sphincter (LES) doesn’t close properly, allowing stomach acid to flow back into the esophagus. Chronic acid reflux is known as gastroesophageal reflux disease (GERD). Symptoms can include heartburn, an acid taste in the mouth, belching, bloating, sore throat, and a persistent cough—but most people do not get all of the symptoms, usually just some.

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    Whether your mind keeps wandering more as you get older, or you’re a young student whose super-active brain is more suited to TikTok than your assigned reading, sustained singular focus can be a challenge for everyone—and yet (alas!) it remains a required skill for so much in life.

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