What is preventative chemotherapy? Experts explain treatment and when it’s used

Published

1 month ago

March 23, 2024

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As the Princess of Wales reveals cancer was found during her abdominal surgery in January, experts explain what preventative chemotherapy is, how it works and when it’s used.

What is preventative chemotherapy?

The Princess of Wales says that at the time of her surgery, it was thought her condition was non-cancerous.

But tests following the surgery revealed that cancer was present.

Also known as adjuvant therapy, preventative chemotherapy is often used after surgery to reduce the chance of cancer coming back and spreading.

Lawrence Young, professor of molecular oncology at the University of Warwick, explains: “Even after successful removal of all visible cancer by surgery, microscopic cancer cells can remain lurking in the body and can’t be detected by current tests.”

When is preventative chemotherapy used?

Leading cancer specialist and consultant oncologist Dr Karol Sikora says it can be used when “risk of recurrence is high”.

He told Sky News: “The way treatment is delivered is so much nicer now and it is really done very professionally and she will be getting the best care possible.”

He explains that doctors are able to predict the “right treatment for the right patient”.

“Although it is unpleasant, chemotherapy is of great benefit”.

Thomas Moore, Sky’s science correspondent, explains the usual procedure following many surgeries.

“They do tests on the cells and that’s when they would have discovered that it was cancerous,” he says.

“When they are talking about preventative chemotherapy, that is in case there are any other cells that were left behind after the surgery, to make sure those are not the seeds of a cancer that grows back.”

The NHS describes adjuvant chemotherapy as chemotherapy used to “reduce the risk of the cancer coming back after radiotherapy or surgery”.

Sometimes cancer can ‘escape the organ of origin’

Dr Mangesh Thorat, Honorary Reader, Queen Mary University of London and Consultant Breast Surgeon, Homerton University Hospital, says tests and scans can’t detect microscopic cancers, so preventative treatments are used when cancer is known to be present.

On discovering cancer was present following her surgery, the decision will have been taken to give the princess chemo to make sure any lingering cancerous cells are killed.

“Surgery is the most curative form of treatment for early-stage cancers of solid organs.

“However, occasionally some cancer cells escape the organ of their origin and start residing in other organs such as lung or liver.

“Tests and scans currently available are unable to detect such microscopic spread and therefore to improve chances of cure, presumptive treatment of such likely spread is often undertaken even after the cancer in the solid organ of origin is completely removed.

“Depending on the type of cancer, a range of drugs that can reach all organs of body where such spread might have occurred are used.

“Chemotherapy is one such type of treatment that uses drugs which particularly act on rapidly dividing cells, for example, cancer cells, and kills such cells.”

Does it work better on certain groups?

Andrew Beggs, MRC Senior Clinical Fellow and Consultant Colorectal Surgeon, University of Birmingham, describes preventative chemo as “a bit like mopping a floor with bleach when you’ve spilt something on it, chemotherapy kills any spilt cells”.

“Age has no effect on the success rate of chemotherapy except when the cancers are ‘immune hot’ which are commoner in young people – in this case a type of chemotherapy called immunotherapy could be given.”

He says that younger people can “tolerate higher doses of chemotherapy” better, so can be given stronger treatment plans that are “more likely to kill any leftover cells”.

He says chemotherapy “is generally given for between three to 12 months, depending on what type of cancer it is”.

How long does preventative chemotherapy last?

It depends on the type and stage of cancer, but the princess has not revealed these details.

Professor Lawrence says: “The sort of chemotherapy and the time length of treatment depends on the type and stage of cancer as confirmed by examining the cancer removed at surgery.”

Prof Lawrence explains that the side effects of chemotherapy “also depend on the type of drugs used but commonly include tiredness, nausea, increased risk of getting an infection and loss of appetite”.

While we don’t know what stage the princess’s cancer is, Prof Lawrence says “an incidental finding of cancer during surgery for other conditions is often associated with the tumour being detected at an early stage when subsequent chemotherapy is much more effective”.

How is preventative chemotherapy usually administered?

Pat Price, chair of Radiotherapy UK and leading cancer doctor, said the surgery itself will have removed the cancer.

“Sometimes in some tumours there’s a little bit of a concern about whether there’s anything that’s been left behind or whether there’s a risk of it coming back,” she told Sky News.

Doctors will then often use preventative chemotherapy, usually in the form of tablets or injections, she says.

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This will often be given for a period of either four or six months and then it is finished, at which point things would “hopefully” be ok.

She explained that chemotherapy hits all of a person’s cells – both the cancer cells and normal tissue.

This can then cause issues with bone marrow and the gut, causing symptoms such as feeling sick or low blood count.

Some people tolerate it well, she says.

The Princess of Wales said she is “well and getting stronger every day”, paying tribute to her husband as a “great source of comfort and reassurance too”.

She called for “time, space and privacy” as she completes her treatment.

UK

Hainault sword attack: Man charged with murder after boy, 14, killed and four injured

Published

8 hours ago

May 1, 2024

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Hainault sword attack: Man charged with murder after boy, 14, killed and four injured

A man has been charged with murder after 14-year-old Daniel Anjorin was killed and four people were injured near a London Tube station.

Two Metropolitan Police officers were among those hurt as they responded to reports of an attacker with a sword in Hainault, northeast London, on Tuesday.

The man charged has been named as Marcus Aurelio Arduini Monzo, a 36-year-old dual Spanish-Brazilian national from Newham, east London.

He has also been charged with two counts of attempted murder, two counts of grievous bodily harm, aggravated burglary and possession of a bladed article.

Monzo will appear at Barkingside Magistrates’ Court on Thursday.

The families of all those affected by the incident have been informed.

Daniel Anjorin was a pupil at Bancroft’s private school in Woodford Green – also attended by Nottingham attack victim Grace O’Malley-Kumar.

Staff and pupils at the school said they were in “profound shock and sorrow” at his death.

Daniel’s family told Sky News he was “a wonderful child” who was “well loved” and “hard working” – and that his death “leaves a gaping wound in the family”.

“No family should have to go through what we are experiencing today,” they said. “Any family will understand it’s an absolute tragedy.”

Monzo is accused of crashing a van into a fence just before 7am, and attacking two members of the public with a sword.

It is alleged he then killed the 14-year-old and seriously injured two police officers as they tried to stop him – one of whom nearly lost her hand.

The suspect was initially taken to hospital after suffering injuries in the van crash.

Jaswant Narwal, chief crown prosecutor for CPS London North, said: “Our thoughts remain firmly with the family of Daniel and all those who have been impacted by this horrific incident.”

“We remind all concerned that criminal proceedings against the defendant are active and that they have a right to a fair trial,” she continued.

“It is extremely important that there should be no reporting, commentary or sharing of information online which could in any way prejudice these proceedings.”

UK

UK weather: Met Office issues thunderstorm warnings for southern England and South Wales

Published

8 hours ago

May 1, 2024

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UK weather: Met Office issues thunderstorm warnings for southern England and South Wales

The Met Office has issued warnings for rain and thunderstorms – with the alerts in place until Thursday morning.

The first warning began at 8pm and covers an area stretching from Portsmouth to Plymouth, and northwards to South Wales, and lasts until 8am.

Heavy rain is expected, with a chance of thunderstorms, and the Met Office said it could bring difficult driving conditions and some flooding.

The second warning kicks in at 11pm and covers nearly all of southeast England, stretching as far north as Oxford and including London. It’s in force until 6am on Thursday.

“Thunderstorms are likely at times later this evening and overnight, leading to travel disruption and some flooding,” said the Met Office.

There will be a risk of sudden flooding and power blackouts in both affected warning areas, added the forecaster.

There’s also a chance of hail and strong winds.

Flooding and lightning strikes could cause disruption on the roads, as well as delays and cancellations to rail and bus services.

Get the latest Sky News forecast for your area

Around 2cm to 4cm of rain is expected overnight, with 5cm possible in some places.

“Much of this rain may fall over a two or three-hour period,” the Met Office said.

Met Office meteorologist Alex Deakin said: “You may well get woken up tonight by a rumble of thunder, or some flashes of lightning across parts of the South.

“A lot of heavy rain falling in a short space of time as well.”

He said it could create a lot of spray and surface water on the roads for commuters on Thursday morning.

Read more from Sky News:
Boy arrested for attempted murder
Radcliffe comments on JK Rowling fallout

Elsewhere, it will stay dry with temperatures mostly holding up in double figures across England and Wales, or staying at around 8C to 9C in towns and cities further north.

Deakin said: “A cloudy start then to Thursday one way or another, still some heavy bursts of rain early on across the South West.

“That should tend to clear away, but always the likelihood of further showers across southern parts of England, Mid and South Wales.”

He added: “Parts of northwest Scotland, Northern Ireland, northwest England, much of the Midlands down towards East Anglia should have a fine and sunny day tomorrow.”

UK

Scottish government survives vote of no confidence at Holyrood

Published

8 hours ago

May 1, 2024

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Scottish government survives vote of no confidence at Holyrood

The Scottish government has survived a vote of no confidence at Holyrood.

Scottish Labour pressed ahead with its motion despite Humza Yousaf announcing earlier this week his intention to stand down as SNP leader and first minister.

It failed by 58 votes to 70.

The Scottish Greens voted against the motion, with party co-leader Patrick Harvie branding it “chaos for the sake of chaos”.

If it had passed, all ministers in the minority SNP government would have been forced to quit.

Opening the debate, Scottish Labour leader Anas Sarwar thanked Mr Yousaf for his service and wished him well, but said Scotland was “crying out for change” from the UK Conservative government and the SNP Scottish government.

He said the country needed “credible and effective leadership” to deal with “twin crises” in the economy and NHS.

Mr Sarwar added: “I have no confidence in the SNP’s ability to deliver that and that is why I am bringing this motion to parliament today.”

The outgoing first minister defended his government’s record, adding that in the 13 months he has spent in charge he had not “heard a single positive idea” from Scottish Labour.

Mr Yousaf added: “What I have heard is the deafening sound of principle after principle being thrown out of Anas Sarwar’s window.

“U-turning on the two-child cap, U-turning on the devolution of employment law, U-turning on the devolution of drug law, U-turning on his support for Waspi women.”

Mr Yousaf said pro-UK parties, in their “cosy Westminster alliance”, would be “terrified” of a vote of no confidence.

He added: “As I have found out only too well in the last few days, politics is definitely about the choices we choose to make.

“As a government, I am exceptionally proud of our choices.”

The debate and vote has come following the breakdown of the Bute House Agreement.

Within hours of the powersharing deal with the Scottish Greens coming to an end last week, Scottish Tory leader Douglas Ross announced he would be bringing a motion of no confidence in the first minister.

Angry over the way the party was dumped from government, the Scottish Greens announced its MSPs would be backing the motion.

Scottish Labour then announced it was planning a motion of no confidence in the Scottish government.

Mr Yousaf reached out to his political opponents in an effort to stem the uprising but conceded that he had “underestimated the level of hurt and upset” his actions had caused Scottish Green colleagues.

Speaking to Sky News earlier on Wednesday, Mr Yousaf said: “I will certainly be regretting the way it ended.”

The Scottish Tories dropped their motion following Mr Yousaf’s resignation, but Scottish Labour pressed on as the party believes the decision on the next first minister should be put to the public.

Mr Yousaf intends to remain in post until his successor is announced.

Former deputy first minister John Swinney and ex-finance secretary Kate Forbes have emerged as potential frontrunners to throw their hat into the ring.

Mr Sarwar pointed to reports that Ms Forbes could struggle to appoint ministers and described Mr Swinney as “the finance secretary that broke the public finances and the worst education secretary in the history of the Scottish parliament”.

Mr Ross, whose party threw its support behind the Scottish Labour motion, was forced to apologise to Mr Swinney after referring to him as “not so honest John” in the Holyrood chamber.

Mr Ross was first reprimanded for referring to Mr Swinney as “honest John”, but when presiding officer Alison Johnstone reminded him not to use nicknames, he said: “Oh sorry, I thought it was on accuracy because it would be not so honest John with some of the things we’ve heard recently.”

Apologising, Mr Ross said: “I will apologise. I’m very sorry for any hurt caused.”

The Scottish Tory leader added: “Whether we have a bitter battle or a cosy coronation to elect the next leader of the SNP, they will continue campaigning for independence and the Scottish people will continue to be failed by them.”