Hello,

My name is Traci and I am an Oncology Certified Nurse of 10 years. Wow. We just got some very sad news that Kate, Princess of Wales, has cancer and I wanted to debrief it together.

Oncology Certified Nurse of 10+ years, Traci Clark, debrief’s Princess Kate’s cancer diagnosis.

KATE HAS CANCER

She shares in the video that she went in for abdominal surgery in January and they thought it was to remove a growth that was NOT cancer. When they sent the tissue removed during surgery, called ‘surgical pathology,’ unfortunately it came back showing cancer. Pathology usually takes 7-10 days after a biopsy or surgery for results. I want to emphasize that there are many organs in the abdomen that can develop cancer including uterine, ovarian, colon, small bowel, appendiceal, pancreatic and liver/gallbladder and peritoneal. An important note is that not only are each of those organs different; there are multiple KINDS of cancer for each organ. This is such an important lesson that I emphasize for all my patients:

NO two cancers are the same. You can have two people, same age, same cancer diagnosis and stage and have two totally different experiences.

Kate shared that she underwent a major abdominal surgery in January for what they thought was a benign condition. Pathology came back that she has cancer and she has started chemotherapy to prevent the cancer cells from growing new tumors.

WHAT STAGE OF CANCER DOES KATE HAVE?

Kate shares that whatever type of cancer she has, the team recommended “preventative” chemotherapy. “Preventative” is a bit of a misnomer here, but this means that the tumor was removed entirely and if she did a scan (like a CT or MRI) of any kind, there would be no cancer seen, which is also called “No Evidence of Disease” or NED. This is used in lieu of “cured” BUT we usually refer to someone as NED after they have completed the recommended treatments. If someone has not had any sign of cancer for 5 years after they were diagnosed, that is when we use the term “cured.”

However, we know that certain types of cancer are at a high risk to recur (grow back), particularly within the first 5 years. The decision to use chemotherapy is based on national guidelines formed from clinical trials and is very specific for each diagnosis and stage. Chemotherapy is usually started 6-8 weeks after surgery to allow the body to heal from surgery. The goal of her chemotherapy is CURE. The goal is to kill any microscopic cancer cells in the blood or lymph system that have the ability to travel and grow a new tumor in a distant organ.

As she is using the terms “early stage” and “preventative” chemotherapy, this tells me she is stage 1-3. Stage 1-2 usually refers to a local tumor size.

Stage 3 means there is evidence that the cancer has spread to the lymph nodes (like the subway system of the body).

Stage 4 is when we have evidence the cancer has traveled on the body’s subway and grown a tumor in a new location (like liver, bones, brain). Even stage 4 cancer is not considered a “death sentence” and depending on the type of cancer, patients can still live for many years with new treatments that are constantly being developed.

Generally, “Preventative Chemotherapy,” or adjuvant chemotherapy to help prevent a recurrence, would usually be about 6 months (again, depending on the TYPE of cancer cells found in the type of organ, so it is VERY specific).

WHAT COULD HAVE CAUSED KATE’S CANCER?

Now, Kate is YOUNG, 42. Colon cancer is trending younger and younger, so the age for screening colonoscopies just changed to 45 (instead of 50). PLEASE, PLEASE get a colonoscopy if you are 45 or older. It is the “gold standard” for colon cancer screening and can remove cancer and pre-cancerous polyps to be the diagnosis AND treatment for early stage colon cancers! I have seen too many people prematurely say goodbye from a cancer that we have a great screening tool for. Shout out to the SmartLess Podcast (Will Arnett, Jason Bateman, Sean Hayes), who talk about their colonoscopy experiences and how much they enjoyed it! “I can tell you I enjoy the hell out of it… they send you off and you wake up real chatty, too. I felt very fresh” (SmartLess).

How to Reduce your Cancer Risk — Poppie Lady

I find it ‘interesting’ that she had a type of abdominal cancer and King Charles also has cancer that was found while evaluating non-cancerous concern (enlarged prostate in his case). Neither have chosen to share the specific diagnosis. I am noting that they both were exposed to asbestos, which can cause Mesothelioma.

In 2014 “a Spokeswoman added asbestos was removed and an overhaul of the electrics was carried out” BBC NEWS. The living space was last refurbished in 1963.

When I traveled to London, years ago, the Big Ben Parliament building was closed off, due to asbestos renovations. Hundreds of government buildings in London contain asbestos, which is a known environmental factor that causes cancer (Mesothilioma) that can grow in the ovaries and peritoneum (lining of the abdomen). As both Kate and Charles live/work in government buildings, this is a known risk factor for both of them.

Most of the time cancer occurs from a random mistake made when our cells turnover (copy themselves to make new cells). The cells have to make over 6 separate errors and your immune system has to miss those errors for a cell to turn cancerous. The CAUSE of these errors for the vast majority of cancer patients is unknown. There is a small percent (~10%) of patients who carry a gene that makes them more likely to develop cancer (like a defect in the cells that catch mistakes or a gene that makes the cells more likely to make a mistake while copying). Only about 10% of all cancers are caused by genetics.

It’s important to know your risk (family history and environment) factors so that you can be properly screened for cancer. Again, the vast majority of cancer is caused by random chance and I must emphasize that NO one deserves cancer and you cannot “prevent” cancer. I have had vegan, triathlete patients with late stage cancer. Cancer does not discriminate. SO many patients report that (well meaning) people make AWFUL and hurtful comments. If I could make one PSA other than please get up to date on your cancer screenings, please read this article about what to say and do (and more importantly, what NOT to say and do) when someone you know has cancer.

HOW WILL KATE LOOK?

Depending on the type of chemotherapy, Kate may not lose her hair. Colon cancer, for example, is treated is FOLFOX or FOLFIRINOX, which causes hair thinning, not hair loss. If the chemotherapy does cause hair loss, there are Cold Caps which can be used. They pump dry ice through a scalp cooling device to cause the blood vessels in the scalp to constrict and limit the chemotherapy exposure to the scalp, thus reducing hair loss.

During my discussion on ScAmanda: people can actually look really healthy and well during chemotherapy. We have many more medications and tools to prevent and manage side effects from treatment than ever before.

She shares that they are telling their three young kids in ways that are age appropriate, which is absolutely what is recommended. Kids are incredibly intuitive and can imagine the worst, so being frank in age-appropriate ways is best (for whatever the diagnosis). They mainly want to know how it will affect them, so sharing what will be different in their day to day lives is helpful.