Princess Catherine, wife of Prince William, reported Tuesday that her cancer was in remission. But what does it mean to be in remission from cancer?
Doctors unexpectedly discovered her cancer last March when she underwent abdominal surgery. He did not reveal the type of cancer he has, nor how advanced it was when it was discovered.
But she said she had chemotherapy, which she said was completed in September. He told British news agency PA Media that he has a port, a small device that is implanted under the skin and connected to a catheter that enters a large vein. It allows medicines such as chemotherapy drugs to be administered directly into the chest veins, avoiding needle sticks.
Catherine told PA Media that the chemotherapy was “really tough”.
“It’s a relief to now be in remission and I remain focused on recovery,” she wrote on Instagram.
His announcement “is certainly good news and it’s reassuring,” said Dr. Kimmie Ng, associate chief of the division of gastrointestinal oncology at the Dana-Farber Cancer Institute in Boston.
But cancer experts like Dr. Ng say what remission means in a patient can vary.
In general, when doctors and patients talk about remission, they mean that there is no evidence of cancer in blood tests or scans.
The problem is that a complete remission does not mean that the cancer is gone. Even when a cancer is “cured” – meaning there is no sign of cancer for five years – it may not be eradicated.
This makes life emotionally difficult for patients, who must undergo frequent visits to oncologists for physical exams, blood tests and imaging.
“It’s really scary,” Dr. Ng said. “The level of uncertainty is very, very difficult,” he added.
But this ongoing surveillance is necessary, despite the toll it takes on patients.
“Different cancers have different propensities to come back or not come back,” said Dr. Elena Ratner, a gynecologic oncologist at the Yale Cancer Center.
About 75 to 80 percent of ovarian cancers, he noted, can recur on average 14 to 16 months after a remission, depending on the stage the cancer has reached at the time of discovery and the biology of the cancer.
“Once the cancer returns, it becomes a chronic disease,” Dr. Ratner said. He tells his patients: “You will live with this cancer. You will have chemotherapy on and off for the rest of your life.
Dr. Ratner’s gynecologic cancer patients must return every three months for CT scans to keep an eye out for any evidence that the cancer has returned.
“Women live from one CT scan to another,” she said. “They say that for two and a half months they live a wonderful life, but then, in time for the next CT scan, the fear returns.”
“It costs them – it costs them a lot,” he said.
“It’s terrible, and yet every day I’m amazed by their strength,” she said of her patients.