Although it is not known what type of cancer Catherine, Britain’s Princess of Wales, has, oncologists say what she described in her public statement on March 22 – discovering a cancer during another procedure, in this case a “major abdominal surgery” – is all too common.
“Unfortunately, so much of the cancer we diagnose is unexpected,” said Dr Elena Ratner, a gynaecologic oncologist at Yale Cancer Centre who has diagnosed many patients with ovarian cancer, uterine cancer and cancers of the lining of the uterus.
She described situations in which women will go in for surgery for endometriosis, a condition in which tissue similar to the lining of the uterus is found elsewhere in the abdomen.
Often, Dr Ratner noted, the assumption is that the endometriosis has appeared in an ovary and caused a benign ovarian cyst. But one to two weeks later, when the supposedly benign tissue has been studied, pathologists report that they found cancer.
In the statement, the princess said she is getting “a course of preventive chemotherapy”.
That, too, is common. In medical settings, it is usually called adjuvant chemotherapy.
Dr Eric Winer, director of Yale Cancer Centre, said, with adjuvant chemotherapy, “the hope is that this will prevent further problems” and avoid a recurrence of the cancer.
It also means, said Dr Michael Birrer, director of Winthrop P. Rockefeller Cancer Institute at University of Arkansas for Medical Sciences, that “you removed everything” that was visible with surgery.
“You can’t see the cancer,” he added, because microscopic cancer cells may be left behind. The chemotherapy is a way to attack microscopic disease, he explained.
Other parts of the princess’ statement also hit home for Dr Ratner, particularly her concern for her family.
“William and I have been doing everything we can to process and manage this privately for the sake of our young family,” she said, and “it has taken us time to explain everything to George, Charlotte and Louis in a way that is appropriate for them and to reassure them that I am going to be OK”.
Those are sentiments that Dr Ratner hears on a regular basis and reveal, she said, “how hard it is for women to be diagnosed with cancer”.
“I see this day in and day out,” she added. “Women always say, ‘Will I be there for my kids? What will happen with my kids?’ They don’t say, ‘What will happen to me?’” NYTIMES
