The Kate Middleton effect: Does preventive chemotherapy work in all cases?

By Stephanie Srakocic | Fact-checked by Davi Sherman
Published April 1, 2024

Key Takeaways

  • Preventive chemotherapy is used to prevent chemotherapy from returning following tumor removal surgery.

  • Chemoprevention is a newer option that is still being studied, and that might help reduce risk for people at high risk of developing breast, colon, or prostate cancers.

Preventive chemotherapy became a topic of conversation on social media after British royal Kate Middleton announced that she was undergoing cancer treatment. The Princess of Wales announced her treatment following weeks of public concern about her health. In a video statement, she addressed the abdominal surgery she had several months ago and thanked viewers for the messages of support she’s received. She stated that tests following her operation found the cancer and that she is now receiving a course of preventive chemotherapy.[]

The statement had many on social media questioning what preventive chemotherapy is, how it works, and what it’s used for. Despite its name, preventive chemotherapy isn’t a preventive treatment or a risk-reduction option. In fact, the treatment is often referred to as adjuvant chemotherapy. Preventive chemotherapy is used to prevent the spread of chemotherapy. Commonly, it’s used after the surgical removal of a tumor. Once a tumor is no longer present, preventive chemotherapy is done to stop the cancer from returning and spreading to nearby areas.[]

Typically, preventive chemotherapy is done for solid tumors such as breast cancer and tumors of the abdominal and pelvic organs.[]

Treatments are received intravenously. Many people who receive preventive chemotherapy are younger cancer patients. Multiple studies have linked preventive chemotherapy to higher survival rates than surgery alone. The use of preventive chemotherapy has risen in recent years.[]


Preventive chemotherapy and chemoprevention aren’t the same. Preventive chemotherapy is a known and well-studied cancer treatment option. Chemoprevention is a newer option that aims to prevent cancer in people who are at high risk of developing cancer. Research on chemoprevention is ongoing. Possible suggestions might include:[]

  • Selective estrogen receptor modulators (SERMS). SERMS such as tamoxifen or raloxifene can reduce the risk of breast cancer in people at high risk. However, they’re associated with side effects, so they’re not often used for cancer prevention. 

  • COX-2 inhibitors. COX-2 inhibitors have been linked with a reduced risk of breast and colon cancer. Unfortunately, they’re also linked with heart problems. They haven’t been studied enough to determine whether they’re a safe option for preventing cancer. 

  • Finasteride. Finasteride can reduce the risk of prostate cancer.

Current cancer prevention

Currently, most cancer prevention methods fall under the umbrella of risk reduction. For instance, smoking is one of the largest known risk factors for lung and other types of cancer. Avoiding or quitting smoking and avoiding secondhand tobacco smoke is a cancer prevention method.[]

Human papillomavirus (HPV) is linked to an increased risk of cervical and other cancer types. This is why the HPV vaccine and safe sex practices are cancer prevention steps. Lifestyle steps such as achieving or maintaining a healthy weight and staying physically active also decrease the risk of developing certain cancer types. 

Some people with a known higher risk of developing cancer take additional preventive steps. This includes women with a high risk of breast cancer who have a prophylactic mastectomy and remove one or both breasts. Removing one or both ovaries to reduce estrogen can also be an option for women at high risk of developing breast cancer. 

The future of cancer prevention

New options for preventing cancer could emerge over the next few years. In March 2024, researchers at the University of Cambridge published results suggesting that current immunotherapy treatments could be used preventively for BRCA1 or BRCA2 carriers to stop the process that leads to the development of breast cancer. Earlier in the year, researchers at the University of North Carolina (UNC) at Chapel Hill School of Medicine and members of the UNC Lineberger Comprehensive Cancer Center published findings suggesting that the loss of the cGAS-STING pathway might be responsible for the excessive inflammation and DNA damage that leads to breast cancer. Finding a way to reactivate this pathway could be a preventive treatment.[][]

In the March 2024 issue of Cancer Prevention Research, an article presented research into a new multi-target stool DNA panel. The panel has the potential to be able to detect colorectal cancer and advanced precancerous lesions. A clinical validation trial is underway.[]

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