Kate Middleton health update: Why The Princess of Wales may find returning to Royal duties difficult after preventative chemotherapy.

Chemotherapy to prevent a cancer coming back after abdominal surgery is usually given in six, three-weekly cycles. That’s 18 weeks of intensive treatments which takes a lot out of someone, physically and emotionally. Being physically fit will certainly help the Princess recover but, as an oncologist, I always emphasise the side effects which can linger on even after chemotherapy has finished - often up to six months, which require proactive lifestyle adaptions.

Although everyone is different, it’s usually best to consider a phased return to work, building up gradually. For many, there is a need for certain readjustments, such as flexible hours or modified duties, to help the transition to full working. This process, on top of more frequent follow-up appointments for scans and medical follow up can involve negotiations with employers which may not always be straightforward.

Here are some of the more common negative effects on the mind and body which linger after chemotherapy, particularly agents such as taxanes and platinum-based drugs often given in this scenario:

Physical fatigue and weakness

Chemotherapy often causes significant fatigue, which can make it difficult to perform tasks that were previously manageable. In the long term regular exercise significantly helps recovery but in the short term post-exercise fatigue can be profound.

Cognitive impairment (”chemo brain”)

This can include difficulties with memory, attention, and executive function, affecting one’s ability to concentrate, make decisions, and complete work-related tasks efficiently. This can last up to six months or longer if women are required to take additional hormone type drugs.

Menopausal Symptoms Chemotherapy often damages ovarian function, which can result in early menopause, even if one or more ovaries have not already been removed at the time of the initial operation. Hot flushes, low mood, aching joints and weight gain are just some of the ailments which affect women during menopause but being brought on earlier in life and more abruptly can increase their intensity. Fortunately there is usually no contraindication to HRT following cancers that originate in the abdomen.

Emotional and psychological impact

The emotional toll of a cancer diagnosis and treatment can be substantial. Anxiety, depression, and fear of recurrence are common among cancer survivors, which can impact their motivation, focus, and overall mental well-being.

Sleep disruption

The are several reasons why sleep can be affected after cancer treatments. Concerns about the diagnosis, physical symptoms after chemotherapy such as joint and muscle aches, indigestion and the drugs such as steroids often given with chemotherapy all conspire to wakefulness. Fortunately, sleep hygiene and other lifestyle habits can help restore regular sleep patterns with time.

Damage to the nerves

Treatment can result in various side effects including neuropathy (nerve damage) that can cause pins and needles and a burning sensation in the hands and feet. As well as being uncomfortable, this can interfere with daily functioning and productivity at work.

Rebuilding physical strength and stamina

Chemotherapy can lead to loss of muscle mass and overall physical conditioning. Patients often need time to rebuild their strength and stamina, which can be a slow process.

Changes in body image and self-confidence

Treatment can alter body image including hair loss, weight gain and damage to the nails. These often affects a person’s sense of identity and confidence especially after they start trying to adjusting back to the workplace and interacting with colleagues which can feel daunting.

In conclusion, these effects on the body and mind often recover with time and regular exercise. It is important, however, to recognise them and not try to brush them under the carpet. Adopting sensible workplace and lifestyle strategies will limit their negative impact and help speed up recovery.