Kate Middleton and Remission: Oncologists Weigh In

Kate Middleton, the Princess of Wales, announced last week that she was in remission from cancer. Since she never disclosed the type of cancer, it’s hard to know exactly what remission means for the princess. But gynecologic oncologists shared some insights with MedPage Today.

In March 2024, Middleton announced that she was “in the early stages” of preventive, or adjuvant, chemotherapy for a cancer that was detected after an abdominal surgery 2 months prior.

Around that time, gynecologic oncologists talked with MedPage Today about the possibility of an ovarian cancer, for which a typical adjuvant chemotherapy regimen would be paclitaxel plus carboplatin given over about 6 cycles every 21 days.

That would take about 6 months — aligning with her announcement in September that she’d completed chemotherapy — and then oncologists would wait some time to do more imaging, according to Mark Einstein, MD, of Montefiore Medical Center in New York City.

“If this is an ovarian cancer, this is right around the time I would feel comfortable saying she’s in remission,” Einstein told MedPage Today, adding this means the princess has no evidence of disease on clinical, blood test, and imaging assessments.

Don Dizon, MD, of Brown University in Providence, Rhode Island, said he typically uses “an end-of-treatment CT scan and a normal CA125, typically done 8 to 12 weeks from last chemo, as ‘proof’ of remission” for ovarian cancer patients.

While remission implies “no evidence of residual disease,” said Julie Gralow, MD, chief medical officer of the American Society of Clinical Oncology, there’s “a chance that microscopic cancer cells that cannot be detected by conventional means could still remain — hence use of the term ‘remission’ instead of ‘cure.'”

Thus, the big question is the likelihood of recurrence, and how soon that may happen. For most people with ovarian cancer, their greatest risk of relapse is in the first 3 years, Dizon said.

Stephanie Blank, MD, director of gynecologic oncology for Mount Sinai Health System in New York City, said Middleton will have follow-up care — including physician visits, blood work, and scans — at regular intervals.

“The intervals spread out with time if everything is negative,” Blank said. “The longer a patient goes without recurrence, the better the prognosis.”

“We do cure some patients, and the proportion of patients we do cure is increasing, but we do not necessarily know who these patients are at the end of frontline therapy or even at 5 years out,” she added.

Einstein added that common epithelial ovarian cancers do tend to recur. However, he believes Middleton is young for that type of cancer, and she may have a germ cell tumor of the ovary instead. In that case, the risk of recurrence is very low, and there’s “a good chance of extended remission,” he said.

Germ cell ovarian tumors account for 5% to 7% of all ovarian cancers, and mainly affect young women in their 20s and 30s, he added.

Cervical cancer is another cancer that occurs among women in Middleton’s age range, and would have a similar timeframe for chemotherapy and remission, Einstein said. However, it has more stigma because of its link to human papillomavirus (HPV).

“That’s the kind of cancer they’d want to keep more hush-hush because there’s a stigma, even though there shouldn’t be,” he said. “I spend a lot of time talking people off the HPV ledge.”

With treatment for both HPV and ovarian cancer, it is indeed possible that Middleton did not lose her hair, oncologists said — even without scalp cooling, which she reportedly said she didn’t have.

“Not every chemo requires scalp cooling and not every chemo makes someone lose their hair,” Einstein said. “Though it’s hard to say for certain whether she did or didn’t.”

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