As a Macmillan cancer expert who’s had the disease twice, I know why Kate Middleton’s ‘new normal’ after chemo is so challenging – everyone expects you to be overjoyed, but life will never be the same

For the first time in public yesterday, the Princess of Wales reflected on her ‘relief’ that she’s now in remission from cancer – and discussed navigating her ‘new normal’ as her recovery continues. 

After spending the day meeting staff and patients at London’s The Royal Marsden hospital on Tuesday, where the royal, 43, was treated for an undiagnosed cancer following abdominal surgery last year, Kate took to Instagram following the visit. 

The princess wrote: ‘It is a relief to now be in remission and I remain focused on recovery. As anyone who has experienced a cancer diagnosis will know, it takes time to adjust to a new normal.

‘I am however looking forward to a fulfilling year ahead. There is much to look forward to. Thank you to everyone for your continued support.’

In the social media message, signed ‘C’, the Princess also thanked staff at the Royal Marsden Hospital for her ‘exceptional’ care in recent months.

The Princess of Wales, who also announced she is to become Joint Patron of the hospital alongside Prince William, spoke about how difficult she’d found juggling treatment with family life, including caring for Princes George, 11, and Louis, six, and Princess Charlotte, nine. 

Chatting with staff about her treatment during her visit, Catherine said: ‘You think treatment’s finished, crack on with that… daily tasks, but that’s still like a real challenge.’

Next month, charity Kidney Cancer UK is set to publish the results of a recent patient survey which found that one in four people are ‘unhappy’ when finishing treatment, further evidence that the weeks and months following successful treatment can see patients endure mental health struggles and even PTSD. 

Andrew Greaves, General Manager at Kidney Cancer UK, told MailOnline that more needs to be done to support people in the aftermath of illness, saying recovery goes far beyond the last medication administered.

He said: ‘A cancer diagnosis has a huge and long-lasting impact on patients. Results from our latest annual survey of kidney cancer patients, due to be published next month, tell us that over one in four kidney cancer patients (27%) were unhappy when they were discharged from hospital. 

‘Most people have follow-up scans to make sure the cancer has not come back, which is good – but they are not offered support to cope with the anxiety these cause.’ 

Adrienne Betteley, a strategic advisor for cancer care at Macmillan Cancer Support, knows only too well the mental health challenges faced by her patients when their physical health is restored – because she’s experienced them first hand.

Adrienne, 57, from Nantwich, Cheshire, has spent her career in nursing and healthcare. 

In 2016, she was diagnosed with malignant melanoma after noticing a suspicious mole on her leg and underwent two rounds of surgery and skin grafting. 

After five years of follow-up tests, she was discharged in 2021. 

In 2022, a routine mammogram detected breast cancer and Adrienne needed surgery and radiotherapy, followed by hormone therapy – she’s currently on the five-year follow-up and undergoes regular scans.

Speaking to MailOnline, Adrienne says the Princess of Wales’ feeling of a new normal is an accurate reflection on how many people feel. 

‘Whilst there is often a sense of relief that treatment is over, this can be a very difficult time for people living with cancer as the psychological impact alongside the physical impact can have a major impact on their lives. It can feel like life will never be the same again.’

She adds ‘Many people say that when they’ve finished their cancer treatment, people often expect them to feel overjoyed and return to how they were before. 

‘A lot of people still suffer with anxiety and depression due to the impact. It can affect sleep and cause fatigue. Cancer can impact on work, relationships, spirituality and sexuality. People are often living in fear of recurrence or a new or different cancer.’

With two cancer diagnoses herself, Adrienne says she can relate to those feelings. 

‘After my first cancer, I used to say I was living with “canxiety”, a fear that my cancer would return. People say they live from scan to scan or test to test and the waiting can feel torturous. 

‘And then to be diagnosed with a new unrelated cancer after just being discharged from my 5 year follow up was such a shock. 

‘There is that sense of “why me?”. I actually thought to myself “surely I have done my stint for team cancer”! Not that it is a team anyone wants to join in the first place.’

It can help to share with others, says Adrienne: ‘Macmillan’s online cancer forum has over 80,000 members and is available 24 hours a day, in a safe environment, at community.macmillan.org.uk. 

‘After my second cancer, I was fortunate enough to be referred for health and well being clinics and with 11 other ladies had six sessions which included psychological support, sessions on sleep, fatigue, sexuality and a whole range of support offers. 

‘And we formed our own what’s app group and two years on we still connect and share our issues and fun things and this helped me as much as anything.’

Clinical therapist Dr Chris Meaden, who specialises in PTSD, trauma, anxiety, panic attacks and is founder of the Meaden Clinic in Kent, says the prospect of an upcoming scan when you’re in remission can be particularly scary. 

Meaden, who’s treated members of the European royal family as well as high-profile celebrities, said: ‘Kate Middleton’s news on being in remission from cancer must have been a huge wave of relief for herself, the royal family and the entire nation, but it’s important to remember that remission doesn’t mean the journey is over.

‘Adjusting to life after treatment brings its own set of challenges, and the Princess of Wales herself has alluded to the difficulty of ‘cracking on’ with daily tasks after such a significant ordeal. Recovery is as much emotional as it is physical.

The clinical therapist says ‘residual trauma’ if all too common, saying: ‘”Scanxiety”, or the intense worry that accompanies follow-up check-ups, often lingers even after going into remission. This is a natural reaction, as our brains are wired to remember past traumas and associate medical appointments with stress and uncertainty.’

He adds: ‘While getting a cancer in remission is a relief, that can be short-lived as life has often been turned upside down. The diagnosis and treatment can leave an emotional imprint, creating trauma that may persist without targeted intervention.’

Meaden uses approaches such as Havening Techniques, grounding techniques including deep belly breathing – or the ‘psychological sigh’, to help calm the nervous system in these moments, and establishing ‘comforting rituals’. 

He added: ‘I also recommend bringing a loved one to appointments or scheduling something enjoyable afterwards to reduce anticipatory anxiety.

‘Kate Middleton’s courage and empathy in sharing this must bring comfort to others who are in the same position. 

He adds: ‘Remind yourself that It’s okay to feel anxious. Simply acknowledge those feelings without judgment. 

‘You’ve already shown incredible resilience, and that same strength will help you navigate life after treatment.’ 

Dr Frances Goodhart, a clinical psychologist and author of The Cancer Survivor’s Companion, previously told the Daily Mail how normal life, the thing patients dream of during treatment, can actually be one of the toughest parts of the cancer journey. 

She said: ‘There is a huge amount of pressure on cancer patients in remission. Family and friends want the person to be back to normal; to be able to throw off the experience of cancer and pick up where they left off.

‘There’s an expectation around the speed of recovery. But often, it’s only at the end of treatment when people start psychologically processing what they’ve been through.’

During the Princess of Wales visit to The Royal Marsden yesterday, a number of the patients opened the conversation by asking how the Princess was feeling. 

The royal replied that she was doing well, but recalled the cycle of treatment, saying: ‘Sometimes you feel relatively well, and then you have another one’.

‘Sometimes from the outside we all think “You’ve finished treatment and you go back to things”. But it’s hard to get back to normal.’

 As she walked through the main entrance of the hospital’s Chelsea site, the Princess – dressed in a long brown winter coat and heels – was heard to say: ‘Coming in the front entrance here, having made so many quiet, private visits, actually it’s quite nice.’

Sitting down to talk to one lady who was undergoing treatment while wearing a cold cap to prevent hair loss, Catherine said: ‘When did you first start treatment? Oh, today? How are you finding it?’

Offering words of comfort, she hugged one well-wisher and told them: ‘I wanted to come and show my support for the amazing work that’s going on here and for those who are going through treatment and having such a hard time. 

‘Are you OK? There is light at the end of that tunnel. Very nice to meet you and best of luck. You are in the best of hands.’ 

The Royal Marsden opened its doors in 1851 as the world’s first hospital dedicated to cancer diagnosis, treatment, research and education.

Today, The Royal Marsden NHS Foundation Trust is a world-leading cancer centre operating across three sites in Chelsea, Sutton and Cavendish Square in central London.

William has held the role of president of the Royal Marsden since 2007, a position which was previously held by his mother Diana. 

He most recently visited the Royal Marsden to open their Oak Cancer Centre in Sutton in June 2023.

The Royal Marsden also confirmed that until now William had been its president – but, with his wife now joining him, the couple would henceforth be joint patrons. 

Call Macmillan Cancer Support Line on 0808 808 0000 or visit macmillan.org.uk