The Princess Of Wales’s Decision To Share Her Cancer Diagnosis Represents A Powerful Break From Royal Tradition

At 6pm on Friday 23 March, the Princess of Wales revealed in a deeply personal video message that she was undergoing preventative chemotherapy for cancer, at last putting to bed weeks of frenzied speculation as to her whereabouts and wellbeing. “In January, I underwent major abdominal surgery in London, and at the time, it was thought that my condition was non-cancerous,” she said. “The surgery was successful. However, tests after the operation found cancer had been present. My medical team therefore advised that I should undergo a course of preventive chemotherapy, and I am now in the early stages of that treatment.”

While there are of course still many questions surrounding exactly what kind of cancer Kate has and the specific type of treatment she is having, the very fact that she has discussed the matter at all is emblematic of the royal family’s new transparency when it comes to medical issues. Just a few months ago, on 5 February, King Charles III made a similar announcement, explaining that he was being treated for an undiagnosed form of cancer. He too had been admitted to hospital for an unrelated condition, an enlarged prostate, when cancer was discovered.

“There’s always been a push and pull of revelation and reticence when it comes to the royals and their history of illness,” says royal historian Gareth Russell. “For instance, it was usually repressed in the Middle Ages when a monarch was close to death, as it could lead to opportunistic foreign invasion. When Henry VIII died, for example, [certain] households actually pretended that the King was alive for several days longer in order to fully prepare for the new reign and avoid a coup. In terms of the modern royals, they tend to march in step with shifting British attitudes around illnesses. We see a real reticence around royals discussing their health in the 19th and early 20th centuries at the peak of the stiff-upper-lip era.”

Charles’s mother, the late Queen Elizabeth II, modernised the monarchy in many ways, but transparency about her health was not one of them. While Buckingham Palace did release short statements whenever the Queen or her husband, Prince Philip, were admitted to hospital during their later years, details were scarce. Indeed, it was only revealed in royal biographer Gyles Brandreth’s 2022 book, Elizabeth: An Intimate Portrait, that the Queen had been suffering from bone marrow cancer at the end of her life, a condition that reportedly caused her much pain. Her death certificate to this day still says that she died of natural causes, namely old age, with no mention of her illness.

Elizabeth’s approach was very much in keeping with the royal default, namely to remain stoic, dignified and silent – in other words, to “never complain, never explain”. The death of her father, King George VI, at the age of 56, was a shock to the nation, despite the fact that he had been suffering from a variety of ailments related to having been a heavy smoker throughout his life. In fact, the King’s lung cancer diagnosis was actually hidden from the monarch by his doctors, who euphemistically referred to his left lung as having “structural abnormalities” rather than a carcinoma when they removed it.

“It seems baffling to us now that even George VI’s wife Elizabeth wasn’t kept informed of his condition, and that there were conversations in Parliament about how much he should be told of it,” shares Russell. “But at the time doctors often withheld a serious cancer diagnosis. It explains why the then Princess Elizabeth went to Kenya just before his death – it came as a huge shock to them all.” 

When King George died on 6 February 1952, it was widely assumed that the cause of death was coronary thrombosis, as he had suffered from vascular disease, but it has since been speculated that his cancer had spread. His mother, Queen Mary, and his brother, the Duke of Windsor, both died of lung cancer, a fact similarly kept hidden until long after the fact.

After her death at the age of 101 in 2002, it was revealed that the Queen Mother had battled cancer privately, too – first, in 1966, when she had a tumour removed from her colon, and then again in 1984, when she had an operation to remove one from her breast. Her condition was kept hidden on both occasions. “Even today the details of her cancer are unclear because she wished to keep it private,” shares Russell.

Non-senior members of the royal family have often been more open about their health battles, however. In 2002, Princess Michael of Kent revealed that she had been treated for skin cancer, while her husband, Prince Michael of Kent, confirmed in 2014 that he had been successfully treated for prostate cancer. Recently, Sarah, Duchess of York confirmed she had undergone a mastectomy following breast cancer, while at the beginning of this year, she was successfully treated for skin cancer.

There are a multitude of reasons why the new generation of royals are more open about their health, the most obvious being the invention of the internet, and in particular social media, where many of the theories around the Princess’s health proliferated. There is an expectation that the public will see working royals multiple times a month, and when they are seen, they are also filmed and photographed. Were any of the senior royals to be absent without explanation, there would be justifiable concern. Authenticity is the key buzzword of the 2020s, and the royals can only achieve it by being honest and upfront about what’s going on behind closed doors, as invasive as that might seem.

Another important distinction between today’s royal family and their ancestors is that modern medicine has come on leaps and bounds. While a cancer diagnosis is still devastating, it has become significantly more treatable, particularly when the disease is caught early, as was reportedly the case with both King Charles and the Princess of Wales. In fact, in coming forward with their own diagnoses, the royals are reminding the public to be vigilant against cancer and to get any suspicions checked out – while simultaneously reaffirming the fact that there is nothing to be ashamed of. As Kate said in the conclusion of her video message, “You are not alone.”

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