Kate Middleton’s cancer diagnosis, explained

The Princess of Wales, formerly Kate Middleton, made her first public appearance since her cancer diagnosis when she attended King Charles’s birthday parade over the weekend. In a statement posted to X, she said she hopes “to join a few public engagements over the summer, but equally knowing I am not out of the woods yet.” She also expressed gratitude for the support she has seen since sharing her diagnosis, and noted she has several months of treatment left. “I am making good progress, but as anyone going through chemotherapy will know, there are good days and bad days,” she wrote. “On those bad days you feel weak, tired and you have to give in to your body resting. But on the good days, when you feel stronger, you want to make the most of feeling well.” The statement was accompanied by a new photo of the princess. [Media: https://twitter.com/KensingtonRoyal/status/1801660649333719231] The world first became aware of Kate’s illness in March, when she announced in a recorded statement that she had been diagnosed with an unspecified form of cancer, which she would be treating with preventive chemotherapy. That video came after months of increasingly fevered speculation regarding her health and well-being. The princess’s last previous formal public appearance was on Christmas Day in 2023, when she was photographed attending church with her family. Most of the conspiracy theories were silly, but they were all reacting to a real issue. Kate has long been a reliable pillar of the British family, showing up and smiling at every public event at which she was asked to appear, reacting to the Sturm und Drang of royal drama with an air of determined normalcy. Then she did something decidedly out of the ordinary: She disappeared. A brief timeline of Kate’s illness On January 17, Kensington Palace announced that Kate had entered the hospital the day before for planned abdominal surgery. “The Princess of Wales appreciates the interest this statement will generate,” the announcement read. “She hopes that the public will understand her desire to maintain as much normality for her children as possible; and her wish that her personal medical information remains private.” It added that she was “unlikely” to resume her public duties until Easter. On January 29, it was announced that she had returned home. Although Kate stuck to her schedule, the long pause in her public appearances and the lack of concrete information about her health created a fertile breeding ground for conspiracy theories. When Prince William canceled a planned appearance of his own in late February, citing a “personal matter,” rumors began to fly. Something, some people theorized, had gone terribly wrong with Kate’s health. Perhaps her marriage to William was on the rocks and she was in hiding. Perhaps she’d been killed and would be replaced by a body double. As the story took off, the joke theories began to take up more space: Kate was waiting for bad bangs to grow out, or to recover from plastic surgery; she’d become the villain in the viral Willy Wonka experience. Meanwhile, responses from Kensington Palace failed to set the public’s mind at ease. At first, all the Palace would say was that Kate “continues to be doing well,” and that her condition was “not cancerous.” In the absence of any official narrative, all pictures of Kate took on the quality of a conspiracy. On March 10, Kensington Palace circulated a picture of the Princess of Wales smiling with her children in honor of Mother’s Day in the UK. The picture would have marked the second of only two public appearances by Kate since Christmas Day — but shortly after the picture came out, it was marred by scandal. Multiple major photo agencies, including the AP and Reuters, concluded that the image had been “manipulated” and issued a kill notice for it. The next day, the X account for the Prince and Princess of Wales posted an apology reading, “Like many amateur photographers, I do occasionally experiment with editing. I wanted to express my apologies for any confusion the family photograph we shared yesterday caused. I hope everyone celebrating had a very happy Mother’s Day.” It was signed “C,” for Catherine. Later that same day, she was reportedly photographed leaving Windsor Castle, according to the Telegraph. The picture shows Prince William in a car next to a brunette woman, with her ear and a bit of cheek visible. Then came Kate’s video statement on March 22. In it, she explained that, when she entered surgery, it was believed her condition was not cancerous, but doctors determined that it was shortly thereafter. She also said that the delay in communicating her diagnosis publicly was due to needing time both to recuperate and to make sure her and William’s three young children understood what was happening to their mother. [Media: https://twitter.com/KensingtonRoyal/status/1771235267837321694] “I am well,” she said she explained to them, “and getting stronger every day by focusing on the things that will help me heal in my mind, body, and spirit.” She closed the video by asking for privacy during her recovery. Why some people thought Kate’s cover story was fishy Officially, Kate was in the hospital for planned abdominal surgery. Still, skeptical onlookers pounced almost immediately on an apparent discrepancy in Kensington Palace’s first statement about her health in January. If Kate’s surgery was “planned,” the onlookers demanded to know, then why had the Palace also said that she was “postponing her upcoming engagements?” How far in advance could this surgery really have been planned? Also raising eyebrows was the detail that Kate would be recovering from her surgery for “10 to 14 days.” Some abdominal surgeries can be minor, like an appendectomy, but those procedures don’t come with such lengthy in-patient stays. What kind of surgery was Kate undergoing that she wouldn’t be able to go back home for two weeks afterward? The speculation only increased when Buckingham Palace announced the same day that King Charles would be receiving treatment for an enlarged prostate. For two such high-ranking royals to be undergoing medical procedures at the same time was unusual, almost shocking. Royal watchers speculated that the palace was trying to cover something up. As the weeks went by, Kate’s condition remained mysterious, while Charles was almost pointedly transparent about his own health. In February he announced that he had been diagnosed with cancer, that it had been caught early, that he was doing well, and that he had begun treatment. As for Kate, Kensington Palace would only say tersely that her condition was “not cancerous.” Why, royal watchers demanded, was Kate’s condition so much more mysterious than the king’s was? The more time went by without so much as a single blurry telephoto lens shot of Kate, the more the rumors built. William was photographed visiting the hospital, but no one saw Kate make her way out of the hospital and back to her own home in Windsor Home Park. Under normal circumstances, the lack of photos of a woman recovering from a medical procedure would be recognized as a reasonable respect for someone’s privacy. However, the life of a future queen of England is not normal circumstances. In a country with a notoriously ruthless tabloid press, royals are considered to be fair game as much as anyone. Royals are expected to keep the public informed on their well-being, to play the game with the media. The royal women, particularly, are expected to meet nearly impossible expectations: to be always beautifully groomed, always pleasant, always available to their public, no matter the circumstances. Kate has traditionally done so with reliable goodwill. After the birth of each of her three children, Kate appeared dutifully in front of the hospital in full hair and makeup for a photo op for the paparazzi within 24 hours, and she did it with a cheerful smile each time to boot. What made this particular procedure different? What had kept Kate from wanting to show her face, and kept the press from demanding to show it anyway? Why did the palace eventually feel driven to release an apparently manipulated photo of her? “You’re telling me that Kate Middleton—the same woman who posed outside the hospital like a freaking supermodel mere hours after giving birth—suddenly requires months of recovery before showing her face?” posted one onlooker on X, summing up the skepticism. “And the British press now magically respects privacy? This feels…sinister.” Princess Kate’s reliability is key to her royal persona Kate’s disappearance seemed to strike people as odd because it was so counter to her brand. For as long as she has been in the public eye, Kate has been dependable, reliable, and always there. Constancy is so clearly central to Kate’s public image that the press has made it at various points her most heroic trait and her only liability. Even early in her relationship with Prince William, during which the press granted her the humiliating nickname of “Waity Katie,” Kate was polite to the paparazzi. She didn’t cultivate a chummy relationship with them, as the late Princess Diana did at certain parts of her career, but she also didn’t try to outmaneuver them. She knew what they wanted and she was matter-of-fact about it. In The Palace Papers, royal journalist Tina Brown describes how the paparazzi would show up outside the midmarket fashion line where Kate worked while she and William were dating. Her boss would ask if she wanted to sneak out the back, but Kate would reply, “To be honest, they’re going to hound us until they’ve got the picture. So why don’t I just go, get the picture done, and then they’ll leave us alone.” She was right. After Kate and William married in 2011, Kate enjoyed a brief honeymoon period as one of the most popular members of the royal family. With her famously shiny hair and demurely polished wardrobe, she had, like Diana before her, a dash of the kind of glamor that could make the dowdy Windsor brand feel new again. At the same time, she was so sensible, so straightforward, so clearly walking into her fate with open eyes and a cool head. She was not the kind of woman who would be destroyed by the pressures of royal life. She would be, as Brown writes in The Palace Papers, “unlike the child-bride Diana, road tested in resilience as well as royal life.” When Prince Harry married Meghan Markle in 2018, Kate and Meghan became each other’s foils in the press, and once again, Kate’s constancy was her defining feature. When Meghan was popular, Kate was the drab and conservative duchess of yesterday compared to Meghan’s exciting progressivism. When Meghan was unpopular, or the British press was feeling particularly racist, Kate was the steadfast maternal icon who could be counted on to lead the British in times of trouble, whereas Meghan was troublingly mercurial and far too trendy to be trusted. The royal family has contracted over the past few years, with the older generation dying off and members of the younger generation drawing back or becoming mired in scandal. Yet as her press coverage fluctuates, Kate continues performing her duties, almost always with her signature public smile: cheerful, dedicated, the face of a woman pleased to be doing what’s right. She is a star player for the royal family in a dangerous time of transition. She is always where she should be. “The inescapable truth is that in the unlikely event that the Cambridge marriage [between William and Kate] ever becomes troubled, the whole Windsor house of cards could come tumbling down,” writes Brown in The Palace Papers. “Kate has become a cherished national icon of flawless motherhood.” Under these circumstances, Kate’s disappearance went from benign oddity to near scandal: something totally out of the norm for a very public and very reliable figure. Update, June 14, 2024, 2 pm ET: This story was originally published on March 1, 2024, and has been updated multiple times, most recently to include the news of Kate’s first public appearance since her cancer diagnosis.