What King Charles’ Cancer Could Mean for the Royal Family
BU historian Kathryn Lamontagne weighs in on the newly crowned king and his decision to go public with his diagnosis, but on his own terms
Buckingham Palace revealed last week that King Charles III has been diagnosed with an unspecified cancer. Charles, 75, was undergoing treatment for an enlarged prostate when the cancer diagnosis was made. The Palace said that the king is pausing his public-facing duties while he receives outpatient treatment for the cancer, but will continue to work on state duties and paperwork.
Charles has been monarch for less than two years. He was crowned at Westminster Abbey in May 2023 (following the death of his mother, Queen Elizabeth II, in September 2022) after waiting 73 years—longer than any previous heir to the throne—to become king. He is said to have been excited to finally get a chance at the job. In his first year as king, he participated in 161 engagements.
The king plans to return to work as soon as possible, and according to the Palace, chose to disclose his diagnosis “to prevent speculation and in the hope it may assist public understanding for all those around the world who are affected by cancer.”
With Charles’ public appearances now on pause, there is much speculation about the future of the monarchy. Many are applauding his decision to reveal he has cancer (something that hadn’t always been the case with previous kings and queens), yet others wish he would specify which type. Many royal watchers are waiting to see which members of Charles’ family will help him with appearances during this time.
We asked historian Kathryn Lamontagne (GRS’16,’20), a College of General Studies lecturer in social sciences and British monarchy expert, for insight into the situation, historical precedence, and what she thinks this means for the Royal Family going forward. Lamontagne worked in the Royal Household during the Diamond Jubilee celebrations for Queen Elizabeth in 2012 and 2013.
With Kathryn Lamontagne
BU Today: This isn’t the first time a member of the Royal Family has had cancer. Charles’ grandfather, King George VI, was diagnosed with lung cancer, and the British public wasn’t told about it. His death came as a surprise to the world. By being candid about his diagnosis, how is Charles breaking with royal tradition?
Lamontagne: It seems there is a continued effort to reach out and be more in touch. They are the monarchy, but you have to respect their privacy to some degree. So, it is tricky to balance the public’s expectations and medical privacy. Historically, if we consider George III [reign: 1760-1820], who had porphyria [a blood disease], the public was, to some degree, kept abreast of what was happening with him, namely because there was a regent [his son, George IV]. But, they certainly didn’t know the whole story, as it would have made the monarch look weak. A weak monarch equates with a weak country, so it is a tightrope for the Royal Household to walk.
When the Queen [Elizabeth II] was unwell, the public was told as vaguely as possible [about her condition], but then reassured that “She is comfortable.” People seek reassurance. To some degree, the Royal Household lets the press and public know some information, but they don’t tell you too much. It’s the same with Kate Middleton [wife of Prince William]—we know she has had surgery, but not what type.
Some things have to be private, and it is appropriate that medical things are kept that way. [TV talk show personality] Piers Morgan keeps pushing [King Charles] on social media: “You must tell us what kind of cancer.” However, it seems more of a bullying tactic than a true interest in his health and well-being.
BU Today: How do you think the palace is weighing the Royal Family’s desire for privacy with the public’s right to know?
Lamontagne: I believe they gauge the climate regarding what the British public expects. What do they need? And then, how do you gauge that against someone’s self-autonomy? They are changing with the times, but there’s only so much you can expect them to say. All of the Royals’ social media platforms are focusing on cancer support [right now]. Charles’ news coincides with World Cancer Day [February 4]. The Royal Family are patrons of many cancer societies in Britain; Macmillan Cancer Support and Maggie’s Cancer Support are two massive charities within the UK, for example, so it is appropriate that the family/institution is taking this opportunity to bring attention to being proactive.
It is laudable that they’re taking something that is traumatic for a family to comprehend and making the best of it. Numbers of searches on the internet for cancer treatments are through the roof in Britain, so this could very well be a positive outcome for someone out there who wouldn’t have thought to get something checked and now will due to the king.
BU Today: The king is pausing his public events, although he has said he will continue his constitutional role as head of state, including paperwork and private meetings. Who will be stepping in to fill his public-facing role?
Lamontagne: Certainly Queen Camilla is stepping in. She has been brought to the forefront over the past couple of months. The irony of that is that 20 years ago she was buried behind closed doors. In this moment, she is the face of the royal family and leading new initiatives, including a book-centered project at Windsor. [Charles has] been making a real effort to pare down who is a working royal. And now they’re finding that they don’t have the staff to fill in when someone’s sick. Even Prince William had to jump in when he probably wanted to be at home helping with his wife a little longer. There seems to be evidence that maybe paring down isn’t the solution in this moment and to bring in some other faces more often, such as Princesses Eugenie and Beatrice. But, their mother, Sarah, Duchess of York, is also currently battling cancer herself.
BU Today: Do you think William is upset about not having this continued privacy during this time?
Lamontagne: I reached out to some of my friends and family in England to gauge their opinions. One [friend] was employed in the Royal Household, and the others are strong Republicans, and it’s interesting to hear their very differing reflections on this. Both groups say there is a general concern that William could be thrust into taking on the monarch’s role sooner than expected. And there is concern he might not be ready to take on the mantle, because he has only just started to do [initiatives] such as the Earthshot Prize [a global environmental award] in the past few years. Is he leaning into being a father, rather than a Head of Church and State? Or, for the Republicans, is this the natural time to think more about the role of the monarch?
BU Today: He wouldn’t be the first heir who unexpectedly took the throne. What are the dangers or issues with that?
Lamontagne: I think the fact of the 24/7 news service/social media and the issues with his brother [Prince Harry]—there is so much speculation and a beady eye is always trained on him now, but the reactions and expectations would be so quickly amped up that it might be untenable. Never-ending speculation about what’s going on in your family life and an ill father and wife are not a great combination for anyone. He has clearly lost his brother as his advisor and friend, and one wonders if he is in the right place mentally to take on this extra burden [of possibly becoming monarch].
BU Today: Might the King’s younger son, Prince Harry, who has largely been estranged from his family the last few years, take on new responsibilities if Charles is forced to take an extended medical leave?
Lamontagne: This is speculation, from having read Spare [Harry’s memoir], talking with friends, etc., but if his family needs him, and, importantly, wants him—on his terms—Harry will be there. But there has to be some kind of “moment of clarity” between the different parties. If that happens, I imagine he would be flying over [from the United States] as much as they needed him. But I don’t know that his brother is at that point. There’s a lot in the news about the family dynamic in Britain, and many Britons are exhausted by the narrative. Others are really hoping that a reunion happens and a bond is re-created in some way. But, it can’t be overlooked that Lilibet [Harry’s daughter, the Princess of Sussex] has never met her grandfather, and she was not on that flight with her father this week, either.
BU Today: Charles was 73 when he became king, making him the oldest monarch ever to take the British throne, and he assumed a very demanding schedule. Should he fully recover, do you think he’ll return even stronger?
Lamontagne: Absolutely. He’s not the kind of person to sit around and let things happen—he wants to be in the thick of it, whether or not he’s meant to be in the thick of it. He’s done a great job since he ascended to the throne in terms of taking on the best aspects of what his mother did and crafting it into what he needs it to be in this post-COVID moment. I am certain that he will be eager to jump back onto that as soon as he can. The London Clinic [the UK’s largest independent private hospital] is excellent. He’s got his own surgeon and his own doctor at the palace, he has access to the best care possible, and [his cancer is] at an early stage.
For the British people, the National Health Service [the publicly funded healthcare system in England] is a point of pride. Created after World War II, it is a tremendous free system with a dedicated staff that treats everyone, no matter what. However, it has been on its knees for the past few years. It’s severely underfunded, and waiting times are high. There will be some grumbling that he’s been able to go private and that he doesn’t have to wait for cancer care. Depending on your region, some people experience long waits to access care, and there will be a debate about the hypocrisy of him being able to go private and the speediness of treatment. So debates over socialized healthcare will happen, and I will be interested to see if that works its way into our conversation in America about healthcare cost, access, and treatments.