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Kate Middleton's cancer announcement brings messages of concern, support

Catherine, Princess of Wales, has an undisclosed form of cancer. She announced the news after months of speculation about her condition and whereabouts, which resulted in intense public pressure for the British royal family.

The princess, in a video posted online Friday, said that after undergoing "major abdominal surgery" in London in January, she was diagnosed with cancer. She is undergoing preventative chemotherapy but said she is OK and hoping to make a full recovery.

Read more: Amid Kate frenzy, hospital responds to Catherine's reported medical-records breach

"The surgery was successful; however, tests after the operation found cancer had been present," she said after noting that she had initially been told her condition was not cancerous.

The 42-year-old, who married into the British royal family in 2011, said it has been "an incredibly tough couple of months" and explained that she took a while to go public with her diagnosis because she and husband Prince William needed to take time to inform their young children, Princes George and Louis and Princess Charlotte, ages 10, 5 and 8, respectively.

"It has taken me time to recover from major surgery in order to start my treatment. But, most importantly, it has taken us time to explain everything to George, Charlotte and Louis in a way that is appropriate for them, and to reassure them that I am going to be OK," Catherine said.

The senior royal is expected to return to public-facing duties when she is cleared to do so by her medical team and is said to be "in good spirits and ... focused on making a full recovery," according to Kensington Palace.

Read more: What the frenzy over Kate Middleton’s ‘disappearance’ says about the royals — and us

What Catherine referred to as “preventative chemotherapy” is known as adjuvant chemotherapy in the United States, experts said. It is given after the primary treatment of a tumor in order to kill off any malignant cells that remain. Doing so reduces the risk that the cancer could return.

“It can improve the chance of long-term cure and survival,” said Dr. Edward Kim, physician-in-chief for City of Hope Orange County in Irvine.

“The fact that they think all of the cancer was removed and preventative or adjuvant chemotherapy was given gives us some cause for optimism,” said Dr. William Dahut, chief scientific officer with the American Cancer Society.

Most patients getting chemotherapy today are able to stay active, including continuing to exercise and go to work, said Dr. Beth Y. Karlan, a gynecologic oncologist at UCLA’s Jonsson Comprehensive Cancer Center. “These images of frail chemo patients are almost archaic,” she said. “It should not have the same sense of fear and dread that it had in the past.”

The announcement comes days after the princess' medical records at the London Clinic were allegedly breached by hospital staffers and months after Buckingham Palace announced that her father-in-law, King Charles III, had been diagnosed with cancer.

Conjecture ran amok after Kensington Palace confirmed that the duchess-turned-princess formerly known as Kate Middleton had been hospitalized in mid-January and would not return to her public duties until after Easter (March 31). With few details clarifying her condition, wild speculation filled the void along with frenzied internet obsessions, conspiracy theories and intense public interest in her well-being.

The crisis was further compounded by the palace’s misstep earlier this month — now affectionately referred to as “Kate-gate” — when it released a doctored photo of the princess and her three children for U.K. Mother's Day. That move was regarded as a shoddy attempt at proof of life and sowed broad distrust in any and all Kate sightings and sourcing, and the monarchy as a whole. William, the heir apparent to the British throne, has continued to carry out his public duties and was spotted with her over the weekend but had deflected questions about his wife’s health.

On Friday, the woman who may be the next queen was dressed casually in a sweater and jeans while seated on a bench in the video, which was shot by BBC Studios. Getting choked up at times, she said that she is "well and getting stronger every day" by focusing on the things that will help her heal "in my mind, body and spirits."

"We hope that you will understand that, as a family, we now need some time, space and privacy while I complete my treatment. My work has always brought me a deep sense of joy and I look forward to being back when I am able, but for now I must focus on making a full recovery," she said.

She also urged anyone battling cancer not to lose faith or hope and added, "You are not alone."

"We wish health and healing for Kate and the family, and hope they are able to do so privately and in peace," Harry and Meghan, Duke and Duchess of Sussex, said in a statement.

The princess, who was at the center of a separate public relations crisis just last year relating to her brother-in-law's memoir, "Spare," also received well-wishes at home and abroad from the Biden administration, Canadian Prime Minister Justin Trudeau and legions of royal watchers.

Read more: Another Kate Middleton sighting? Unedited pics or it didn't happen

It’s impossible to say what kind of cancer diagnosis was given to Catherine. Knowing she had abdominal surgery eliminates breast cancer, the leading cause of cancer deaths in women under 50. Other than that, “We don’t really know anything,” said Dr. Syma Iqbal, a gastrointestinal oncologist at USC Norris Comprehensive Cancer Center.

Generally speaking, the risk of cancer increases with age, but the incidence of several kinds of cancer has been rising in younger adults, experts said.

“Unfortunately we’re seeing younger and younger patients present with gastrointestinal malignancies,” Iqbal said. “Recently the screening age for colon cancer has gone down to 45 because of the increasing incidence of colon cancer in younger patients. We’re seeing the same thing now in gastric cancer patients. [Catherine] is quite young, but it doesn’t necessarily eliminate any of the potential GI malignancies.”

Kensington Palace said in a statement to The Times that it will not be sharing any further private medical information, noting, "The Princess has a right to medical privacy, as we all do." The palace also would not comment on the type of cancer, stage of cancer or treatment that she is undergoing.

Among women in the U.K., the most common types of cancers that affect the abdominal area are cancers of the bowel, uterus, ovaries, pancreas and kidney, according to the World Cancer Research Fund.

"The Princess is now on a recovery pathway having commenced a course of preventative chemotherapy," a palace spokesperson said.

It’s not particularly common for a patient to learn they have cancer after seeming to get an all-clear after surgery, but it’s not rare either, said Kim. When a biopsy or surgical procedure is done, the tissue that’s removed may not look like cancer, Kim said. It is only after samples are sent to a pathology lab and examined under a microscope that the cancer diagnosis is made.

Read more: By disclosing his cancer, Charles breaks centuries of royal tradition. But he shares only so much

Charles, 75, who broke with royal tradition by revealing in February that he had cancer, said in a Buckingham Palace statement obtained by the Associated Press that he is “so proud of Catherine for her courage in speaking as she did." The monarch, who formally ascended the throne less than a year ago after the 2022 death of Queen Elizabeth II, received prostate treatment in the same hospital and at the same time that Kate had her surgery. He said he has remained in the “closest contact with his beloved daughter-in-law” in the recent weeks.

Meanwhile, William will continue to balance supporting his wife and family with maintaining his official duties. He is likely to resume carrying out his engagements when their children return to school after the spring holidays.

On Thursday, a spokesperson for Kensington Palace confirmed to the Telegraph that Catherine was slowly returning to her Royal Foundation Centre for Early Childhood commitments, charity work that seeks to improve the lives of babies and young children. She reportedly has been receiving updates about her campaign during her recovery.

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This story originally appeared in Los Angeles Times.