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Roosevelt's Last DaysDid cancer kill FDR?

Franklin D. Roosevelt. Click image to expand.Is it conceivable that Franklin D. Roosevelt's doctors knew he had widespread cancer in 1944 and still let him run for his fourth term as president? New research makes this astounding argument—and claims that the physician who supposedly told the truth about Roosevelt's death in 1970 was in fact continuing the deception he had helped create.

FDR may have died more than 60 years ago, but these questions still matter. Not only does presidential health—and the public's right to know about it—remain a controversial issue, but in Roosevelt's case, the lies in question, if true, changed history. As neurologist Steven Lomazow and journalist Eric Fettman point out in a book coming out this January, FDR's Deadly Secret, widespread knowledge of Roosevelt's cancer would have prevented him from running in 1944 and thus likely altered the shaping of postwar Europe.

Roosevelt was in the business of concealing his medical afflictions. After a bout with polio in 1921, he never regained the use of his legs and used braces and a wheelchair, but he asked not to be photographed in ways that would reveal his disabilities.

Beginning in early 1944, the fact that Roosevelt had severely elevated blood pressure and congestive heart failure was also kept secret. These diagnoses were made by Howard G. Bruenn, a Columbia University cardiologist and Navy physician who became Roosevelt's primary doctor. When Roosevelt died of a brain hemorrhage on April 12, 1945, early in his fourth term, Bruenn misleadingly analogized the bleed to a "bolt of lightning." Of course, he knew better: Very high blood pressure can cause bleeding in the brain.

It was not until 1970 that Bruenn came clean—or at least seemed to. In an article in the Annals of Internal Medicine, he described his heretofore secret efforts to treat Roosevelt's blood pressure and heart problems. The article became the definitive account of FDR's passing. However, according to Lomazow and Fettman, it was just another attempt to obscure the truth.

Over the years, other rumors about Roosevelt's health circulated, including the claim that he had suffered strokes. Most interesting was a 1979 paper in Surgery, Gynecology and Obstetrics by a surgeon and amateur historian, Harry Goldsmith, who noted that an enlarging skin lesion above Roosevelt's left eye disappeared in photographs after 1940. He theorized that the lesion was a melanoma, the deadliest of skin cancers, and that the disease had spread to Roosevelt's abdomen, causing him episodes of severe pain during the last months of his life.

Goldsmith's article received national attention, and he eventually self-published a book on Roosevelt's medical condition. But Lomazow and Fettman have greatly expanded Goldsmith's research. What they believe is that the melanoma spread not only to Roosevelt's abdomen but to his brain. The bleed that killed the president, they hypothesize, was due to the cancer, not the hypertension.

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Barron H. Lerner, M.D., Ph.D., and professor of medicine and public health at Columbia University, is the author, most recently, of When Illness Goes Public: Celebrity Patients and How We Look at Medicine.
Photograph of President Franklin D. Roosevelt by AFP/AFP/Getty Images.
COMMENTS

A couple of years ago, I had read in the Guillian Barre Society Letter that there was speculation that FDR may not have suffered from Polio but from Guillian Barre. This autoimmune disorder causes temporary to permanent paralysis in its victims. Not much was known about this disorder back then and it is still very hard to diagnose today.

-- Judy Willoughby
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This is not the 1st time I have heard that FDR died from melenoma metastatic to the brain that caused his cerebral hemorrhage. I was in a medical practice in NC in 1977, when an older MD joined the same practice. I was a child during FDR's presidency, but he was 10 years older than I and in fact had joined the Navy as WW II had just ended. Somehow while discussing politics, he mentioned that FDR's cerebral hemorrhage had not been caused by high blood pressure leading to a ruptured cerebral artery, but that FDR had melanoma metastasis in the brain and this hemorrhaged and killed him. This article merely confirms information I had received previously. FDR we know hid his paralysis from the public, so it is not difficult to believe he concealed his other health problems.

For those of you who are unfamiliar with the term, "left-sided hemianopsia", it means that both eyes are blinded to anything to the left side of the body. It does not mean you are blind in your left eye. The retina on the right side of each eyeball, receives its enervation from nerve coming from the left side of the occipital lobe of the brain. The retina on the right side picks up images coming in from the left, while the retina on the left of each eyeball picks up the images coming in from the right. Anopsia means blind, hemi means half. Left hemianopsia means FDR could not see anything to his left.

It is possible that the hemianopsia was caused by an earlier stroke due to a small thrombus, but metastatic cancer ties everything together in a neater package. Of course now no one will ever be able to prove anything unless actual medical records could be produced.

-- rick 72
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The speculation about Roosevelt and melanoma was extensively discussed in a 1969 book by a British doctor, Hugh L'Etang, called "The Pathology of Leadership" (Heinemann). He also writes about the 1944 electoral race and what the responsibilities of the doctors were, or should have been.

-- Herschel Flax MD
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