As the son of Holocaust survivors, I have always had a particular gratitude for our lives here in the U.S., as did my parents. This has translated into a fascination with U.S. history, which I love to read. The biographies of the presidents and generals of our country have been particularly interesting.
A friend of the family, Jill Kornmehl, brought to my attention recently an article about Grant and his cancer. A few years ago, I read a particularly good biography of Ulysses S. Grant by Ron Chernow that gave a very balanced review of all the periods of his life, including pre-Civil War, as a general and as president. Andrew Johnson succeeded Lincoln as president after his assassination, but failed miserably with regard to Reconstruction, and it was clear going into the next election that a general would win, so it came down to Sherman and Grant—I guess we know who won. There seems to be a widespread impression that Grant was not a particularly good president, but the truth is that he was exemplary, particularly with regard to the implementation of Reconstruction. In addition, he dealt well with putting veterans back to work and with the economy. So why is he held in low regard? His administration was marred by major financial scandals that mainly involved his Treasury secretary, but led to a recession for which Grant was blamed.
After leaving the presidency in 1877, he came to live in New York City. He had no pension and ultimately lost his savings to an unscrupulous business partner, so he became impoverished. In 1884, he developed a sore throat and was found to have a tumor of the tonsil. This has been ascribed to his heavy use of cigars throughout his life and possibly intermittent heavy drinking as well. A biopsy showed what today would be called a squamous cell carcinoma. It would be staged today as T1N1 (spread to lymph nodes). He had difficulty speaking and had significant pain that was controlled with cocaine and various gargles. The tumor slowly began to progress. During this period, he worked on his memoir in order to provide a source of financial support for his wife. This book ultimately provided $450,000 in royalties for her (approximately $15 million in today’s currency).
He ultimately expired in July of 1885 at the age of 64, the only president to have died of cancer. (Jimmy Carter may be headed in that direction as well.) Do you know where Grant is buried?
Interestingly another president also had a cancer of the oral cavity. Grover Cleveland started his second term in office in 1893 (the only president to have non-consecutive terms in office—at least until now) at age 56. He noted a rough spot on the roof of his mouth, the palate, and showed it to his physician. His doctor described it as the size of a quarter and had a biopsy sent anonymously to William Welch, who had recently been made the first chair of pathology at the new Johns Hopkins University medical school. He diagnosed a carcinoma.
At the time, the president had significant political problems that precluded his being absent for surgery. So arrangements were made for several outstanding surgeons and a dentist to accompany him on a private yacht where the surgery could be undertaken secretly. This surgery was accomplished on July 1, 1893, and took 90 minutes. It was considered remarkable that it could be done so quickly. The president recovered there for four days before returning to the White House, and his only apparent problem was some difficulty with speech. He did apparently lose some of his energy and was more irritable after the surgery. He died in 1908 from a heart attack.
The fact that he had surgery for cancer was kept secret until years after he died. It was never fully clear what the nature of the tumor actually was. Review of the biopsy material of the tumor took place in the 1980s and it was diagnosed as a verrucous carcinoma, a relatively indolent form of cancer that rarely metastasizes.
So as with Grant, why did Cleveland get an oral malignancy? He was also a very heavy smoker of cigars. And it is very well known that he drank at least four glasses of beer daily. His heart attack and death at age 71 were probably not unrelated to these two habits also.
Alfred I. Neugut, MD, PhD, is a medical oncologist and cancer epidemiologist at Columbia University Irving Medical Center/New York Presbyterian and Mailman School of Public Health in New York. Email: [email protected].
This article is for educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice. Always seek the advice of your qualified health provider with any questions you may have regarding a medical condition or treatment.
