March 4, 2007

New Study Says Napoleon Died Of Stomach Cancer

Scientists have studied historical evidence in the light of today's knowledge and concluded that Napoleon Bonaparte died of stomach cancer brought on by an ulcer.

The scientists, who come from Switzerland, Canada and the US are experts in human nutrition and the pathology of various cancers such as gastrointestinal and colorectal cancer.

Their findings are reported in a case study in the latest issue of Nature Clinical Practice Gastroenterology & Hepatology.

The scientists used information from Napoleon's autopsy report and other documents written at the time that described his deteriorating health and symptoms. They compared these descriptions with those contained in recent clinical and pathological records of 135 gastric cancer patients.

Napoleon Bonaparte was a "self-made" Emperor of France at the turn of the 19th Century and at the height of his power ruled over 44 million people across Europe. He reformed governments, invented a new system of law now known as the Napoleonic Code, and brought in the metric system of measurement. He was defeated by the British at Waterloo (now in Belgium) in 1815 and exiled (for the second and last time) to a remote island in the South Atlantic called Saint Helena where he died six years later at the age of 51.

According to records made at the time, it appears that Napoleon bled to death, and in the two months before he died he had lost 10 to 15 kilos (22 to 33 pounds) in weight and his complexion had become very pale. He had also complained of abdominal pain, was vomiting blood and having to change his clothes several times a day because of profuse sweating.

There have been many theories about the cause of Napoleon's death, the most recent one being arsenic poisoning after traces of it were found in strands of his hair two years ago. Other theories have suggested he died of hereditary gastric cancer and poor medical treatment.

The autopsy that was performed at the time said he had died of stomach cancer. It is thought that his father had also died of stomach cancer which led to the theory that he had inherited the disease.

The new study dismisses these theories, pointing to the fact that the autopsy performed on him described his stomach as containing ulcerated lesions, which, using today's knowledge, suggests he was chronically infected with the bacteria Helicobacter pylori.

The scientists suggest that Napoleon died from a T3N1M0 (stage IIIA) gastric cancer. This means the tumour (T3) was quite large, had spread to some local lymph nodes (N1) near the stomach, but had not spread or metastased (M0) to other organs. Their diagnosis based on the available evidence and comparison with current patient records is that he had a sporadic, advanced gastric carcinoma. The prognosis for such tumours is known to be very poor.

They concluded that the main risk factor, because of the ulcerated lesions mentioned in Napoleon's autopsy, was the presence of H. pylori rather than an inherited one.

"Napoleon Bonaparte's gastric cancer: a clinicopathologic approach to staging, pathogenesis, and etiology."
Alessandro Lugli, Inti Zlobec, Gad Singer, Andrea Kopp Lugli, Luigi M Terracciano and Robert M Genta.
Nature Clinical Practice Gastroenterology & Hepatology (2007) 4, 52-57

Click here for full text of case study (no subscription required).

Information on treatment of gastric cancer from the National Cancer Institute (US):
Click here for Health Professional version.
Click here for Patient version.

Written by: Catharine Paddock
Writer: Medical News Today

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