Did Abraham Lincoln Have Cancer Too?

President Lincoln was assassinated when he was just 56 years old in 1865. But one California doctor theorizes that Lincoln—who had lost a lot of weight before his death and complained of intense headaches and cold extremities—might not have lived much longer anyway.

Cardiologist John Sotos from the Baltimore, Maryland's Johns Hopkins Hospital said that Lincoln probably had a rare genetic syndrome, called Multiple Endocrine Neoplasia Syndrome type 2B [1] (MEN2B) that causes small, benign tumors to grow on victims' lips and inside their intestines.

MEN2B patients also exhibit Marfan Syndrome features, as did Lincoln, meaning that they tend to be tall and lanky, with unusually long limbs and fingers. Other symptoms consistent with this disease include Lincoln’s well-known history of constipation and facial asymmetries. The greatest challenge to this theory is that MEN2B causes cancer; in the last few months of his life, the President’s health had declined drastically (in a potentially cancer-like fashion)—but he still had survived to the relatively old age of 56.

Sotos claimed that these tell-tale bumps were clearly visible on his lips and surmised that tumors in Lincoln's gut could have caused his notorious problems with constipation. He analyzed 130 photographs and two plaster face masks of Lincoln, one in 1860 and the other in 1865, stored in the National Portrait Gallery. 

Leonard Volk completed this first mask in Chicago, Illinois, in April 1860.
Multiple Endocrine Neoplasia Syndrome type 2B is indicated by bumps on his lips.

There is more evidence of this genetic disease; Two of Lincoln's sons had the same lip tumors and died at young ages. The problem with Sotos's theory is that people with MEN2B usually develop cancer in their 20s and die in their 30s.

MEN2B can only be confirmed or refuted through DNA sequencing. With Lincoln’s body encased in concrete and buried underground, this mystery might have gone unsolved. However, a limited amount of Lincoln’s DNA remains above ground. It might be extractable from multiple sources: his surgeon’s blood-stained shirt, a bloody pillowcase from his deathbed, and even skull fragments from his autopsy.

These are skull fragments from Lincoln's autopsy
and the probe used to locate the bullet.

However, concern about technical difficulties and the potential destruction of important historical artifacts have stalled these requests for now. Nevertheless, support for the project continues; the major argument is that confirmation of such diagnoses could bring much-needed public awareness and advocacy to rare diseases.

Perhaps one day, we’ll finally sequence Lincoln’s DNA and discover the truth about him. Maybe he did have a rare genetic disease. Or maybe he was just a tall, skinny man dealing with the everyday stresses of leading a nation. In the end, science may reveal that he had a normal bill of health, but history has already proved, without a doubt, that Abraham Lincoln was certainly far from ordinary.

Compiled by Dr. Neil Gale, Ph.D.

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[1] Multiple Endocrine Neoplasia Syndrome type 2B - A benign tumor of nerve tissue commonly found on the tongue, lips, or in the gastrointestinal tract. Mucosal neuromas are a characteristic feature of multiple endocrine neoplasia type 2B, a hereditary syndrome associated with the development of medullary thyroid cancer.