An international team of medical experts has issued a new verdict in the case of the long-debated death of Napoleon Bonaparte: The French leader died of stomach cancer, not poison, and even modern medicine couldn't have kept him alive.
Other medical historians have come to the same conclusion regarding the cause of death. But the team's new report may be the first to examine Napoleon's illness from the perspective of today's cancer treatment.
"He would have been unlikely to be saved, even if he had been seen at Sloan-Kettering today," said study senior author Robert Genta, chief of pathology at the VA North Texas Health Care System and a professor at the University of Texas Southwestern Medical Center at Dallas. "It was basically a terminal type of cancer."
A death that fascinated historians
Napoleon's death at the age of 52 has long fascinated historians, especially because of the possibility that he was murdered, robbing him of a chance to return to power. His death in 1821 came on the island of St. Helena in the south Atlantic, after he was exiled there following the French defeat at Waterloo.
Some historians have argued that Napoleon was assassinated through arsenic poisoning, while others have suggested his doctors inadvertently bumped him off by relying on dangerous treatments.
But the stomach cancer theory has plenty of support, especially considering the results of an autopsy and the fact that Napoleon's father may have died of the disease.
With Canadian and Swiss colleagues, Genta examined the Napoleon autopsy findings, eyewitness reports and the memoirs of attending doctors. They report their findings in the January issue of Nature Clinical Practice Gastroenterology & Hepatology.
Extensive tumour growth
The medical records indicate that Napoleon had extensive tumour growth and blood in his stomach. According to the new study, this suggests that the former emperor suffered from stomach cancer - also known as gastric cancer - in its later stages and died of stomach haemorrhaging.
Napoleon's cancer couldn't be easily treated today, the researchers found. The level of tumor growth was so severe that anyone with a similar diagnosis would have only a 20 percent chance of living five years after treatment with chemotherapy and surgery, Genta said.
Indeed, stomach cancer remains extremely deadly almost two centuries after Napoleon's death. According to Genta, it's a leading cause of death in Japan and South America.
Despite medical advances, stomach cancer remains hard to detect in its early stages and spreads rapidly throughout the body even when tumours are small, Genta said.
Doctors to blame?
Some experts have blamed doctors for Napoleon's death, and Genta said it's quite possible they were anything but helpful. "All doctors in those days made things worse by giving people drugs that were more toxic than the disease," he said.
A possible family history of stomach cancer could have boosted Napoleon's risk of developing the disease. But the study authors pointed a finger at his diet.
According to Genta, the salted meat eaten by soldiers of the time could have harboured a bacterium that causes stomach cancer. Napoleon's medical history, Genta said, suggests he was infected by the germ.
History turned on its head
If Napoleon had lived, he could have conceivably returned to power in France during a crisis in 1830, said Howard Brown, professor of history at State University of New York, Binghamton.
If that had happened, "there's little doubt that he would have pursued French expansion once again," Brown said. "It was in his blood, and it had always been his biggest source of legitimacy."
And that could have had a huge effect on the modern world, Brown said. "Had France captured and hung on to the Middle East until the oil age, it would have been more important to them than India was to Britain. Furthermore, with Middle East oil, France would have dominated the first half of the 20th century at least."
Despite the new findings, no one expects the debate over Napoleon's demise to die down.
The controversy is "a typical case of people looking for exotic causes of death of extraordinary people," said Dr Philip Mackowiak, chief of the medical service at VA Maryland Health Care system, and host of an annual conference on the cause of death of a famous person. "Gastric cancer, to their way of thinking, would just be too ordinary a diagnosis to have dispatched Napoleon." - (HealthDayNews, January 2007)
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