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Did FDR have melanoma? Did it kill him?

[Dr. Lomazow, Assistant Professor of Neurology at Mount Sinai School of Medicine, is working on a book about FDR's health problems. Click here for his blog.]

Based on new and original research, my article, co-authored with leading dermatopathologist, A. Bernard Ackerman, entitled “An Inquiry Into the Pigmented Lesion Above the Franklin Delano Roosevelt’s Left Eyebrow” has just been released in the April 2008 issue of the highly respected peer-reviewed journal Archives of Dermatology, re-igniting the long-standing debate over Roosevelt’s health. While the article does not unequivocally state that the President had Melanoma, a highly malignant skin tumor with potentially fatal consequences, it presents photographic evidence of an expanding and evolving lesion felt by Doctor Ackerman to closely resemble it based on criteria commonly employed by present-day dermatologists. The article also discusses the rapid disappearance of the lesion, inconsistent with either of the diagnostic possibilities, the other being a benign process, Solar Lentigo, attributable to excessive exposure to the sun.

The possibility that our thirty-second President had Melanoma was first raised in the historical literature by Hugh L’Etang in his 1970 book “The Pathology of Leadership,” evoking a prompt response by one of FDR’s personal physicians, cardiologist Howard G. Bruenn in Annals of Medicine, with the consent, cooperation and active participation of the Roosevelt family and historian James MacGregor Burns, presenting previously unrevealed evidence of the President’s severe cardiovascular disease and stating in the accompanying editorial:

“The speculation in a recently published book (based on the showing of an unlabelled slide from Walter Reed Hospital) that the President was suffering from a metastatic melanoma in the brain, is laid to rest by Dr. Bruenn; there was no clinical evidence for such a lesion, and no autopsy was performed. We are given, by Dr. Bruenn, the picture of a great and gallant man, fatigued by the burdens of his office and by his hypertension and reduced cardiac reserve, yet quite able to exercise his judgment and to use the fruits of his unique knowledge and experience in guiding the war effort.”

In 1979, surgeon Harry Goldsmith’s article in Surgery, Gynecology and Obstetrics “Unanswered Mysteries in the Death of Franklin D. Roosevelt” again raised the specter of Melanoma based on photographic evidence, extensive research and conversations with influential physicians who had allegedly been told of the President’s medical condition. Once again, Doctor Bruenn rapidly and vigorously rebutted Goldsmith’s contentions.

In the 1980’s, the controversy continued to percolate. Well respected medical historian, Doctor Robert Hudson, presented a series of lectures on Roosevelt’s melanoma while Doctor Bruenn, who died in 1995, continued to assert that FDR’s death was solely a consequence of cardiovascular disease.

Recent research supports the ever-increasing probability that Roosevelt had and died of melanoma; a conclusion with far-reaching and important historical implications, offering a more refined explanation of many of the ongoing controversies about how his health affected his performance and judgment in office. It also raises some spellbinding new ones.

Hopefully, this paper will re-energize a continuing dialogue, and ultimately enhance the understanding of one of the most important figures in American history.