Unless steps are taken to prevent it, cancer occurs in everyone with MEN2B.

Although cancer was known in Lincoln's time (he even likened slavery to a cancer in one of his speeches), MEN2B was not. Thus, Lincoln had none of the preventive treatments used today.

It is often said that the burden of the Presidency wore Lincoln down. This belief should be re-evaluated.

The two photographs below were taken 13 months apart.

January 1864 (National Archives)

February 1865* (Library of Congress)

The change in Lincoln's appearance is marked, especially in so short a time.

Although 1864 was a bad year, the truly awful events in Lincoln's life had already occurred by the time the left-hand picture was taken.

The weeks-long Ft. Sumter crisis was in 1861. Lincoln's close friends, Elmer Ellsworth and Edward Baker, were killed in action in 1861. Lincoln's son Willie died in 1862. And there was plenty of battlefield slaughter, too, including Shiloh, The Seven Days, Antietam, Fredericksburg, Chancellorsville, and Gettysburg.

Why would Lincoln's appearance change so dramatically and so late?

The major cancer in MEN2B is MTC -- medullary carcinoma of the thyroid. The second most common cancer is a pheo, short for "pheochromocytoma." Pheos can be benign or malignant -- most are benign in MEN2B, at least initially.

^* The date of this photo is unknown. For many years it was supposed to have been taken in April 1865. This is no longer widely accepted. February is thought to be the most likely date.