Kate Middleton is seen in public for first time since most cancers analysis

The Princess of Wales has made her first public appearance this year by joining the Royal Family at Trooping the Colour despite her ongoing cancer treatment.

Kate, who has been receiving chemotherapy for an undisclosed form of cancer since February, will travel in a carriage alongside her three children, Prince George, Princess Charlotte and Prince Louis, for the traditional procession through London.

The family were photographed arriving at Buckingham Palace just after 10am, with George sitting between Kate and William, and Charlotte and Louis sat opposite. 

At 1pm, she is set to gather with King Charles and Queen Camilla, her husband Prince William and other royals on Buckingham Palace’s balcony for the RAF flypast.

Scotland Yard has a ‘substantial’ policing operation for the event, with anti-monarchy group Republic allowed to protest but banned from using amplified sound.

Hundreds of Metropolitan Police officers were deployed on the ceremonial route to ensure the safety and security of attendees, with tens of thousands expected.

Crowds of people gathered outside Buckingham Palace this morning, with many holding Union flags.

Jane Ing, 61, said she had travelled from Yorkshire with her husband and a friend to witness the royal procession through The Mall ahead of the ceremony.

She said: ‘The ceremony is part of our heritage. It’s an iconic parade and exhibition of our royal family that we should be proud about and come to support.’

She added it was ‘lovely’ that Kate has announced she will be in attendance.

And royal commentator Richard Fitzwilliams told MailOnline: ‘Kate’s appearance today is pivotal as the royal family is much weakened by two senior members fighting cancer. It is especially significant as we have not seen her on an official engagement since December.

‘It is clear, both from the moving video message in March and from the statement released yesterday, that she is resilient.

‘The new photograph emphasises this aspect of her character too, but she is also having an extremely tough time, as those undergoing chemotherapy usually do.

‘The details we were given of her condition are an attempt to help other sufferers from this pernicious disease.

‘There will be considerable speculation as to what events she will be able to attend during the summer. They will have a very special cachet as today’s Birthday Parade will. She is a very special person with a place in all our hearts.’

Last night, Kate issued a candid statement outlining her personal cancer journey and said she is experiencing ‘good days and bad days’ as she undergoes chemotherapy.

But she has begun to work from home, undertaking meetings with her foundation and Kensington Palace team, and hopes ‘to join a few public engagements over the summer’ but stressed ‘I am not out of the woods yet’.

The princess has been receiving treatment for an undisclosed form of cancer since late February and her decision to choose a major national event today to return briefly to the public spotlight, the first time since Christmas Day, has been welcomed by the King.

A new photograph of the royal, taken earlier this week in the grounds of the Windsor Castle estate, shows Kate in a smart casual outfit stood in a tranquil setting against a weeping willow tree near a body of water.

She said in her statement: ‘I am making good progress, but as anyone going through chemotherapy will know, there are good days and bad days. On those bad days you feel weak, tired and you have to give in to your body resting.

‘But on the good days, when you feel stronger, you want to make the most of feeling well.

‘My treatment is ongoing and will be for a few more months. On the days I feel well enough, it is a joy to engage with school life, spend personal time on the things that give me energy and positivity, as well as starting to do a little work from home.’

The princess will be joined by her three children in a carriage for the traditional procession to Trooping the Colour and later they will gather with other royals on Buckingham Palace’s balcony.

Kate said: ‘I’m looking forward to attending the King’s Birthday Parade this weekend with my family and hope to join a few public engagements over the summer, but equally knowing I am not out of the woods yet.

‘I am learning how to be patient, especially with uncertainty. Taking each day as it comes, listening to my body, and allowing myself to take this much needed time to heal.’

The future Queen has received thousands of letters and cards from well-wishers, some sharing their own battles with cancer, and Kate said she had been ‘blown away’ by the ‘kind messages’ that had made a ‘world of difference to William and me and has helped us both through some of the harder times’.

A Buckingham Palace spokesperson said: ‘His Majesty is delighted that the princess is able to attend tomorrow’s events, and is much looking forward to all elements of the day’.

The princess’s public appearance at Trooping will be her first official outing of 2024 after she missed engagements at the start of the year when she was admitted to hospital for abdominal surgery on January 16.

At the time her condition was thought to be non-cancerous but tests after the successful operation found the disease, and Kate disclosed the medical development in an emotional video released in March.

Trooping will not mark the start of a return to full-time duties, and Kate has no plans to attend the Garter Day service on Monday or Royal Ascot, as she is still undergoing treatment, with the royal appearing to indicate in her statement it will last until the end of summer.

Chemotherapy can be used even when surgeons believe they have removed all the cancer, owing to the risk the disease might come back, and it can reduce the chances of a new cancer.

Kate has been holding meetings with her palace staff, the Foundation of the Prince and Princess of Wales and her Royal Foundation Centre for Early Childhood, which in the future will be noted in the Court Circular, the official record of royal events.

A Kensington Palace spokesperson said: ‘The prince is pleased to see the princess starting to engage with the work and projects that are important to her.

‘He will continue to focus his time on supporting his wife and children, while continuing to undertake his public duties.’

A time frame has not been set for Kate’s return to a full schedule of public engagements as she is being given time to convalesce and recover before full-time work.

Trooping will be a special event for the princess as Number 9 Company, Irish Guards, a regiment she represents as Colonel, will be Trooping their King’s Colour today, but Lieutenant General Sir James Bucknall will take the salute on her behalf.

The King, who is also undergoing cancer treatment, will not ride during the ceremony but will inspect the troops formed up in Horse Guards Parade in Whitehall from a carriage.

Meanwhile Rishi Sunak has said it is ‘wonderful news’ that Kate is attending the event.

During a press conference at the G7 in Italy, he said: ‘It’s obviously wonderful, wonderful news. The whole country will be behind the Princess of Wales for her recovery.

‘I saw her statement earlier, I thought it was brave, I thought it was honest and I’m sure it will bring an enormous amount of comfort to so many other people who are grappling with similar health challenges, so I think she deserves enormous praise for what she said and it will be great to see her there tomorrow.’

Meanwhile a ‘substantial’ policing operation will be in place during Trooping the Colour, with an anti-monarchy group banned from using amplified sound.

Hundreds of Metropolitan Police officers will be deployed along the ceremonial route to ensure the safety and security of attendees amid a planned demonstration by pressure group Republic.

Scotland Yard has imposed a condition under Section 14 of the Public Order Act 1986 prohibiting protesters from using systems to amplify sound ‘within the footprint’ of Trooping the Colour between 8am and 3pm.

Chief Superintendent Colin Wingrove said: ‘Trooping the Colour holds national significance and as you would expect with this ceremonial event there is a substantial security operation to ensure everyone who attends and participates can do so in a safe and secure way.

‘Alongside colleagues at the Ministry of Defence and the Royal Parks, our policing plan has focused on achieving this aim.’

He added: ‘It’s imperative this event is safe, which is why along with our partners we have considered factors, such as how amplified noise could disrupt and impact mounted regiments taking part.

‘We have also taken into account the views of Republic. Our concern, along with partners, is that amplified noise could cause a public safety issue and serious disruption to the event and crowds attending.

‘That is why the Met has taken a considered decision to impose a condition prohibiting amplified sound.’

Republic, which campaigns for the abolition of the monarchy and its replacement with a directly elected head of state, said the protest will go ahead without amplified sound.

Chief executive Graham Smith said: ‘We don’t agree with their reasons but we have to go along with it because otherwise we’ll be arrested.

‘It isn’t a big problem, we’ve got quite loud voices.’

The latest update on Kate comes after her video statement revealing her diagnosis back in March.

In that announcement, Kate highlighted the importance of giving her children – George, Charlotte and Louis – time and space to come to terms with their mother’s illness.

The princess’ major public project is supporting the early years development of children, and last year she launched her long-term campaign Shaping Us, described as her ‘life’s work’ and aimed at highlighting the crucial first five years of a child’s life.

Kate has carefully carved out this public role focusing on the wellbeing of children and mental health since marrying the Prince of Wales in 2011 and becoming an HRH.

She remains close to her parents Carole and Michael Middleton and siblings Pippa Matthews and James Middleton, and had a happy home life growing up.

Catherine Elizabeth Middleton was born to the Middletons at the Royal Berkshire Hospital in Reading on January 9 1982.

She was christened at the parish church of St Andrew’s Bradfield in Berkshire on June 20 the same year.

Amman in Jordan was home to Kate and her family for a few years in the mid-1980s, where she attended a nursery school from the age of three, before the family returned to Berkshire.

At 13, she went to the exclusive private Marlborough College in Wiltshire, where she part-boarded.

She graduated in 2005 with a 2:1 in history of art from St Andrews University, where she met and began dating William, whom she married at Westminster Abbey in 2011.

She was dubbed ‘Waity Katie’ by the press for her patience during their long courtship, and was described by William in their engagement interview as having ‘a really naughty sense of humour’.

A keen photographer, the princess usually takes the publicly released photos of her children to mark their birthdays.

Kate is also known for being fit, sporty and competitive at team games and even enjoys the thrill of cold water swimming.

In an interview last September with former rugby international Mike Tindall, who is married to her husband’s cousin Zara, she said her family were ‘always active’.

‘I suppose as a family we were just very active,’ she said ‘And I can always remember being physical, using our bodies, whether it’s walking, climbing the lake district in Scotland… swimming from a young age.’

Kate also spoke about the attraction of a chilly dip: ‘Cold swimming – the colder, the better. I absolutely love it. Slightly to the point where William’s (saying) ‘You’re crazy’ and it’s dark and it’s raining’. I will go and seek out cold water. I love it.’

Kate was initially admitted to hospital for abdominal surgery on January 16 and at the time her condition was thought to be non-cancerous, but cancer was found after a successful operation.

Kate has been receiving regular doses of drugs, which kill existing cancer cells and can help prevent the disease returning, with her chemotherapy treatment believed to have begun in late February.

The princess was diagnosed after a major abdominal operation in January, and it was initially thought she did not have the disease, but tests after surgery found cancer had been present.

Chemotherapy can be used even when surgeons believe they have removed all the cancer, because of the risk the disease might come back, and it can reduce the chances of a new cancer.

Professor Bob Phillips, professor of paediatric oncology at the University of York, said: ‘For some types of cancers, chemotherapy can be given after, to act to ‘mop up’ if there are any cancer cells left.

‘The value of this varies between cancer types, and even the size and place of the same cancer type.’

Prof Andrew Beggs, consultant colorectal surgeon at the Queen Elizabeth Hospital Birmingham, echoed Prof Phillips’ comments, saying preventive chemotherapy was ‘a bit like mopping a floor with bleach when you’ve spilt something on it, chemotherapy kills any spilt cells’.

There are many different types of chemotherapy drugs and patients can take the treatment via tablets at home, with regular check-ups from medical staff, or intravenously, with the liquid drug fed into the body through a vein during an outpatient hospital appointment.

Chemotherapy can also be combined with other treatments like radiotherapy to make them more effective, and the length of treatment depends on the stage and type of cancer.

Prof Phillips said the timeframe for chemotherapy treatment was ‘hugely variable’, adding that it was ‘traditionally between four and six ‘cycles’ (blocks) of chemo, each cycle lasting 21 days and consisting of a day or few days of chemo’.

He added there would then be ‘time for the body to recover from it, while the chemo keeps damaging the cancer cell.

‘There are also some which are daily, some which are four-weekly and some which are two-weekly’.

The treatment has side effects, as healthy cells are damaged alongside cancer cells, and patients can experience tiredness, vomiting, hair loss and have an increased risk of getting infections, dry, sore or itchy skin and bowel issues.

More than 375,000 people are diagnosed with cancer each year in the UK, and there are more than 167,000 deaths from the disease.

Half of people with cancer survive for a decade or longer after diagnosis. Cancer survival depends on the cancer type and whether the disease is caught early.

Breast cancer is the most common cancer in the UK, followed by prostate cancer, lung cancer and bowel cancer.

Asked whether age was a factor in survival rates and the success of chemotherapy treatment, Prof Phillips said: ‘Sort of, but not in a simple way.

‘Generally speaking, the healthier someone is before cancer treatment, the closer to optimal the amount of chemo and the gaps between chemo can be.

‘Generally, the younger someone is, the healthier they will be.’

Prof Beggs said: ‘Young onset cancer is by no means rare. I run a clinic for early-onset cancer in adults and we are seeing more and more people in their 40s with cancer.’

He went on: ‘Age has no effect on the success rate of chemotherapy except when the cancers are ‘immune hot’, which are commoner in young people, in this case a type of chemotherapy called immunotherapy could be given.

‘Young people also better tolerate higher doses of chemotherapy and so can be given stronger regimens that are more likely to kill any leftover cells.’

Last Saturday, Kate wrote a letter to the Irish Guards to apologise for not being able to take the salute and wish them luck for The Colonel’s Review in London.

The Prince of Wales gave a positive update about his wife’s treatment during a visit to the Isles of Scilly in May, saying ‘she’s doing well’ when asked by a hospital administrator.

William spent a number of weeks with Kate and their children during the Easter holidays before returning to public work in mid-April.

Charles was admitted to hospital just days after Kate, also for a procedure deemed unrelated to cancer.

In February, Buckingham Palace confirmed that he had been diagnosed with a form of cancer, which is not prostate cancer, that was discovered while the King was being treated at the private London Clinic for an enlarged prostate.

In wishing the monarch a full recovery, Prime Minister Rishi Sunak said thankfully the cancer had been ‘caught early’.

Charles initially postponed public-facing duties but resumed at the end of April, speaking of his ‘shock’ at being diagnosed with cancer as he met patients on a visit to University College Hospital Macmillan Cancer Centre in central London.

His appearance at a D-Day event in Portsmouth last week was his first public speech and most high-profile appearance since his cancer diagnosis.

The Queen provided an update on her husband’s health at the Queen’s Reading Room Literary Festival at Hampton Court Palace in Surrey last Saturday, telling author Lee Child the King is ‘doing fine’ but ‘won’t slow down and won’t do what he’s told’.

Sarah, Duchess of York announced a medical procedure at the beginning of 2024, when she revealed a diagnosis of malignant melanoma, a form of skin cancer.

It was her second cancer diagnosis within a year, having been diagnosed with breast cancer the summer before, which led to her undergoing a mastectomy and subsequent reconstructive surgery.

She had discovered an early form of breast cancer during a routine mammogram screening.

‘Naturally another cancer diagnosis has been a shock, but I’m in good spirits and grateful for the many messages of love and support,’ Sarah said on Instagram.

Princess Beatrice shared an update on her mother’s health on This Morning in May when she said the duchess was ‘all clear’ and ‘doing really well’.

In late February, tragedy befell Prince Michael of Kent‘s family when Thomas Kingston, the husband of Prince Michael’s daughter, Lady Gabriella Windsor, died from a ‘catastrophic head injury’ with a gun found close to his body.

For many years, it was the estrangement of the Duke and Duchess of Sussex that dominated discourse around the royal family after the pair stepped down as working royals in 2020.

Having relocated to Montecito, California, Harry has returned to the UK infrequently but did so after the King’s cancer diagnosis.

Though the duke only conducted a whirlwind 45-minute meeting with his father, Harry suggested that the King’s cancer diagnosis could lead to a reconciliation with the family.

Asked by a US breakfast show if the diagnosis could have a ‘reunifying effect’, the duke replied: ‘Yeah, I am sure.’

In May, a spokesperson for Harry said he ‘hopes’ to see his father ‘soon’ after the King’s ‘full programme’ meant a reunion was not possible during the duke’s UK trip to celebrate his Invictus Games.

Meanwhile, leading cancer charities have praised Kate for her ‘thoughtful words’ that will ‘resonate’ with many.

A Macmillan Cancer Support spokesperson said: ‘Her Royal Highness, The Princess of Wales’ thoughtful words on her treatment experience will resonate with, and provide inspiration for, so many people with cancer who are in a similar situation.

‘For many people, managing the effects of cancer treatment can be challenging. Day in day out we hear from people about the impact treatment is having on their emotional wellbeing, as well as the physical symptoms and side effects they are experiencing, such as tiredness, insomnia, nausea and more.’

Dame Laura Lee, chief executive of cancer support charity Maggie’s, of which the Queen is president, said: ‘It’s wonderful that Her Royal Highness The Princess of Wales feels well enough to be at Trooping the Colour.

‘Her statement echoes precisely what we hear in our centres every day – that with cancer there are good days and bad days, and no two experiences of cancer are ever the same.

‘Her comment that it is important to go with how you feel each day is absolutely true and I am sure that will resonate with a huge number of people living with cancer.’

Kate announced she was having chemotherapy in a recorded video message on March 22, after tests following her surgery found cancer had been present.