Grover Cleveland's Secret Operation and What Head and Neck Cancer Is

An operation nobody was meant to see

In the spring of 1893, weeks into his second term, Grover Cleveland noticed a rough patch on the roof of his mouth. Columbia University's surgery department records that it grew quickly, and that he sought help that June. He was 56, overweight, had gout, and smoked cigars often.

His White House physician, Dr. Robert O'Reilly, called it a bad looking tenant that he would have evicted at once. Cleveland was told he had a cancerous tumor and would die without surgery.

The country was in the Panic of 1893, and Cleveland was pushing Congress to repeal the Sherman Silver Purchase Act. He agreed to the operation on one condition. Nobody could know.

Ninety minutes on a moving boat

The University of Arizona's health sciences library sets out how it was done. Commodore Elias Benedict lent his yacht, the Oneida, and its saloon became an operating room. The team included Dr. Joseph Bryant, Dr. William Williams Keen, and a dentist, Ferdinand Hasbrouck, who gave the anesthetic.

On July 1, 1893, they operated as the boat moved. Cleveland was propped in a chair. Cocaine numbed the surface, ether took him under, and the surgeons worked entirely through his mouth so no scar would show.

They performed a partial maxillectomy, meaning they removed part of the upper jaw. The Arizona account quotes the surgeon Ronald Spiro. Only during the operation did the team realize the tumor had reached the antrum, the air-filled sinus above the upper teeth. The rest of the left upper jaw came out in pieces. Five teeth went with it. It took about ninety minutes.

He lost a section of palate about two and a half inches long. A prosthodontist fitted a rubber plate, and UPI later reported his speech was not impaired.

The cover-up worked. A Philadelphia reporter, E. J. Edwards, published the story that August. The White House denied it and set out to wreck his name. The Library of Congress keeps the newspaper record of that summer. Keen described the operation publicly only decades later.

What the tissue actually showed

The specimen survived in alcohol and went to the Mütter Museum in Philadelphia. That is why the case is still argued over.

UPI reported in 1981 that two pathologists, Brooke Roberts and Horatio T. Enterline, had made the first detailed examination of it. Their reading was verrucous carcinoma of the hard palate and gum. That is a rare oral cancer which, once removed, does not spread. Stains for syphilis were negative.

UPI also notes what they were reacting against. Two diagnoses made soon after the 1893 operation had both described a normally fatal cancer. The tissue had been off limits to researchers for decades, over family concerns about what it might show.

Cleveland lived fifteen more years with no recurrence. The Miller Center at the University of Virginia records that he died on June 24, 1908, in Princeton, of a gastrointestinal disease complicated by heart and kidney trouble.

What these cancers are

NCI groups head and neck cancers by where they start. The list runs: the oral cavity, the pharynx, the larynx or voice box, the sinuses and nasal cavity, and the salivary glands. Most begin in the squamous cells lining those surfaces. That is why they are called squamous cell carcinomas of the head and neck. Cancers of the brain, eye, esophagus, thyroid, and the skin of the head and neck are not counted in this group.

NCI names alcohol and tobacco as the two most important risk factors, and states that people who use both are at greater risk than people who use either alone. Most squamous cell carcinomas of the mouth and voice box are caused by tobacco and alcohol. Our page on tobacco and cancer covers that link.

One part of the picture has shifted since 1893. NCI reports that cancer-causing human papillomavirus, especially HPV type 16, causes about three-quarters of all oropharyngeal cancers. Those are the ones involving the tonsils or the base of the tongue. Cases from that cause are rising in the United States, while cases from other causes fall.

Mouth changes worth showing someone

NCI states there are no standard or routine screening tests for oral cavity and nasopharyngeal cancers, and that no study has shown screening lowers the risk of dying from them. Detection therefore rests on someone looking.

A dentist or doctor checking your mouth looks for two things in particular. Leukoplakia is an abnormal white patch of cells. Erythroplakia is an abnormal red patch. Both can turn cancerous.

Ask to have it looked at if you have had, for more than two or three weeks:

• A sore or ulcer in the mouth or on the lip that has not healed.
• A white or red patch on the gum, tongue, or lining of the mouth.
• A lump or thickened area you can feel with your tongue, or bleeding with no injury to explain it.
• Loose teeth, or dentures that stopped fitting.
• Trouble chewing, swallowing, or moving the tongue or jaw. A lump in the neck counts too.

See our page on oral cancer screening for what an examination involves.

What this story cannot tell you

• The diagnosis is still disputed. The 1893 reports and the 1981 re-reading do not agree. Stating it flatly goes further than the evidence.
• Verrucous carcinoma behaves differently from ordinary squamous cell carcinoma. Even if the 1981 reading was right, his outcome is not a typical one.
• His cause of death fifteen years later was described as gastrointestinal disease with heart and kidney complications. It is not recorded as a cancer recurrence.
• Nineteenth-century surgery is not a guide to modern care. Treatment today involves imaging, staging, reconstruction, and often radiation.
• The American Cancer Society projects about 60,480 new oral cavity and pharynx cancers in the United States in 2026, a figure SEER, the federal cancer surveillance program, republishes. SEER's own measurement of five-year relative survival is 69.9 percent. That is a group average, not a description of any individual.

Sources

• Columbia Surgery: President Grover Cleveland had a Deadly Secret
• University of Arizona: Grover Cleveland — Secret Surgery
• Library of Congress: President Cleveland and Rumors of a Cancerous Growth
• UPI Archives (1981): Pathologists solve 88-year-old presidential mystery
• Miller Center: Grover Cleveland — Life After the Presidency
• NCI: Head and Neck Cancers Fact Sheet
• NCI: Oral Cavity and Nasopharyngeal Cancer Screening (PDQ)
• NCI SEER Cancer Stat Facts: Oral Cavity and Pharynx Cancer

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

Cancer Explained is published by the National Cancer Information Foundation. It is not medical advice and does not suggest a test or treatment.

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