Since the then Kate Middleton joined the Royal Family, her birthday is usually a peaceful affair as it happens in the ‘downtime’ month of January, which is kept mostly free for diary planning following a busy period of high-profile events over Christmas.

But today, as the Princess of Wales celebrates her 43rd birthday, she will be looking back on a year that her husband William described as the ‘hardest year in my life’.

That is because a week after her birthday on January 17, 2024, a statement from Kensington Palace announced she had undergone abdominal surgery.

It would be just the beginning of a tumultuous year of health concerns for the princess which became more serious when she announced in March she had been diagnosed with cancer – putting an unprecedented strain on the entire Royal Family.

Here MailOnline looks back at all the twists and turns in Kate’s brutal year, and how with the support of her family she has managed to get through it all. 

The princess’s tough year began in January when she was secretly admitted to The London Clinic for abdominal surgery.

Kensington Palace said at the time she had ‘planned abdominal surgery’ and estimated that she would spend the next tento 14 days in hospital.

Specifics about the nature of the operation were, and remain, private, although aides let it be known her condition was ‘non-cancerous’.

The Princess of Wales announced in an emotional video message that she was receiving cancer treatment in March

The Princess of Wales showed no sign of the year’s strain when she accepted bouquets of flowers from well-wishers at Sandringham on Christmas Day

Entirely understandably, the Princess of Wales wished to keep her recovery as private as possible, according to royal author Robert Hardman in his new book Charles III. 

But in the absence of an explanation or updates, a series of conspiracy theories began to take flight around the world.

Spanish TV reported that the princess was in a coma, while a rumour emerged from South America stating that she was either in hiding following a disastrous haircut or failed cosmetic surgery.

Other trolls and conspiracy theorists have used her absence and the lawlessness of social media to spread deeply sinister and highly libellous claims. 

A community on the widely popular internet forum Reddit set up a ‘KateMiddletonMissing’ section where they discussed their various suspicions.

And a #WhereIsKateMiddleton hashtag also began to trend every day allowing conspiracy theorists to share their thoughts with other enthusiasts. 

The swirling theories began to get more bewilderingly and fanciful, which would have been extremely distressing for the pPrincess and her children Prince George, 11, Princess Charlotte, nine, and Prince Louis, six.

However the family were given a brief respite from the internet focus when King Charles announced on February 5 that he had an undisclosed form of cancer.

But it would return with a vengeance on March 4 after Kate was photographed by paparazzi for the first time since her operation while she was being driven near Windsor Castle by her mother, Carole Middleton.

The photos were taken shortly before 9am, suggesting Kate was doing her best to soldier on and continuing to take her children on the school run. 

The pictures were published by US gossip website TMZ but not in the UK after Kensington Palace appealed for her to be able to recuperate in private. 

However in spite of the increasingly deranged speculation about her whereabouts, the Waleses decided to stick to their original strategy with William continuing to go about his official engagements while Kate recovered privately.

Their strategy was in contrast to the King’s who was being more open than any monarch in history with his health issues.  

‘No constitutional responsibility sits on the Princess of Wales and never will,’ a senior aide to the King told Hardman. 

‘She is not in the line of succession. She plays an absolutely vital supporting role to the Prince of Wales and in bringing up their children who are in the line of succession. 

‘But she herself is not. Her situation is different and it can be treated differently.’

On March 10 Kensington Palace released a photograph of Kate and her children, but instead of calming the speculation down, it sent the online sleuths into overdrive due to inconsistencies with the photograph due to minor editing

After almost two weeks of hysteria and wild speculation, the ‘Where is Kate?’ brigade had an answer of sorts on March 10 as Kensington Palace released a photograph of Kate and her children.

But instead of calming the speculation down, it sent the online sleuths into overdrive due to inconsistencies with the photograph due to minor editing.

Some had spotted small inconsistencies such as a missing section of a child’s sleeve or the blurring of a knee – revealing that the photo had undergone minor editing prior to release. 

The Waleses and their staff were ‘astonished’ by what happened next, according to Hardman. 

The world’s four main international photographic agencies issued a ‘kill notice’, industry jargon for retracting a photograph.

‘At closer inspection, it appears that the source has manipulated the image,’ Associated Press announced, declaring that the photograph had thus fallen short of its standards. Getty, AFP and Reuters said similar.

It was deemed an oddly exaggerated, almost performative, response, which some commentators think came from the industry’s concerns about the threat of artificial intelligence (AI) to the integrity of mainstream photography.

If there was frustration from William and Kate that the media should be making quite such a meal of a well-intentioned, homespun gesture, there was no time to dwell on it.

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MailOnline found at least 16 potential issues with the photo after it was published

Charlotte’s floating left wrist is believed to be the reason that picture was pulled