It’s probably not surprising that Kate Middleton reportedly was not feeling well “for some time” before she underwent major abdominal surgery in January, after which it was discovered she had cancer.

But if that’s the case, it means the Princess of Wales could have been dealing with the symptoms of a very serious, yet-to-be-diagnosed medical condition around the same time that her name was revealed in a highly incendiary royal race scandal.

The Dutch-language edition of “Endgame,” a book by Omid Scobie, a pro-Prince Harry and Meghan Markle journalist and author, was released in late November. This version of Scobie’s scathing critique of the modern monarchy named Kate and King Charles III as the so-called “royal racists” — the family members who, Harry and Meghan claimed, expressed concerns about what skin color their son Archie would have when he is born.

In a new report in the Daily Mail, royal correspondent Rebecca English said that Kate was feeling “unwell for some time” before she went into the hospital in January for “planned” abdominal surgery. It was because of that surgery that her cancer was discovered.

“It’s been a rough, rough time, a really difficult year for the entire family,” a royal insider told English. “And as she herself said, she is not out of the woods yet.”

English’s report raises questions about whether the furor around Scobie’s book and the unconfirmed “royal racist” allegations added to Kate and Prince William’s “difficult year.”

The rollout of “Endgame” was “splashy, gaudy” and “a hot mess,” as the book promised to dish some new royal dirt, as the New York Times reported. It presented Charles as a pampered, “unpopular” leader, William as “power-hungry” and scheming against his father, and Kate as a “Stepford royal wife,” who doesn’t want to work that hard and who was “cold” to Meghan when she married Harry in 2018 and joined the royal family.

The book also re-ignited uproar over Harry and Meghan’s claims to Oprah Winfrey that the biracial Duchess of Sussex faced racist attitudes — or unconscious bias, as Harry would later say — during her time as a working royal. The late Queen Elizabeth II famously responded to those claims with her statement, “Recollections may vary.”

Scobie’s unflattering portrait of royal family members didn’t surprise many, given that he co-wrote “Finding Freedom,” a book that was sympathetic to Harry and Meghan’s choice to leave royal life. The U.K. tabloids have taken to calling Scobie the Sussexes’ “mouthpiece,” or unofficial spokesperson, leading to questions about whether Harry and Meghan cooperated with Scobie in his reporting for “Endgame.”

The California-based Sussexes denied any affiliation with the book through anonymous media leaks. But they didn’t publicly distance themselves from the book, prompting the Times U.K. editorial board to opine that they at least “may have given their blessing to (the book’s) largely unsubstantiated Windsor-bashing allegations.”

The editorial board also made the startling call to Charles to strip Harry and Meghan of their royal titles. Given such a response from an establishment newspaper, it’s likely that the royal family was pretty put out by the Sussexes’ perceived association with Scobie and his book.

Moreover, if Kate was dealing with symptoms of her cancer at the time, it’s easy to imagine that William would be even more angry at his brother than he already reportedly was and far less likely to ever want to mend fences with him.

The book’s roll-out really became “a hot mess,” as the New York Times said, when the Dutch-language edition of the book was released, and it contained that “unconfirmed, thoroughly radioactive nugget” — the allegations that Kate and Charles were the family members who talked about Archie’s skin color.

An international mystery of sorts erupted over how Kate and Charles’ names ended up in the Dutch-language version of “Endgame.” Scobie said he didn’t know, and he denied that their identities were snuck into the Dutch version as a publicity stunt. He said his gave his British publisher, Harper Collins, only a manuscript that didn’t contain their names, out of concern for U.K. libel laws.

But the Times U.K. reported that the author’s agent, United Talent Agency, sent the Dutch publisher an earlier draft which cited the Princess of Wales and the king as the concerned family members. Scobie’s agent did send the Dutch publisher a later, final version that did not contain the names, the Times U.K. said. Whatever happened, the Dutch translators ended up basing the Dutch-language interpretation on the earlier version, which contained the names, and that version was released in the Netherlands and Belgium.

Meanwhile, Kate was presumably “unwell.” But before and after her surgery in January, she “hid her suffering,” English reported, citing insider sources.

“I don’t think people realize how much she has gone through behind the scenes and for how long, far longer than anyone actually appreciates,” an insider told English. “She’s an incredibly strong woman, but she really has been through the wars.”

The Daily Mail’s report emphasized that there’s been no timeline given for if or when she’ll make a regular return to royal duties, even if her cancer treatment is going well and there’s hope she’ll make a full recovery. The princess made her first public appearance after her diagnosis at Trooping the Color in June. She also attended the men’s final at Wimbledon last month.

In a recent Daily Beast report, a friend said that Kate would probably maintain a much lower profile than in the past, even if she makes a full recovery. That means she would appear at fewer public engagements. Her “brush with mortality” has led her to want to focus on her family, which includes her three children, Prince George, 11, Princess Charlotte, 9, and Prince Louis, 6.

“My understanding is that people are going to have to get used to seeing a lot less of Kate,” the friend told the Daily Beast. “The priority for her now is going to be family and the children.”