In the photo, Charles, 76, wears a gray suit and blue tie while Camilla, 77, coordinates in a blue dress. The card reads, “Wishing you a very Happy Christmas and New Year.”

The royal couple, who have been married since April 2005, have dealt with a barrage of medical issues this year. The ordeal began when Charles underwent a “corrective procedure” for a benign prostate enlargement in January. The following month, Buckingham Palace announced that “a separate issue of concern was noted” during the king’s hospitalization and “subsequent diagnostic tests … identified a form of cancer.”

Although the palace did not provide specifics on the type or stage of cancer, the statement confirmed that Charles had “commenced a schedule of regular treatments” and he would be postponing his “public-facing duties” for the time being.

In March, Charles returned to some of his royal duties while continuing to receive cancer treatments. He later resumed his public role in April.

Royal expert Rebecca English reported to the Daily Mail in October that Charles was putting his cancer treatments on “pause” to travel to Australia and Samoa later that month. Doctors were reportedly “happy” to briefly halt the treatments for the sake of the trip, with English noting that they would resume upon his return to the U.K. from the nine-day tour.

Two months earlier, Charles shared a minor update on his progress, saying during an August appearance in Southport, England, that he was “not too bad.”

As Charles battled cancer, Camilla faced her own health setback in November. “Her Majesty The Queen is currently unwell with a chest infection, for which her doctors have advised a short period of rest,” Buckingham Palace said in a November 5 statement to the BBC, adding that Camilla needed to withdraw from some previously scheduled engagements as a result of her diagnosis.

Although Camilla was expected to recover quickly, she was ultimately forced to cancel additional appearances at Remembrance Day and the London premiere of Gladiator II later that month. She returned to some of her royal duties on November 12, but Buckingham Palace later confirmed that she had been suffering from pneumonia.

As a result, Camilla was unable to attend the outdoor portions of a two-day state visit to the U.K. from the emir of Qatar. However, she was on hand for an indoor luncheon on December 3, where she told guests that she contracted pneumonia after her and Charles’ trip to Australia and Samoa but avoided hospitalization while ill.