Keep in mind that the role of imposter is to maintain credibility in being humanlike at all times and in all ways. If the royal family is uniformly free of illness with respect to major scourges like cancer, this would become suspicious. So it is part of the cover story that those who sign on to play a role as a human royal family member, to substitute for a human who actually has that birthright, must accept the slings and arrows that come along. That could be something like an early death from physical hazards, like serving in the military or being assassinated. It could also include developing infirmities and succumbing to infectious illness if it can get out of hand. So this maintains the disguise quite effectively, as you can see from posing the question and pondering what this might mean if extraterrestrial imposters have replaced the actual human royal family members on a wide basis. Keep in mind as well, that even an early demise from illness does not destroy that being. It will actually free them from duty because they can simply transform back into a Reptilian upon death of the body, and even benefit from getting a break in the action before possibly resuming the role of imposter, yet again, somewhere else.
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